A literature review of heart rate variability in depressive and bipolar disorders

Aust N Z J Psychiatry. 2016 Jun;50(6):511-9. doi: 10.1177/0004867415622689. Epub 2015 Dec 23.


Objective: Autonomic nervous system dysfunction has the potential to adversely impact general medical health and is known to exist in a number of psychiatric disorders. It reflects alterations in the function of several regions of the central nervous system. Measurement of heart rate variability provides a non-invasive tool for studying autonomic function. While the literature relating to the technical process of heart rate variability and aspects of depressive disorders has been reviewed in the past, research relating to both depressive and bipolar disorders has not been comprehensively reviewed. This paper critically considers the published research in heart rate variability in both depressive and bipolar affective disorders.

Method: A literature search using Medline, EMBASE, PsycINFO, ProQuest Psychology and references included in published literature was conducted using the following keywords: 'heart rate variability and autonomic, combined with depression, depressive disorder, bipolar, mania and sleep'.

Results: The evidence demonstrates that, using heart rate variability measures, significant distortions of autonomic function are evident in both depressive and bipolar disorders and from most of their pharmacological treatments.

Conclusion: The autonomic dysfunction evident in both unipolar and bipolar affective disorders, and many psychotropic medications, has significant implications for our understanding of the neurophysiology of these disorders, their treatment and associated general health.

Keywords: Heart rate variability; autonomic; bipolar; depression; neurophysiology.

Publication types

  • Review

MeSH terms

  • Antipsychotic Agents / adverse effects*
  • Bipolar Disorder / drug therapy
  • Bipolar Disorder / physiopathology*
  • Depressive Disorder / drug therapy
  • Depressive Disorder / physiopathology*
  • Heart Rate / drug effects*
  • Humans
  • Neurophysiology
  • Randomized Controlled Trials as Topic


  • Antipsychotic Agents