ArticleDepression and anxiety2019
The association of depression and anxiety with cardiac autonomic activity: The role of confounding effects of antidepressants.
Article in Depression and anxiety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed.
- The effect of cranial techniques on the heart rate variability response to psychological stress test in firefighter cadets.Scientific reports · 2023Trial
- Severity of depression and anxiety symptoms is reflected in physiological and behavioral metrics collected from a consumer-grade wearable ring.BMC medicine · 2026Article
- Interplay between resting heart rate variability, daily affective dynamics and mental health difficulties in autistic youths.Scientific reports · 2026Article
- Heart rate variability and heart rate in a sample of medicated and unmedicated adolescents with obsessive-compulsive disorder.Clinical neurophysiology practice · 2026Article
- The Bidirectional Relationship Between Myocardial Infarction and Depression: Risk Factors, Mechanisms, and Interventions.Biomedicines · 2025Review
- From Rhythm to Relief: Heart Rate Variability as a Window into Anhedonia Response During Agomelatine Treatment in Major Depressive Disorder.Medicina (Kaunas, Lithuania) · 2025Article
- Respiratory Sinus Arrhythmia-Common and Distinct Mechanisms of Emotional Adjustment in the Depressive and Anxiety Disorders Spectrum?Psychophysiology · 2025Article
- Integrating genome-wide information and wearable device data to explore the link of anxiety and antidepressants with pulse rate variability.Molecular psychiatry · 2025Article
- Robust and time-resolved estimation of cardiac sympathetic and parasympathetic indices.Royal Society open science · 2025Article
- Heart-Brain Axis: A Narrative Review of the Interaction between Depression and Arrhythmia.Biomedicines · 2024Review
- Review
- Prevalence and prognostic significance of cardiac autonomic neuropathy in community-based people with type 2 diabetes: the Fremantle Diabetes Study Phase II.Cardiovascular diabetology · 2024Observational
- Heart rate response to cognitive load as a marker of depression and increased anxiety.Frontiers in psychiatry · 2024Article
- Serotonin antidepressants and atrial fibrillation burden from cardiac implantable electronic devices.Journal of arrhythmia · 2023Article
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- Article
- Ventromedial hypothalamus relays chronic stress inputs and exerts bidirectional regulation on anxiety state and related sympathetic activity.Frontiers in cellular neuroscience · 2023Article
- Heart Rate Variability: A Measure of Cardiovascular Health and Possible Therapeutic Target in Dysautonomic Mental and Neurological Disorders.Applied psychophysiology and biofeedback · 2022Review
- Interictal Heart Rate Variability as a Biomarker for Comorbid Depressive Disorders among People with Epilepsy.Brain sciences · 2022Article
- QT interval is correlated with and can predict the comorbidity of depression and anxiety: A cross-sectional study on outpatients with first-episode depression.Frontiers in cardiovascular medicine · 2022Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDepression and anxiety may unfavorably impact on cardiac autonomic dysregulation. However, it is unclear whether this relationship results from a causal effect or may be attributable to confounding factors. We tested the relationship between depression and anxiety with heart rate (HR) and heart rate variability (HRV) across a 9-year follow-up (FU) period and investigated possible confounding by antidepressant use and genetic pleiotropy.
methodsData (no. of observations = 6,994, 65% female) were obtained from the longitudinal Netherlands Study of Depression and Anxiety, with repeated waves of data collection of HR, HRV, depression, anxiety, and antidepressant use. Summary statistics from meta-analyses of genome-wide association studies were used to derive polygenic risk scores of depression, HR, and HRV.
resultsAcross the 9-year FU, generalized estimating equations analyses showed that the relationship between cardiac autonomic dysregulation and depression/anxiety rendered nonsignificant after adjusting for antidepressant use. A robust association was found between antidepressant use (especially tricyclic antidepressants, selective serotonin, and noradrenalin reuptake inhibitors) and unfavorable cardiac autonomic activity across all waves. However, no evidence was found for a genetic correlation of depression with HR and HRV, indicating that confounding by genetic pleiotropy is minimal.
conclusionsOur results indicate that the association between depression/anxiety and cardiac autonomic dysregulation does not result from a causal pathway or genetic pleiotropy, and these traits might therefore not be inevitably linked. Previously reported associations were likely confounded by the use of certain classes of antidepressants.
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