• Korean Journal of Biological Psychiatry
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• v.28 no.1
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• pp.13-22
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• 2021

Objectives Despite growing attention to anxiety in bipolar disorder (BD), little research has assessed anxiety symptoms in the course of BD. The current prospective follow-up study examines the influence of subjectively and objectively measured anxiety symptoms on the course of BD. Methods A total of 49 patients with BD were followed-up prospectively for average of one year at an average of four months interval. The Korean version of the Beck Anxiety Inventory (K-BAI), the Hamilton Anxiety Rating Scale, heart rate variability (HRV) were used to measure anxiety subjectively, objectively and physiologically. Participants were divided into high and low anxiety groups based on their K-BAI scores. Kaplan-Meier survival analysis was performed to compare the recurrence of mood episode, suicide attempt, emergency room visit, and psychiatric hospitalization between two groups. Mediators were investigated with Cox proportional hazards models. Results Compared to the low anxiety group, the high anxiety group reported significantly higher impulsiveness (p = 0.016) and lower high frequency component on HRV (p = 0.007) after controlling for severity of BD. Regarding survival analysis, the high anxiety group showed hastened depressive episode recurrence (p = 0.048) and suicidal ideation was the mediator of the hazard ratio (HR) 1.089 (p = 0.029) in the Cox model. Moreover, the high anxiety group showed a tendency of accelerated suicide attempt (p = 0.12) and impulsivity was the risk factor of suicide attempt (HR = 1.089, p = 0.036). Conclusions This interim analysis of prospective study suggests that high anxiety level in BD may anticipate unfavorable course. Further studies are needed to understand the multifactorial mechanism of anxious bipolar patients.

• Korean Journal of Adult Nursing
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• v.29 no.1
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• pp.87-97
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• 2017

Purpose: The purpose of this study was to investigate the relationship among sleep quality, heart rate variability (HRV), fatigue, depression, and anxiety reported by Korean adults. Methods: A cross-sectional study of 208 adults aged 20~60 years was conducted using a short-term HRV analysis and self-reported questionnaires of Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale, Beck Depression Inventory, and State Trait Anxiety Inventory. Results: Subjects with good sleep quality (PSQI $score{\leq}5$) had higher HRV total power (t=2.03, p=.043) and high-frequency (t=2.04, p=.043) with lower fatigue (t=-4.08, p<.001), depressive mood (t=-3.66, p<.001), and trait anxiety (t=-3.84, p<.001) than subjects with poor sleep quality. Poor sleep quality was negatively correlated with HRV total power (r=-.17, p=.016), high-frequency (r=-.14, p=.049), and positively fatigue (r=.39, p<.001), depression (r=.44, p<.001), state anxiety (r=.23, p=.001) and trait anxiety (r=.34, p<.001). Conclusion: The results indicated that sleep quality is correlated with HRV which reflects the activities of the autonomic nerve system, fatigue, depression, and anxiety in adults.

• Anxiety and mood
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• v.16 no.2
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• pp.83-90
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• 2020

Objective : Heart rate variability (HRV) is known to reflect autonomic nervous system activity. Individuals with posttraumatic stress disorder (PTSD) are reported to have lower HRVs. We attempted to find HRV indices with head up tilt position that reflect the symptoms well in order to evaluate PTSD symptoms. Methods : Sixty-seven patients with PTSD and 72 patients without PTSD were assessed using the PTSD Checklist for DSM-5 (PCL-5), the Beck Depression Inventory, the Beck Anxiety Inventory and the Pittsburgh Sleep Quality Index. HRV was measured in the head-up tilt position. We collected data regarding heart rate (HR), standard deviation of the NN intervals (SDNN), the square root of the mean squared differences of successive NN intervals (RMSSD), log low-frequency (LNLF) and log high-frequency (LNHF). Results : The value of LNHF was different according to presence or absence of PTSD after head-up tilt position. In the findings of the association between PTSD symptoms and HRV indices as based on head-up tilt, LNHF had a significant correlation with the total score of PCL-5. Conclusion : The reduction of the high-frequency component of HRVs in the PTSD group might reflect more PTSD symptoms.

• Mood & Emotion
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• v.15 no.3
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• pp.117-122
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• 2017

Objectives : Early life stress (ELS) may have impact on functions of the autonomic nervous system. Heart rate variability (HRV) is a reliable psychophysiological marker for functions of the autonomic nervous system. The purpose of this study was to investigate characteristics of HRV associated with ELS in patients with major depressive disorder (MDD). Methods : We compared HRV measures of MDD patients with ELS and without ELS in a 5-minute resting-state electrocardiogram recoding. Forty subjects participated in the study (25 with ELS, 15 without ELS). The Mann-Whitney test was conducted to identify group differences. Results : We found significant group differences in standard deviation of the NN interval (SDNN) and total power (TP). SDNN was lower in the ELS group (M=38.80 ms, SD=13.05 ms) than in the Non-ELS group (M=53.53 ms, SD=19.47 ms). TP was lower in the ELS group ($M=7.07ms^2$, $SD=0.69ms^2$) than in the Non-ELS group ($M=7.72ms^2$, $SD=0.77ms^2$). Conclusion : ELS may have a negative impact on the autonomic nervous system function in patients with MDD. ELS and dysfunction of autonomic nervous system should be considered in treatment for patients with MDD.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.57 no.6
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• pp.1087-1094
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• 2008

This study describes a system for human sensibility evaluation using PPG(photoplethysmogram) signal and biofeedback algorithm to respond the bad(negative) mood. For this objective, PPG signals for two emotional states(positive/negative) are collected. To evoke the test emotions, happy(or joyful) and sad(or irritating) movie files are collected and played in subjects' monitor. From the acquired PPG signal, the heart rate variability(HRV) is calculated. Using the HRV and its FFT spectra, the human sensibility is evaluated. Since the heart is a representative organ which is controlled by the autonomic nervous system(ANS), the ANS may reflect the changes in emotion. The biofeedback algorithm is designed with motion image player interacting with the results of the sensibility evaluation. It was shown that HRV was changed according to the subject's emotions. Accordingly, the sensibility evaluation test showed feasibility of the our method.

• Proceedings of the KIEE Conference
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• 2008.07a
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• pp.2010-2012
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• 2008

This study describes a system for human sensibility evaluation using PPG(photoplethysmogram) signal and biofeedback algorithm to respond the bad(negative) mood. For this objective, PPG signals for two emotional states(positive/negative) are collected. To evoke the test emotions, happy(or joyful) and sad(or irritating) movie files are collected and played in subjects' monitor. From the acquired PPG signal, the heart rate variability(HRV) is calculated. Using the HRV and its FFT spectra, the human sensibility is evaluated. Since the heart is a representative organ which is controlled by the autonomic nervous system(ANS), the ANS may reflect the changes in emotion. The biofeedback algorithm is designed with motion image player interacting with the results of the sensibility evaluation. It was shown that HRV was changed according to the subject's emotions. Accordingly, the sensibility evaluation test showed feasibility of the our method.

• International Journal of Fuzzy Logic and Intelligent Systems
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• v.10 no.1
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• pp.37-42
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• 2010

Final year students are normally encountering high pressing in their study. In view of this fact, this research focuses on determining mental states condition of college student in final year based on the psycho-physiological information. The experiments were conducted in two times, i.e., prior- and post- graduation seminar examination. The early results indicated that the student profile of mood states (POMS) in prior final graduation seminar showed higher scores than students in post final graduation seminar. Thus, in this research, relation between biosignal representing by heart rate variability (HRV) and questionnaire responses were evaluated by hidden Markov model (HMM) and neural networks (NN).

• Journal of the Korean Institute of Landscape Architecture
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• v.39 no.5
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• pp.111-118
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• 2011

With increasing interest in health promotion and quality of life, growing attention has been focused on the beneficial effects of urban green area. However, very few evidence-based approaches have been conducted on the health-related benefits of urban greenery. Therefore, this study examined the health-related benefits of green areas using physiological and psychological indices to obtain evidence-based data on these benefits. Twenty male university students were selected as subjects. Data were collected when participants viewed landscapes in a green area or an urban area for fifteen minutes. This research was reviewed and approved by the Ethics Committee of School of Medicine, Chungnam National University. Physiological data in the green area revealed significantly decreased heart rates, significantly increased high-frequency value of heart rate variability, an index of parasympathetic activity, and reduced salivary cortisol concentration, a stress hormone, compared to the urban area. Psychological tests showed the green area significantly reduced the negative mood state and psychological symptoms, and significantly increased the positive mood state. Our data provided evidence for the health-related benefits of green areas, and the findings of this study support that green areas can play a critical role in health promotion for urban residents, by positively affecting autonomic nervous and endocrinal activities.

• Journal of People, Plants, and Environment
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• v.24 no.5
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• pp.545-550
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• 2021

Background and objective: With increasing land use intensity in urban areas, apartment buildings have been recognized as a typical type of urban residence. In this study, the impacts of different views through a window on health-related responses were investigated using psychological and physiological parameters. Methods: Photos of three different types of views taken on low (2-12 m), middle (28-35 m), and high (over 54 m) floors of dense apartment building areas were used as visual stimuli. Twenty-two healthy adults participated in the indoor experiment. Semantic differential methods and profile of mood states were used as psychological tools. Autonomic nervous activity was evaluated using blood pressures, pulse rate and heart rate variability (HRV). Results: Analytic data showed different characteristics of psychological and physiological outcomes in three different apartment views. In the analysis of psychological parameters, significantly negative responses to the views on middle floors were found in the subscales of tension-anxiety and anger-hostility, compared to low floors. Significantly positive scores in the subscale of vigor were found on low floors with abundance of vegetation and high floors with a view of the sky. A significantly increased value of HF was found on low floors (2,294.96 ± 169.79), compared to the middle(1,553.45 ± 84.66) and high (1,523.02 ± 70.49) floors. Despite the high scores in openness and vigor, high floor views showed significantly higher LF/HF values (1.83 ± 0.09), the indicator of the sympathetic nervous system, than low (1.30 ± 0.07) and middle floor views (1.34 ± 0.06), which might be related to the unconscious fear of heights. Conclusion: Views from different heights in an apartment building can affect the psychological states of residents. Green space through the window may have a positive health outcome by reducing physiological stress.

• Journal of Oriental Neuropsychiatry
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• v.34 no.2
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• pp.83-94
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• 2023

Objectives: To investigate the correlation of anxiety or depression mood with physical stress of 59 participants (29 who complained of chronic headache and 30 who did not complain of headache) using a questionnaire on chronic headache symptoms, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Heart Rate Variability (HRV). Methods: In this study, medical records of 59 participants (29 who complained of chronic headache and 30 who did not complain of headache) who completed the BAI, BDI, HRV, and Questionnaire for chronic headache symptoms were evaluated. All data were analyzed using SPSS (Statistical Package for the Social Sciences, Version 26.0). Descriptive Analysis, Mann-Whitney U test, Chi square test (Fisher's exact test), and Pearson correlation coefficient were used for data analysis. Results: 1. The chronic headache group had significantly lower SDNN, RMSSD, TP, LF, and HF values on HRV than the general control group. 2. As BAI and BDI scores of the chronic headache group increased, the overall HRV value tended to decrease, indicating a deep association. 3. There was a negative association between BDI and HRV values in the chronic headache group, although such association was not statistically significant. Conclusions: BDI can be negatively correlated with HRV (SDNN, RMSSD, TP, LF, HF) in chronic headache patients.