Depression and resting state heart rate variability in children and adolescents — A systematic review and meta-analysis. (June 2016)

• Record Type: Journal Article
• Authors: Koenig, Julian; Kemp, Andrew H.; Beauchaine, Theodore P.; Thayer, Julian F.; Kaess, Michael
• Is Part Of: Clinical psychology review. Volume 46(2016)
• Page Start: 136
• Page End: 150
• Publication Date: 2016-06
• Subjects: AD anxiety disorders -- BDI Beck Depression Inventory -- CABI Child Adaptive Behavior Inventory -- CBCL child behavior checklist -- CES-D Center for Epidemiological Studies Depression Scale -- COD childhood-onset depression -- CSI Child Symptom Inventory -- DISC Diagnostic Interview Schedule for Children -- HF high frequency -- HRV heart rate variability -- IBI inter-beat-interval -- ISCA Interview Schedule for Children and Adolescents -- LF low frequency -- MDD major depressive disorder -- POMS Profile of Moods Scale -- PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses -- RCADS Revised Child Anxiety and Depression Scale -- RMSSD root-mean-square of successive R-R-interval differences -- RSA respiratory sinus arrhythmia -- SCID Structured Clinical Interview -- SCL Symptom Checklist -- SCL-90 Symptom Checklist 90 Revised -- SD standard deviation -- SEM standard error of the mean -- SSRI selective serotonin reuptake inhibitors -- TRAILS Tracking Adolescents' Individual Lives Survey -- tVNS transcutaneous vagus nerve stimulation -- VNS vagus nerve stimulation -- YSR youth self-report; Depression -- Depressive symptoms -- Vagal activity -- Heart rate variability -- Children -- Adolescents; Clinical psychology -- Periodicals; Psychology, Pathological -- Periodicals; Psychotherapy -- Periodicals; Psychology, Clinical -- Periodicals; Electronic journals; 616.89
• DOI: 10.1016/j.cpr.2016.04.013
• Languages: English
• ISSNs: 0272-7358

Abstract

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. Highlights: In adults, depression is associated with reduced resting state high-frequency heart rate variability (HF-HRV). We reviewed the evidence on such association in children and adolescents. We found lower resting state HF-HRV in clinically depressed adolescents. Unlike in adults, depressive symptom severity is not associated with HF-HRV. Clinical implications and suggestions for future research are provided.