Department of Psychiatry, Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou 510630, China.
Department of Psychiatry, Fifth Affiliated Hospital of Sun Yat-sen University, No. 52 East Meihua Road, Zhuhai 519000, China.
Compr Psychiatry. 2022 Nov;119:152347. doi: 10.1016/j.comppsych.2022.152347. Epub 2022 Sep 28.
Several studies have demonstrated that patients with major depressive disorder (MDD) commonly show reductions in heart rate variability (HRV) parameters. Thus, interventions for the improvement of low HRV may be advantageous in treating MDD. This systematic review and meta-analysis aimed to explore the improvement effects of current clinical treatments on low HRV in patients with MDD.
Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the PubMed, EMBASE, PsycINFO, and CNKI databases were searched for relevant literature. Interventional studies of patients with confirmed MDD, which included baseline and post-intervention data and at least one HRV parameter as an outcome indicator, were included for meta-analysis.
Twenty-one studies were included in the review. Several studies affirmed the role of psychotherapy in improving low HRV in patients with MDD showing a significant increase in high-frequency and low-frequency power after psychotherapy in the meta-analysis. However, both pharmacotherapy studies and physiotherapy studies included in the meta-analysis showed significant heterogeneity.
The main limitation of this study was the relatively small samples for the meta-analysis, and more high-quality randomized controlled trials in this field are wanted.
Psychotherapy was effective for improving low HRV in patients with MDD. However, the effect of pharmacotherapy or physical therapy on low HRV in MDD remains unclear. Regarding research methods, it is necessary to formulate and standardize operational guidelines for future HRV measurements.
多项研究表明，患有重度抑郁症（MDD）的患者通常会出现心率变异性（HRV）参数降低。因此，改善低 HRV 的干预措施可能对治疗 MDD 有益。本系统评价和荟萃分析旨在探讨当前临床治疗对 MDD 患者低 HRV 的改善作用。
根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，检索了 PubMed、EMBASE、PsycINFO 和中国知网数据库中相关文献。纳入了包含基线和干预后数据且至少有一个 HRV 参数作为结局指标的确诊 MDD 患者的干预性研究，进行荟萃分析。
本综述纳入了 21 项研究。一些研究证实了心理治疗在改善 MDD 患者低 HRV 中的作用，荟萃分析显示心理治疗后高频和低频功率均显著增加。然而，纳入荟萃分析的药物治疗研究和物理治疗研究均显示出显著的异质性。
本研究的主要局限性是荟萃分析的样本相对较小，该领域需要更多高质量的随机对照试验。
心理治疗对改善 MDD 患者的低 HRV 有效。然而，药物治疗或物理治疗对 MDD 患者低 HRV 的影响尚不清楚。关于研究方法，有必要制定和规范未来 HRV 测量的操作指南。
