Heart rate variability in bipolar disorder: A systematic review and meta-analysis

Research output: Contribution to journalReviewResearchpeer-review

Maria Faurholt-Jepsen, Lars Vedel Kessing, Klaus Munkholm

Background Heart rate variability (HRV) has been suggested reduced in bipolar disorder (BD) compared with healthy individuals (HC). This meta-analysis investigated: HRV differences in BD compared with HC, major depressive disorder or schizophrenia; HRV differences between affective states; HRV changes from mania/depression to euthymia; and HRV changes following interventions. Methods A systematic review and meta-analysis reported according to the PRISMA guidelines was conducted. MEDLINE, Embase, PsycINFO, The Cochrane Library and Scopus were searched. A total of 15 articles comprising 2534 individuals were included. Results HRV was reduced in BD compared to HC (g = -1.77, 95% CI: −2.46; −1.09, P < 0.001, 10 comparisons, n = 1581). More recent publication year, larger study and higher study quality were associated with a smaller difference in HRV. Large between-study heterogeneity, low study quality, and lack of consideration of confounding factors in individual studies were observed. Conclusions This first meta-analysis of HRV in BD suggests that HRV is reduced in BD compared to HC. Heterogeneity and methodological issues limit the evidence. Future studies employing strict methodology are warranted.

Original languageEnglish
JournalNeuroscience and Biobehavioral Reviews
Pages (from-to)68-80
Number of pages13
Publication statusPublished - Feb 2017

    Research areas

  • Bipolar disorder, Heart rate variability, HRV, Meta-analysis, Systematic review

ID: 180934483