E-ISSN 1309-4866
Research Article
Evaluation of Heart Rate Variability in Drug Free Panic Disorder Patients
1 Çiğli Bölge Eğitim Hastanesi, Psikiyatri Kliniği, İzmir, Türkiye  
2 Ege Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İzmir, Türkiye  
3 Ege Üniversitesi Tıp Fakültesi, Psikiyatri Anabilim Dalı, İzmir, Türkiye  
4 Ege Üniversitesi Tıp Fakültesi, Bioistatistik Anabilim Dalı, İzmir, Türkiye  
Arch Neuropsychiatry ; : -
DOI: 10.5152/npa.2017.19429
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Key Words: Panic disorder, heart rate variability, autonomic nervous system

Introduction: It is well-known that autonomic function is impaired in panic disorder (PD). Heart rate variability (HRV) is a reliable and noninvasive method to evaluate autonomic functions. The aim of this study is to evaluate 24-hour heart rate variability (HRV) parameters in drug-free panic disorder patients. These results are compared with those obtained from healthy controls.


Methods: Thirty-two (mean age 33.12 ± 11.94 years, 20 female, 12 male) drug-free patients for at least 2 weeks,(for fluoksetin 3 weeks) diagnosed  with panic disorder (PD) on the basis of  DSM-IV criteria were included in the study.  The control group comprised of  24 age and gender-matched healthy individuals (mean age 33.45±8.6 years, 17 female and 7 male) without any cardiac, endocrine (including diabetes) and neurological diseases. Two groups were evaluated for any axis-I diagnosis with SCID-I. We used Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Panic Disorder Severity Scale (PDSS) and Anxiety Sensitivity Index-3 (ASI-3) tests in both groups.  After the psychiatric evaluation 24 hours Holter ECG monitoring was performed in all participants for the determination of HRV including frequency and time domain parameters.


Results: The time domain RMSSD and PNN50 values tended to be lower in panic patients but this difference did not reach significance (p:0.229, p:0.571) . There was no significant difference in mean values for all time and frequency domain HRV measures over the total 24-hours recording between patients and controls. RMSSD, pNN50 and HF was increased to reflect the parasympathetic predominance in the sleeping period (p:0.0001) but there was no significant difference between groups. However LF value which showing sympathetic activity was increased significantly in healthy control and patients in the sleeping period (p = 0.0001) but there was no significant difference between two groups (p: 0.905) Correlation analysis in the panic disorder patients was found a negative correlation between disease age at onset HF value (p:0.004)  and positive correlation between LF/HF value (p:0.007). HRV parameters between smokers and non-smokers were same in both arms.


Discussion: HRV parameters of panic disorder patients were not different from healthy controls. To better clarify the effects of panic disorder on HRV; factors effecting HRV should be minimized and more Holter ECG studies with longer records should be obtained to reflect the daily life activities.

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Latest Update: 29.12.2017