Depression and cardiac dysautonomia in eating disorders

  • Herbert F. Jelinek
  • Ian Spence
  • David J. Cornforth
  • Mika P. Tarvainen
  • Janice Russell
Original Article



Individuals with eating disorder (ED) are at an increased risk of cardiac arrhythmias due to cardiac dysautonomia, which may be exacerbated if depression is also present. The aim of the study was to use heart rate analysis as a marker for cardiac dysautonomia in patients with eating disorders and depression as a comorbidity.


Clinical data, including presence of depression, was obtained from all participants. A three-lead ECG was used to determine interbeat intervals, and these were analyzed using time domain, frequency domain, and nonlinear heart rate variability measures.


Thirty ED patients and 44 healthy controls participated in the research. The presence of depression was associated with additional decreased time domain (RMSSD 36.8 ± 26 vs. 22.9 ± 12.3; p < 0.05), frequency domain (HF power 788 ± 1075 vs. 279 ± 261; p < 0.05), and nonlinear domain (DFAα2 0.82 ± 0.1 vs. 0.97 ± 0.1; p < 0.01) which results in the ED group compared to patients with no depression.


The presence of depression in ED patients decreased HRV even further compared to the non-depressed patient group and controls, suggesting that higher vigilance and a holistic treatment approach may be required for these patients to avoid cardiac arrhythmia complications.


Eating disorders Depression Heart rate variability Dysautonomia Sudden cardiac death 



We wish to acknowledge the support by staff and patients at the Northside Clinic. Susan Beale provided the data, which was collected as part of her honours project.


No sponsorship or grants were received for this research.

Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Australian School of Advanced MedicineMacquarie UniversitySydneyAustralia
  2. 2.School of Community Health and Centre for Research in Complex SystemsCharles Sturt UniversityAlburyAustralia
  3. 3.Discipline of Pharmacology, Sydney Medical SchoolSydney UniversitySydneyAustralia
  4. 4.School of Design, Computing and Information TechnologyUniversity of Newcastle andApplied Informatics Research Group, University of NewcastleCallaghanAustralia
  5. 5.Department of Applied PhysicsUniversity of EasternKuopioFinland
  6. 6.Department of Clinical Physiology and Nuclear MedicineKuopio University HospitalKuopioFinland
  7. 7.Discipline of Psychiatry, Sydney Medical SchoolUniversity of SydneySydneyAustralia
  8. 8.Northside Clinic Eating Disorders ProgramSydney UniversitySydneyAustralia

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