Lee Dongbin, Baek Ji Hyun, Cho Yun Ji, Hong Kyung Sue
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Front Psychiatry. 2021 Apr 30;12:652340. doi: 10.3389/fpsyt.2021.652340. eCollection 2021.
Objectively measurable biomarkers have not been applied for suicide risk prediction. Resting heart rate (HR) and heart rate variability (HRV) showed potential as trans-diagnostic markers associated with suicide. This study aimed to investigate the associations of resting HR and HRV on proximal suicide risk in patients with diverse psychiatric diagnoses. This chart review study used the medical records of psychiatric patients who visited the outpatient clinic at an academic tertiary hospital. A total of 1,461 patients with diverse psychiatric diagnoses was included in the analysis. Proximal suicide risk was measured using the Mini-International Neuropsychiatric Interview (MINI) suicidal score. Linear regression analyses with the MINI suicidal score as a dependent variable and binary logistic regression analyses with moderate-to-high suicide risk (MINI suicidal risk score ≥6) as a dependent variable were conducted to explore the effects of resting HR and HRV parameters on acute suicide risk after adjusting for age, sex, presence of major depressive disorder (MDD) and bipolar disorder (BD), severity of depression and anxiety severity. We found that 55 (34.6%) patients in the MDD group, 40 (41.7%) in the BD group and 36 (3.9%) in the others group reported moderate-to-high suicide risk. Linear regression analysis revealed that both resting HR and root-mean-square of successive difference (RMSSD) had significant associations with the MINI suicidal score ( = 0.037 with HR, = 0.003 with RMSSD). In logistic regression, only RMSSD showed a significant association with moderate-to-high suicide risk ( = 0.098 with HR, = 0.019 with RMSSD), which remained significant in subgroup analysis with patients who reported any suicide-related symptom (MINI suicidal score >0; = 472; = 0.017 with HR, = 0.012 with RMSSD). Our study findings suggest the potential for resting HR and RMSSD as biomarkers for proximal suicide risk prediction. Further research with longitudinal evaluation is needed to confirm our study findings.
客观可测量的生物标志物尚未应用于自杀风险预测。静息心率（HR）和心率变异性（HRV）显示出作为与自杀相关的跨诊断标志物的潜力。本研究旨在调查静息HR和HRV与不同精神疾病诊断患者的近期自杀风险之间的关联。这项图表回顾研究使用了在一家学术三级医院门诊就诊的精神科患者的病历。分析共纳入1461例不同精神疾病诊断的患者。使用简明国际神经精神访谈（MINI）自杀评分来衡量近期自杀风险。以MINI自杀评分为因变量进行线性回归分析，以中度至高度自杀风险（MINI自杀风险评分≥6）为因变量进行二元逻辑回归分析，以探讨静息HR和HRV参数在调整年龄、性别、重度抑郁症（MDD）和双相情感障碍（BD）的存在、抑郁严重程度和焦虑严重程度后对急性自杀风险的影响。我们发现，MDD组中有55例（34.6%）患者、BD组中有40例（41.7%）患者以及其他组中有36例（3.9%）患者报告有中度至高度自杀风险。线性回归分析显示，静息HR和逐次差值的均方根（RMSSD）均与MINI自杀评分有显著关联（HR的β = 0.037，RMSSD的β = 0.003）。在逻辑回归中，只有RMSSD与中度至高度自杀风险有显著关联（HR的β = 0.098，RMSSD的β = 0.019），在报告有任何自杀相关症状的患者（MINI自杀评分>0；n = 472）的亚组分析中，该关联仍然显著（HR的β = 0.017，RMSSD的β = 0.012）。我们的研究结果表明，静息HR和RMSSD作为近期自杀风险预测生物标志物的潜力。需要进行进一步的纵向评估研究来证实我们的研究结果。
