title: Depression and cardiac dysautonomia in eating disorders.
abstract: OBJECTIVE
  Individuals with eating disorder (ED) are at an increased risk of cardiac arrhythmias due to cardiac dysautonomia, which may be exacerbated if depression is also present. The aim of the study was to use heart rate analysis as a marker for cardiac dysautonomia in patients with eating disorders and depression as a comorbidity.
  
  
  METHODS
  Clinical data, including presence of depression, was obtained from all participants. A three-lead ECG was used to determine interbeat intervals, and these were analyzed using time domain, frequency domain, and nonlinear heart rate variability measures.
  
  
  RESULTS
  Thirty ED patients and 44 healthy controls participated in the research. The presence of depression was associated with additional decreased time domain (RMSSD 36.8 ± 26 vs. 22.9 ± 12.3; p < 0.05), frequency domain (HF power 788 ± 1075 vs. 279 ± 261; p < 0.05), and nonlinear domain (DFAα20.82 ± 0.1 vs. 0.97 ± 0.1; p < 0.01) which results in the ED group compared to patients with no depression.
  
  
  CONCLUSIONS
  The presence of depression in ED patients decreased HRV even further compared to the non-depressed patient group and controls, suggesting that higher vigilance and a holistic treatment approach may be required for these patients to avoid cardiac arrhythmia complications.
authors.affiliation: Australian School of Advanced Medicine, Macquarie University, Sydney, Australia. hjelinek@csu.edu.au.|School of Community Health and Centre for Research in Complex Systems, Charles Sturt University, Albury, NSW2460, Australia. hjelinek@csu.edu.au.
authors.forename: Herbert F
authors.identifier: http://orcid.org/0000-0001-5457-6193
authors.initials: HF
authors.lastname: Jelinek
authors.affiliation: Discipline of Pharmacology, Sydney Medical School, Sydney University, Sydney, Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: Spence
authors.affiliation: School of Design, Computing and Information Technology, University of Newcastle andApplied Informatics Research Group, University of Newcastle, Callaghan, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Cornforth
authors.affiliation: Department of Applied Physics, University of Eastern, Kuopio, Finland.|Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Mika P
authors.initials: MP
authors.lastname: Tarvainen
authors.affiliation: Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, Australia.|Northside Clinic Eating Disorders Program, Sydney University, Greenwich, Sydney, Australia.
authors.forename: Janice
authors.initials: J
authors.lastname: Russell
mesh_terms: D000293:Adolescent; D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology; D003863:Depression / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D003866:Depressive Disorder / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D004562:Electrocardiography; D001068:Feeding and Eating Disorders / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D054969:Primary Dysautonomias / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D055815:Young Adult
keywords: Depression; Dysautonomia; Eating disorders; Heart rate variability; Sudden cardiac death