title: Depression and resting state heart rate variability in children and adolescents - A systematic review and meta-analysis.
abstract: Among adults, depression is associated with reduced vagal activity, as indexed by high frequency heart rate variability [HF-HRV]), which correlates inversely with depression severity. Available evidence in depressed children and adolescents remains to be reviewed systematically. A search of the literature was performed to identify studies reporting (i) HF-HRV in clinically depressed children/adolescents relative to controls (k=4, n=259) and (ii) the association between HF-HRV and depressive symptoms as measured by standardized psychometric instruments in children and adolescents (k=6, n=2625). Random-effects meta-analysis on group differences revealed significant effects that were associated with a moderate effect size (Hedges' g=-0.59; 95% CI [-1.05; -0.13]), indicating lower resting state HF-HRV among clinically depressed children/adolescents (n=99) compared to healthy controls (n=160), consistent with findings among adults. While no correlation between HF-HRV and depressive symptom severity was observed (r=-.041 [-0.143; 0.062]), these additional correlational findings are limited to non-clinical samples. Findings have important clinical implications including a potentially increased risk for future physical ill health and also the identification of potential new treatment targets in child and adolescent depression.
authors.affiliation: Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany. Electronic address: Julian.Koenig@med.uni-heidelberg.de.
authors.forename: Julian
authors.initials: J
authors.lastname: Koenig
authors.affiliation: School of Psychology & Discipline of Psychiatry, University of Sydney, Sydney, Australia; Department of Psychology, Swansea University, Swansea, United Kingdom. Electronic address: andrew.kemp@sydney.edu.au.
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Kemp
authors.affiliation: The Ohio State University, Department of Psychology, Columbus, OH, USA. Electronic address: beauchaine.1@osu.edu.
authors.forename: Theodore P
authors.initials: TP
authors.lastname: Beauchaine
authors.affiliation: The Ohio State University, Department of Psychology, Columbus, OH, USA. Electronic address: Thayer.39@osu.edu.
authors.forename: Julian F
authors.initials: JF
authors.lastname: Thayer
authors.affiliation: Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany; Clinic of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany. Electronic address: Michael.Kaess@med.uni-heidelberg.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Kaess
mesh_terms: D000293:Adolescent; D002648:Child; D003866:Depressive Disorder / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D012146:Rest
keywords: Adolescents; Children; Depression; Depressive symptoms; Heart rate variability; Vagal activity