Assistant Professor Oregon Health and Science University OHSU Portland, Oregon, United States
Background: Suicide is the 2nd leading cause of death in adolescence, and acute pediatric mental health emergency department (ED) visits have doubled in the past decade. Heart rate variability (HRV) is an objective measure of the autonomic nervous system and the downregulation of the parasympathetic nervous system (PNS) has been hypothesized to play an important role in suicidality. The high frequency (HF) component of HRV is a measure of the PNS.
Objective: The objective of this study was to assess the correlation between heart rate variability; namely the HF component and suicide severity in a cohort of acutely suicidal adolescents using wearable technology.
Design/Methods: This was a prospective, observational study from April 2018 thru November 2019 in a tertiary care pediatric emergency department (ED) and inpatient pediatric psychiatric unit enrolling acutely suicidal adolescent patients. Patients wore a wrist device that used photoplethysmography for 7 days during their acute hospitalization to measure heart rate variability (HRV). During that time, Columbia Suicide Severity Scores (CSSRS) were assessed at 3 time points.
Results: Our final cohort consisted of 51 acutely suicidal adolescents admitted to the ED or inpatient psychiatric unit. There was an increase in the high frequency (HF) component of HRV in patients that had a 25% or greater decrease in their CSSRS (mean difference 11.89 ms/Hz-1; p-value 0.005). Patients with a CSSRS>15 on day of enrollment had a lower, although not statistically significant, HF component (mean difference -7.52 ms/ ms/Hz-1; p-value 0.063). Conclusion(s): We found an inverse correlation between parasympathetic activity measured through the HF component and suicidality in an acutely suicidal population of adolescents. Wearable technology may have the ability to improve outpatient monitoring for earlier detection and intervention.
Authors/Institutions: David C. Sheridan, OHSU, Portland, Oregon, United States; Steven D. Baker, OHSU, Portland, Oregon, United States; Ryan Dehart, OHSU, Portland, Oregon, United States; Amber Lin, Oregon Health & Science University, Portland, Oregon, United States; Matthew Hansen, Oregon Health & Science University, Portland, Oregon, United States; Larisa G. Tereshchenko, Oregon Health & Science University, Portland, Oregon, United States; Nancy Le, Oregon Health & Science University, Portland, Oregon, United States; Craig Newgard, Oregon Health & Science University, Portland, Oregon, United States; Bonnie Nagel, Oregon Health & Science University, Portland, Oregon, United States
