{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T02:34:07Z","timestamp":1789526047813,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,4,13]],"date-time":"2014-04-13T00:00:00Z","timestamp":1397347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychiatry Clin Neurosci"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Decreased heart rate variability (<jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content>) has been proposed in bipolar disorder. To date, there has been no adequate study that has investigated resting <jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content> in unmedicated patients with bipolar disorder in the manic state.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To examine whether bipolar mania is associated with decreased <jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content>, 61 unmedicated patients with bipolar mania and 183 healthy volunteers aged 20\u201365 years were recruited for this case\u2013control analysis. The Young Mania Rating Scale (<jats:styled-content style=\"fixed-case\">YMRS<\/jats:styled-content>), Clinical Global Impression\u2010Severity, Hamilton Depression Rating Scale (<jats:styled-content style=\"fixed-case\">HAM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>), and Hamilton Anxiety Rating Scale (<jats:styled-content style=\"fixed-case\">HAM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>) were used for the clinical ratings. Cardiac autonomic function was evaluated by measuring <jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content> parameters and the frequency\u2010domain indices of <jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content> were obtained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with bipolar mania exhibited significantly lower mean <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> interval, variance, low\u2010frequency (<jats:styled-content style=\"fixed-case\">LF<\/jats:styled-content>)\u2010<jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content>, and high\u2010frequency (<jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>)\u2010<jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content> but higher <jats:styled-content style=\"fixed-case\">LF<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content> compared to controls. Decreased <jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content> (variance) was associated with the <jats:styled-content style=\"fixed-case\">YMRS<\/jats:styled-content> total scores. Both the <jats:styled-content style=\"fixed-case\">YMRS<\/jats:styled-content> total scores and the Clinical Global Impression\u2010Severity scores were positively correlated with the <jats:styled-content style=\"fixed-case\">LH<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content> ratio and inversely correlated with the <jats:styled-content style=\"fixed-case\">HF\u2010HRV<\/jats:styled-content>. There was no significant correlation between the <jats:styled-content style=\"fixed-case\">HAM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">HAM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> scores and any <jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content> parameter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Bipolar mania is associated with cardiac autonomic dysregulation, highlighting the importance of assessing <jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content> in manic patients. Further studies examining the influence of anti\u2010manic psychotropic drugs on cardiac autonomic regulation in bipolar mania are needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pcn.12178","type":"journal-article","created":{"date-parts":[[2014,2,26]],"date-time":"2014-02-26T10:10:46Z","timestamp":1393409446000},"page":"674-682","source":"Crossref","is-referenced-by-count":45,"title":["Heart rate variability in unmedicated patients with bipolar disorder in the manic phase"],"prefix":"10.1111","volume":"68","author":[{"given":"Hsin\u2010An","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Psychiatry Tri\u2010Service General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan\u2010Chia","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Tri\u2010Service General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nian\u2010Sheng","family":"Tzeng","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Tri\u2010Service General Hospital  Taipei Taiwan"},{"name":"Student Counseling Center National Defense Medical Center  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry B. 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