Heart rate variability and dissociation in panic disorder

Abstract

The aim of our study is to measure very low frequency band (VLF), low frequency band (LF) and high frequency band (HF) components of R-R interval during orthostatic experiment in panic disorder patients before and after treatment.

Methods

We assessed heart rate variability in 19 patients with panic disorder before and after 6-weeks treatment with antidepressants combined with CBT and 18 healthy controls. They were regularly assessed on the CGI, BAI and BDI. Heart rate variability was assessed during 5 min standing, 5 min supine and 5 min standing positions before and after the treatment. Power spectra were computed using a fast Fourier transformation for very low frequency - VLF (0.0033 - 0.04 Hz), low-frequency - LF (0.04-0.15 Hz) and high frequency - HF (0.15-0.40 Hz) powers.

Results

19 panic disorder patients entered a 6-week open-label treatment study with combination of SSRI and cognitive behavioral therapy. A combination of CBT and pharmacotherapy proved to be the effective treatment of patients. They significantly improved in all rating scales. There were highly statistical significant differences between panic patients and control group in all components of power spectral analysis in 2^nd and in two component of 3^rd (LF and HF in standing) positions. There was also statistically significant difference between these two groups in LF/HF ratio in supine position (2^nd). During therapy there was tendency to increasing values in all three positions in components of HRV power spectra, but there was only statistically significant increasing in HF1 component.

Supported by project IGA MZ ČR NS 10301-3/2009