The usability of daytime and night-time heart rate dynamics as digital biomarkers of depression severity

PAB members; S Siddi; R Bailon; I Giné-Vázquez; F Matcham; F Lamers; S Kontaxis; E Laporta; E Garcia; F Lombardini; P Annas; M Hotopf; B W J H Penninx; A Ivan; K M White; S Difrancesco; P Locatelli; J Aguiló; M T Peñarrubia-Maria; V A Narayan; A Folarin; D Leightley; N Cummins; S Vairavan; Y Ranjan; A Rintala; G de Girolamo; S K Simblett; T Wykes; I Myin-Germeys; R Dobson; J M Haro

doi:10.1017/S0033291723001034

The usability of daytime and night-time heart rate dynamics as digital biomarkers of depression severity

PAB members, S Siddi, R Bailon, I Giné-Vázquez, F Matcham, F Lamers, S Kontaxis, E Laporta, E Garcia, F Lombardini, P Annas, M Hotopf, B W J H Penninx, A Ivan, K M White, S Difrancesco, P Locatelli, J Aguiló, M T Peñarrubia-Maria, V A NarayanA Folarin, D Leightley, N Cummins, S Vairavan, Y Ranjan, A Rintala, G de Girolamo, S K Simblett, T Wykes, I Myin-Germeys, R Dobson, J M Haro

Research output: Contribution to journal › Review article › peer-review

9 Citations (Scopus)

3 Downloads (Pure)

Abstract

BACKGROUND: Alterations in heart rate (HR) may provide new information about physiological signatures of depression severity. This 2-year study in individuals with a history of recurrent major depressive disorder (MDD) explored the intra-individual variations in HR parameters and their relationship with depression severity.

METHODS: Data from 510 participants (Number of observations of the HR parameters = 6666) were collected from three centres in the Netherlands, Spain, and the UK, as a part of the remote assessment of disease and relapse-MDD study. We analysed the relationship between depression severity, assessed every 2 weeks with the Patient Health Questionnaire-8, with HR parameters in the week before the assessment, such as HR features during all day, resting periods during the day and at night, and activity periods during the day evaluated with a wrist-worn Fitbit device. Linear mixed models were used with random intercepts for participants and countries. Covariates included in the models were age, sex, BMI, smoking and alcohol consumption, antidepressant use and co-morbidities with other medical health conditions.

RESULTS: Decreases in HR variation during resting periods during the day were related with an increased severity of depression both in univariate and multivariate analyses. Mean HR during resting at night was higher in participants with more severe depressive symptoms.

CONCLUSIONS: Our findings demonstrate that alterations in resting HR during all day and night are associated with depression severity. These findings may provide an early warning of worsening depression symptoms which could allow clinicians to take responsive treatment measures promptly.

Original language	English
Pages (from-to)	3249-3260
Number of pages	12
Journal	Psychological Medicine
Volume	53
Issue number	8
Early online date	15 May 2023
DOIs	https://doi.org/10.1017/S0033291723001034
Publication status	Published - 15 Jun 2023

Access to Document

10.1017/S0033291723001034

The usability of daytime_SIDDI_Publishedonline15May2024_GREEN AAMAccepted author manuscript, 947 KB

Cite this

PAB members, Siddi, S., Bailon, R., Giné-Vázquez, I., Matcham, F., Lamers, F., Kontaxis, S., Laporta, E., Garcia, E., Lombardini, F., Annas, P., Hotopf, M., Penninx, B. W. J. H., Ivan, A., White, K. M., Difrancesco, S., Locatelli, P., Aguiló, J., Peñarrubia-Maria, M. T., ... Haro, J. M. (2023). The usability of daytime and night-time heart rate dynamics as digital biomarkers of depression severity. Psychological Medicine, 53(8), 3249-3260. https://doi.org/10.1017/S0033291723001034

@article{06acfd90de25441690d0b259ffff67ec,

title = "The usability of daytime and night-time heart rate dynamics as digital biomarkers of depression severity",

abstract = "BACKGROUND: Alterations in heart rate (HR) may provide new information about physiological signatures of depression severity. This 2-year study in individuals with a history of recurrent major depressive disorder (MDD) explored the intra-individual variations in HR parameters and their relationship with depression severity.METHODS: Data from 510 participants (Number of observations of the HR parameters = 6666) were collected from three centres in the Netherlands, Spain, and the UK, as a part of the remote assessment of disease and relapse-MDD study. We analysed the relationship between depression severity, assessed every 2 weeks with the Patient Health Questionnaire-8, with HR parameters in the week before the assessment, such as HR features during all day, resting periods during the day and at night, and activity periods during the day evaluated with a wrist-worn Fitbit device. Linear mixed models were used with random intercepts for participants and countries. Covariates included in the models were age, sex, BMI, smoking and alcohol consumption, antidepressant use and co-morbidities with other medical health conditions.RESULTS: Decreases in HR variation during resting periods during the day were related with an increased severity of depression both in univariate and multivariate analyses. Mean HR during resting at night was higher in participants with more severe depressive symptoms.CONCLUSIONS: Our findings demonstrate that alterations in resting HR during all day and night are associated with depression severity. These findings may provide an early warning of worsening depression symptoms which could allow clinicians to take responsive treatment measures promptly.",

author = "{PAB members} and S Siddi and R Bailon and I Gin{\'e}-V{\'a}zquez and F Matcham and F Lamers and S Kontaxis and E Laporta and E Garcia and F Lombardini and P Annas and M Hotopf and Penninx, {B W J H} and A Ivan and White, {K M} and S Difrancesco and P Locatelli and J Aguil{\'o} and Pe{\~n}arrubia-Maria, {M T} and Narayan, {V A} and A Folarin and D Leightley and N Cummins and S Vairavan and Y Ranjan and A Rintala and {de Girolamo}, G and Simblett, {S K} and T Wykes and I Myin-Germeys and R Dobson and Haro, {J M}",

note = "Funding Information: The RADAR-CNS project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 115902. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation programme and EFPIA, www.imi.europa.eu . This communication reflects the views of the RADAR-CNS consortium and neither IMI nor the European Union and EFPIA are liable for any use that may be made of the information contained herein. The funding body has not been involved in the design of the study, the collection or analysis of data, or the interpretation of data. Participants in the CIBER site came from following four clinical communities in Spain: Parc Sanitari Sant Joan de D{\'e}u Network services, Institut Catal{\`a} de la Salut, Institut Pere Mata, and Hospital Cl{\'i}nico San Carlos. Participant recruitment in Amsterdam was partially accomplished through Hersenonderzoek.nl, a Dutch online registry that facilitates participant recruitment for neuroscience studies Hersenonderzoek.nl is funded by ZonMw-Memorabel project no 73305095003, a project in the context of the Dutch Deltaplan Dementie, Gieskes-Strijbis Foundation, the Alzheimer's Society in the Netherlands and Brain Foundation Netherlands. We thank all GLAD Study volunteers for their participation, and gratefully acknowledge the NIHR BioResource, NIHR BioResource centres, NHS Trusts and staff for their contribution. We also acknowledge NIHR BRC, King's College London, South London and Maudsley NHS Trust and King's Health Partners. We thank the National Institute for Health Research, NHS Blood and Transplant, and Health Data Research UK as part of the Digital Innovation Hub Programme. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. This paper represents independent research part funded by the National Institute for Health Research NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. We thank all the members of the RADAR-CNS patient advisory board for their contribution to the device selection procedures, and their invaluable advice throughout the study protocol design. This research was reviewed by a team with experience of mental health problems and their careers who have been specially trained to advise on research proposals and documentation through the Feasibility and Acceptability Support Team for Researchers FAST-R: a free, confidential service in England provided by the National Institute for Health Research Maudsley Biomedical Research Centre via King's College London and South London and Maudsley NHS Foundation Trust. RADAR-MDD will be conducted per the Declaration of Helsinki and Good Clinical Practice, adhering to principles outlined in the NHS Research Governance Framework for Health and Social Care 2nd edition. Ethical approval has been obtained in London from the Camberwell St Giles Research Ethics Committee REC reference: 17/LO/1154, in London from the CEIC Fundacio Sant Joan de Deu CI: PIC-128-17 and in the Netherlands from the Medische Ethische Toetsingscommissie VUms METc VUmc registratienummer: 2018.012 – NL63557.029.17. All authors acknowledged the contribution of the Patient Advisory Board. This work has been dedicated to the memory of Rita Siddi. Publisher Copyright: Copyright {\textcopyright} The Author(s), 2023. Published by Cambridge University Press.",

year = "2023",

month = jun,

day = "15",

doi = "10.1017/S0033291723001034",

language = "English",

volume = "53",

pages = "3249--3260",

journal = "Psychological Medicine",

issn = "0033-2917",

publisher = "Cambridge University Press",

number = "8",

}

PAB members, Siddi, S, Bailon, R, Giné-Vázquez, I, Matcham, F, Lamers, F, Kontaxis, S, Laporta, E, Garcia, E, Lombardini, F, Annas, P, Hotopf, M, Penninx, BWJH, Ivan, A , White, KM, Difrancesco, S, Locatelli, P, Aguiló, J, Peñarrubia-Maria, MT, Narayan, VA, Folarin, A , Leightley, D , Cummins, N, Vairavan, S, Ranjan, Y, Rintala, A, de Girolamo, G, Simblett, SK , Wykes, T, Myin-Germeys, I, Dobson, R & Haro, JM 2023, 'The usability of daytime and night-time heart rate dynamics as digital biomarkers of depression severity', Psychological Medicine, vol. 53, no. 8, pp. 3249-3260. https://doi.org/10.1017/S0033291723001034

TY - JOUR

T1 - The usability of daytime and night-time heart rate dynamics as digital biomarkers of depression severity

AU - PAB members

AU - Siddi, S

AU - Bailon, R

AU - Giné-Vázquez, I

AU - Matcham, F

AU - Lamers, F

AU - Kontaxis, S

AU - Laporta, E

AU - Garcia, E

AU - Lombardini, F

AU - Annas, P

AU - Hotopf, M

AU - Penninx, B W J H

AU - Ivan, A

AU - White, K M

AU - Difrancesco, S

AU - Locatelli, P

AU - Aguiló, J

AU - Peñarrubia-Maria, M T

AU - Narayan, V A

AU - Folarin, A

AU - Leightley, D

AU - Cummins, N

AU - Vairavan, S

AU - Ranjan, Y

AU - Rintala, A

AU - de Girolamo, G

AU - Simblett, S K

AU - Wykes, T

AU - Myin-Germeys, I

AU - Dobson, R

AU - Haro, J M

N1 - Funding Information: The RADAR-CNS project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 115902. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation programme and EFPIA, www.imi.europa.eu . This communication reflects the views of the RADAR-CNS consortium and neither IMI nor the European Union and EFPIA are liable for any use that may be made of the information contained herein. The funding body has not been involved in the design of the study, the collection or analysis of data, or the interpretation of data. Participants in the CIBER site came from following four clinical communities in Spain: Parc Sanitari Sant Joan de Déu Network services, Institut Català de la Salut, Institut Pere Mata, and Hospital Clínico San Carlos. Participant recruitment in Amsterdam was partially accomplished through Hersenonderzoek.nl, a Dutch online registry that facilitates participant recruitment for neuroscience studies Hersenonderzoek.nl is funded by ZonMw-Memorabel project no 73305095003, a project in the context of the Dutch Deltaplan Dementie, Gieskes-Strijbis Foundation, the Alzheimer's Society in the Netherlands and Brain Foundation Netherlands. We thank all GLAD Study volunteers for their participation, and gratefully acknowledge the NIHR BioResource, NIHR BioResource centres, NHS Trusts and staff for their contribution. We also acknowledge NIHR BRC, King's College London, South London and Maudsley NHS Trust and King's Health Partners. We thank the National Institute for Health Research, NHS Blood and Transplant, and Health Data Research UK as part of the Digital Innovation Hub Programme. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. This paper represents independent research part funded by the National Institute for Health Research NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. We thank all the members of the RADAR-CNS patient advisory board for their contribution to the device selection procedures, and their invaluable advice throughout the study protocol design. This research was reviewed by a team with experience of mental health problems and their careers who have been specially trained to advise on research proposals and documentation through the Feasibility and Acceptability Support Team for Researchers FAST-R: a free, confidential service in England provided by the National Institute for Health Research Maudsley Biomedical Research Centre via King's College London and South London and Maudsley NHS Foundation Trust. RADAR-MDD will be conducted per the Declaration of Helsinki and Good Clinical Practice, adhering to principles outlined in the NHS Research Governance Framework for Health and Social Care 2nd edition. Ethical approval has been obtained in London from the Camberwell St Giles Research Ethics Committee REC reference: 17/LO/1154, in London from the CEIC Fundacio Sant Joan de Deu CI: PIC-128-17 and in the Netherlands from the Medische Ethische Toetsingscommissie VUms METc VUmc registratienummer: 2018.012 – NL63557.029.17. All authors acknowledged the contribution of the Patient Advisory Board. This work has been dedicated to the memory of Rita Siddi. Publisher Copyright: Copyright © The Author(s), 2023. Published by Cambridge University Press.

PY - 2023/6/15

Y1 - 2023/6/15

N2 - BACKGROUND: Alterations in heart rate (HR) may provide new information about physiological signatures of depression severity. This 2-year study in individuals with a history of recurrent major depressive disorder (MDD) explored the intra-individual variations in HR parameters and their relationship with depression severity.METHODS: Data from 510 participants (Number of observations of the HR parameters = 6666) were collected from three centres in the Netherlands, Spain, and the UK, as a part of the remote assessment of disease and relapse-MDD study. We analysed the relationship between depression severity, assessed every 2 weeks with the Patient Health Questionnaire-8, with HR parameters in the week before the assessment, such as HR features during all day, resting periods during the day and at night, and activity periods during the day evaluated with a wrist-worn Fitbit device. Linear mixed models were used with random intercepts for participants and countries. Covariates included in the models were age, sex, BMI, smoking and alcohol consumption, antidepressant use and co-morbidities with other medical health conditions.RESULTS: Decreases in HR variation during resting periods during the day were related with an increased severity of depression both in univariate and multivariate analyses. Mean HR during resting at night was higher in participants with more severe depressive symptoms.CONCLUSIONS: Our findings demonstrate that alterations in resting HR during all day and night are associated with depression severity. These findings may provide an early warning of worsening depression symptoms which could allow clinicians to take responsive treatment measures promptly.

AB - BACKGROUND: Alterations in heart rate (HR) may provide new information about physiological signatures of depression severity. This 2-year study in individuals with a history of recurrent major depressive disorder (MDD) explored the intra-individual variations in HR parameters and their relationship with depression severity.METHODS: Data from 510 participants (Number of observations of the HR parameters = 6666) were collected from three centres in the Netherlands, Spain, and the UK, as a part of the remote assessment of disease and relapse-MDD study. We analysed the relationship between depression severity, assessed every 2 weeks with the Patient Health Questionnaire-8, with HR parameters in the week before the assessment, such as HR features during all day, resting periods during the day and at night, and activity periods during the day evaluated with a wrist-worn Fitbit device. Linear mixed models were used with random intercepts for participants and countries. Covariates included in the models were age, sex, BMI, smoking and alcohol consumption, antidepressant use and co-morbidities with other medical health conditions.RESULTS: Decreases in HR variation during resting periods during the day were related with an increased severity of depression both in univariate and multivariate analyses. Mean HR during resting at night was higher in participants with more severe depressive symptoms.CONCLUSIONS: Our findings demonstrate that alterations in resting HR during all day and night are associated with depression severity. These findings may provide an early warning of worsening depression symptoms which could allow clinicians to take responsive treatment measures promptly.

UR - http://www.scopus.com/inward/record.url?scp=85163913480&partnerID=8YFLogxK

U2 - 10.1017/S0033291723001034

DO - 10.1017/S0033291723001034

M3 - Review article

C2 - 37184076

SN - 0033-2917

VL - 53

SP - 3249

EP - 3260

JO - Psychological Medicine

JF - Psychological Medicine

IS - 8

ER -

The usability of daytime and night-time heart rate dynamics as digital biomarkers of depression severity

Abstract

Access to Document

Other files and links

Fingerprint

Cite this