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Cardiac autonomic dysregulation in acute schizophrenia

Published online by Cambridge University Press:  31 May 2013

Hsin-An Chang ,
Chuan-Chia Chang ,
Nian-Sheng Tzeng ,
Terry B. J. Kuo ,
Ru-Band Lu  and
San-Yuan Huang
Hsin-An Chang
Affiliation:
Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
Chuan-Chia Chang
Affiliation:
Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
Nian-Sheng Tzeng
Affiliation:
Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
Terry B. J. Kuo
Affiliation:
Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan, ROC
Ru-Band Lu
Affiliation:
Institute of Behavioral Medicine and Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
San-Yuan Huang*
Affiliation:
Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
*
San-Yuan Huang, Department of Psychiatry, Tri-Service General Hospital, No. 325, Cheng-Kung Road, Sec. 2, Nei-Hu District, Taipei 114, Taiwan, ROC. Tel: 011-886-2-8792-7220; Fax: 011-886-2-8792-7221; E-mail: chang.ha@msa.hinet.net
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Abstract

Objective

Altered cardiac autonomic function has been proposed in schizophrenia, but the results are mixed. Therefore, analyses with larger sample sizes and better methodology are needed.

Methods

To examine whether acute schizophrenia is associated with cardiac autonomic dysfunction, 314 unmedicated patients with acute schizophrenia and 409 healthy volunteers, aged 18–65 years, were recruited for a case–control analysis. The severity of schizophrenia symptoms was assessed with the Positive and Negative Syndrome Scale. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV) parameters during the supine–standing–supine test. Frequency-domain indices of HRV were obtained.

Results

Unmedicated patients with acute schizophrenia consistently exhibited reduced mean RR interval and HRV levels in a supine rest and standing position compared with healthy volunteers. The severity of psychopathology, in particular positive symptoms, was negatively correlated with cardiac vagal control.

Conclusion

These data suggest that acute schizophrenia is accompanied by cardiac autonomic dysregulation. In view of the higher risk for cardiac complications in these patients, one might also consider the antipsychotic treatment in favour of improving cardiac autonomic modulation. Further studies using larger patient groups and controlled therapeutics may better understand the influence of antipsychotic treatment on cardiac autonomic regulation in schizophrenia.

Keywords

cardiac autonomic functionheart rate variabilityschizophrenia
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 25 , Issue 3 , June 2013 , pp. 155 - 164
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2013 

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