The relationship between psychiatric illness and the circadian pattern of heart rate.
OBJECTIVE
The aim of this study was to investigate the relationship between psychiatric status and the circadian pattern of heart rate.


METHODS
Serial 24-hour recordings of minute average heart rate were obtained from 30 normal volunteers and 200 patients representing a range of DSM-III-R diagnoses. Records were compared in terms of their circadian 'morphology' and grouped into different pattern types. The distribution of patterns in different diagnoses was analysed statistically.


RESULTS
It was found that states such as generalised anxiety and depression are strongly associated with a distinctive circadian pattern, whereas others such as somatoform disorder show more variation in this regard. Serial recordings show that the relationship between psychiatric status and circadian pattern is state-dependent; a change in clinical status leads to a change in the circadian pattern.


CONCLUSIONS
The presented findings together suggest that there is a systematic relationship between psychiatric status and heart rate in which core physiological differences between certain states are reflected in distinctively different circadian patterns of activity. The state-dependent nature of this relationship suggests obvious practical applications, and examples are given of how these adjunct data can provide objective indices of clinical status and change. At a theoretical level, the physiological dimension revealed by these data may help to define more reliable syndromal distinctions between various clinical manifestations and hence contribute to a more robust nosology.
Stampfer
H G
HG
University Department of Psychiatry, QEII Medical Centre, Nedlands, Australia. hgstamp@cyllene.uwa.edu.au
D000293:Adolescent; D000328:Adult; D000368:Aged; D002940:Circadian Rhythm / Q000502:physiology; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011603:Psychophysiology