Skip to main content

Advertisement

SpringerLink
Log in

A pilot study of heart rate variability biofeedback therapy in the treatment of perinatal depression on a specialized perinatal psychiatry inpatient unit

  • Original Article
  • Published:
Archives of Women's Mental Health Aims and scope Submit manuscript

Abstract

Heart rate variability biofeedback (HRVB) therapy may be useful in treating the prominent anxiety features of perinatal depression. We investigated the use of this non-pharmacologic therapy among women hospitalized with severe perinatal depression. Three questionnaires, the State Trait Anxiety Inventory (STAI), Warwick–Edinburgh Mental Well-Being Scale, and Linear Analog Self Assessment, were administered to 15 women in a specialized inpatient perinatal psychiatry unit. Participants were also contacted by telephone after discharge to assess continued use of HRVB techniques. The use of HRVB was associated with an improvement in all three scales. The greatest improvement (−13.867, p < 0.001 and −11.533, p < 0.001) was among STAI scores. A majority (81.9 %, n = 9) of women surveyed by telephone also reported continued frequent use at least once per week, and over half (54.6 %, n = 6) described the use of HRVB techniques as very or extremely beneficial. The use of HRVB was associated with statistically significant improvement on all instrument scores, the greatest of which was STAI scores, and most women reported frequent continued use of HRVB techniques after discharge. These results suggest that HRVB may be particularly beneficial in the treatment of the prominent anxiety features of perinatal depression, both in inpatient and outpatient settings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Association for Applied Psychophysiology and Biofeedback Inc. (2011) About Biofeedback. http://www.aapb.org/i4a/pages/index.cfm?pageid=3463. Accessed 10 Jun 2012

  • Balogh S, Fitzpatrick DF, Hendricks SE, Paige SR (1993) Increases in heart rate variability with successful treatment in patients with major depressive disorder. Psychopharmacol Bull 29:201–206

    PubMed  CAS  Google Scholar 

  • Barragan Loayza IM, Sola I, Juando Prats C (2011) Biofeedback for pain management during labour. Cochrane Database Syst Rev 6:CD006168

    PubMed  Google Scholar 

  • Beck CT (2001) Predictors of postpartum depression: an update. Nurs Res 50:275–278

    Article  PubMed  CAS  Google Scholar 

  • Beck CT, Indman P (2005) The many faces of postpartum depression. J Obstet Gynecol Neonatal Nurs 34:569–576

    Article  PubMed  Google Scholar 

  • Bernstein IH, Rush AJ, Yonkers K, Carmody TJ, Woo A, McConnell K, Trivedi MH (2008) Symptom features of postpartum depression: are they distinct? Depress Anxiety 25:20–26

    Article  PubMed  Google Scholar 

  • Brouwers EP, van Baar AL, Pop VJ (2001) Does the Edinburgh Postnatal Depression Scale measure anxiety? J Psychosom Res 51:659–663

    Article  PubMed  CAS  Google Scholar 

  • Campbell SB, Brownell CA, Hungerford A, Spieker SI, Mohan R, Blessing JS (2004) The course of maternal depressive symptoms and maternal sensitivity as predictors of attachment security at 36 months. Dev Psychopathol 16:231–252

    Article  PubMed  Google Scholar 

  • Childre D, Martin H (1999) The HeartMath solution. Harper, San Francisco

    Google Scholar 

  • Cohen H, Benjamin J (2006) Power spectrum analysis and cardiovascular morbidity in anxiety disorders. Auton Neurosci 128:1–8

    Article  PubMed  Google Scholar 

  • Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786

    Article  PubMed  CAS  Google Scholar 

  • Dennis CL, McQueen K (2007) Does maternal postpartum depressive symptomatology influence infant feeding outcomes? Acta Paediatr 96:590–594

    Article  PubMed  Google Scholar 

  • Dennis CL, Chung-Lee L (2006) Postpartum depression help-seeking barriers and maternal treatment preferences: a qualitative systematic review. Birth 33:323–331

    Article  PubMed  Google Scholar 

  • Einarson TR, Einarson A (2005) Newer antidepressants in pregnancy and rates of major malformations: a meta-analysis of prospective comparative studies. Pharmacoepidemiol Drug Saf 14:823–827

    Article  PubMed  CAS  Google Scholar 

  • Field T (2010) Postpartum depression effects on early interactions, parenting, and safety practices: a review. Infant Behav Dev 33:1–6

    Article  PubMed  Google Scholar 

  • Friedman BH (2007) An autonomic flexibility-neurovisceral integration model of anxiety and cardiac vagal tone. Biol Psychol 74:185–199

    Article  PubMed  Google Scholar 

  • Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T (2005) Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 106:1071–1083

    Article  PubMed  Google Scholar 

  • Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, Brody S, Miller WC (2005) Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evid Rep Technol Assess (Summ) 119:1–8

    Google Scholar 

  • Hassett AL, Radvanski DC, Vaschillo EG, Vaschillo B, Sigal LH, Karavidas MK, Buyske S, Lehrer PM (2007) A pilot study of the efficacy of heart rate variability (HRV) biofeedback in patients with fibromyalgia. Appl Psychophysiol Biofeedback 32:1–10

    Article  PubMed  Google Scholar 

  • HeartMath (2011) The Science Behind the emWave® Desktop & emWave2 Products. http://www.heartmathstore.com/cgi-bin/category.cgi?category=sciencebehind. Accessed 3 Nov 2012

  • Hendrick V, Altshuler L, Strouse T, Grosser S (2000) Postpartum and nonpostpartum depression: differences in presentation and response to pharmacologic treatment. Depress Anxiety 11:66–72

    Article  PubMed  CAS  Google Scholar 

  • Hiscock H, Wake M (2001) Infant sleep problems and postnatal depression: a community-based study. Pediatrics 107:1317–1322

    Article  PubMed  CAS  Google Scholar 

  • Horowitz S (2006) Biofeedback applications. J Altern Complement 12:275–281

    Google Scholar 

  • Karavidas MK, Lehrer PM, Vaschillo E, Vaschillo B, Marin H, Buyske S, Malinovsky I, Radvanski D, Hassett A (2007) Preliminary results of an open label study of heart rate variability biofeedback for the treatment of major depression. Appl Psychophysiol Biofeedback 32:19–30

    Article  PubMed  Google Scholar 

  • Locke DE, Decker PA, Sloan JA, Brown PD, Malec JF, Clark MM, Rummans TA, Ballman KV, Schaefer PL, Buckner JC (2007) Validation of single-item linear analog scale assessment of quality of life in neuro-oncology patients. J Pain Symptom Manage 34:628–633

    Article  PubMed  Google Scholar 

  • Lovejoy MC, Graczyk PA, O'Hare E, Neuman G (2000) Maternal depression and parenting behavior: a meta-analytic review. Clin Psychol Rev 20:561–592

    Article  PubMed  CAS  Google Scholar 

  • Malm H, Klaukka T, Neuvonen PJ (2005) Risks associated with selective serotonin reuptake inhibitors in pregnancy. Obstet Gynecol 106:1289–1296

    Article  PubMed  CAS  Google Scholar 

  • Marc I, Toureche N, Ernst E, Hodnett ED, Blanchet C, Dodin S, Njoya MM (2011) Mind-body interventions during pregnancy for preventing or treating women's anxiety. Cochrane Database Syst Rev 7:CD007559

    PubMed  Google Scholar 

  • McLearn KT, Minkovitz CS, Strobino DM, Marks E, Hou W (2006a) Maternal depressive symptoms at 2 to 4 months post partum and early parenting practices. Arch Pediatr Adolesc Med 160:279–284

    Article  PubMed  Google Scholar 

  • McLearn KT, Minkovitz CS, Strobino DM, Marks E, Hou W (2006b) The timing of maternal depressive symptoms and mothers' parenting practices with young children: implications for pediatric practice. Pediatrics 118:e174–e182

    Article  PubMed  Google Scholar 

  • Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J, Ericksen J, Ellwood D, Buist A (2008) Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord 108:147–155

    Article  PubMed  Google Scholar 

  • O'Hara MW, Swain A (1996) Rates and risk of postpartum depression—a meta-analysis. Int Rev Psych 8:37–54

    Article  Google Scholar 

  • Paulson JF, Dauber S, Leiferman JA (2006) Individual and combined effects of postpartum depression in mothers and fathers on parenting behavior. Pediatrics 118:659–668

    Article  PubMed  Google Scholar 

  • Robertson E, Grace S, Wallington T, Stewart DE (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry 26:289–295

    Article  PubMed  Google Scholar 

  • Ross LE, Gilbert Evans SE, Sellers EM, Romach MK (2003) Measurement issues in postpartum depression part 1: anxiety as a feature of postpartum depression. Arch Womens Ment Health 6:51–57

    Article  PubMed  CAS  Google Scholar 

  • Siepmann M, Aykac V, Unterdorfer J, Petrowski K, Mueck-Weymann M (2008) A pilot study on the effects of heart rate variability biofeedback in patients with depression and in healthy subjects. Appl Psychophysiol Biofeedback 33:195–201

    Article  PubMed  Google Scholar 

  • Spielberger C (1983) Manual for the state trait anxiety inventory (STAI). Consulting Psychologists, Palo Alto

    Google Scholar 

  • Stein A, Gath DH, Bucher J, Bond A, Day A, Cooper PJ (1991) The relationship between post-natal depression and mother–child interaction. Br J Psychiatry 158:46–52

    Article  PubMed  CAS  Google Scholar 

  • Tennant R, Hiller L, Fishwick R, Platt S, Joseph S, Weich S, Parkinson J, Secker J, Stewart-Brown S (2007) The Warwick–Edinburgh Mental Well-Being Scale (WEMWBS): development and UK validation. Health Qual Life Outcomes 5:63

    Article  PubMed  Google Scholar 

  • Wen SW, Yang Q, Garner P, Fraser W, Olatunbosun O, Nimrod C, Walker M (2006) Selective serotonin reuptake inhibitors and adverse pregnancy outcomes. Am J Obstet Gynecol 194:961–966

    Article  PubMed  CAS  Google Scholar 

  • Yonkers KA, Ramin SM, Rush AJ, Navarrete CA, Carmody T, March D, Heartwell SF, Leveno KJ (2001) Onset and persistence of postpartum depression in an inner-city maternal health clinic system. Am J Psychiatry 158:1856–1863

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA

    A. Jenna Beckham & Samantha Meltzer-Brody

  2. Department of Maternal and Child Health, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA

    A. Jenna Beckham

  3. Department of Psychiatry, University of North Carolina at Chapel Hill, Campus Box # 7160, Chapel Hill, NC, 27599, USA

    Tammy B. Greene & Samantha Meltzer-Brody

Authors
  1. A. Jenna Beckham
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tammy B. Greene
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Samantha Meltzer-Brody
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Samantha Meltzer-Brody.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Beckham, A.J., Greene, T.B. & Meltzer-Brody, S. A pilot study of heart rate variability biofeedback therapy in the treatment of perinatal depression on a specialized perinatal psychiatry inpatient unit. Arch Womens Ment Health 16, 59–65 (2013). https://doi.org/10.1007/s00737-012-0318-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00737-012-0318-7

Keywords

Search

Navigation