We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters to the Editor |

Heart Rate Variability and Depression

Andreas Birkhofer, MD; Georg Schmidt, MD, PhD; Hans Förstl, MD, PhD
Arch Gen Psychiatry. 2006;63(9):1052. doi:10.1001/archpsyc.63.9.1052-a.
Text Size: A A A
Published online


With great interest we have read the article by Gehi et al titled “Depression and Heart Rate Variability in Patients With Stable Coronary Heart Disease.”1

In this outstanding large study no association was found between depression and heart rate variability (HRV) in patients with stable coronary heart disease. This is surprising because most studies revealed a reduced HRV in depressive syndromes independent of underlying cardiovascular disease.24 The participants of Gehi et al's investigation were considerably older than those in most other studies on this subject. As HRV substantially decreases with increasing age,5 this may have led to a less-detectable effect of depression on HRV. Moreover, the large difference in mean age in both strata may not have been sufficiently considered because depressed participants were on average 7 years younger. To our knowledge, no other study investigating HRV in depressed patients with heart disease included participants with such a huge difference in age. The antagonistic effects of age and depression may have additionally confounded the results. Several possible interactions between depression and HRV were tested by analysis of covariance, but this large amount of interactions might have produced multicorrelations and therefore might have “hidden” the effect of age on HRV. An analysis of covariance solely with age as the covariate would be of great interest.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...