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Biomarkers of Mental Illness—What Can We Learn from Circadian Heart Rate?

机译：心理疾病的生物标志物—我们从昼夜节律心律中学到什么？

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Background: Much research in psychiatry has been a search for diagnostic biomarkers of mental illness but practically useful markers have remained elusive. The problem may be unrealistic expectations and the aim in this paper is to show that the relationship between circadian heart rate and psychiatric status can contribute to useful understanding in this regard. Aim: To discuss the biomarker implications of changes in circadian heart rate (CHR) in psychiatric disorders. Methods: Comparisons of CHR were made between and within individuals receiving treatment for different psychiatric disorders diagnosed according to criteria defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Results: Broadly different DSM-5 disorders are associated with distinctly different changes in CHR. Some disorders are more consistently associated with distinctive changes but CHR does not predict symptoms or specific clinical diagnoses reliably. Changes in CHR, particularly during sleep, are state-dependent. Clinical improvement is associated with normalisation of CHR. Conclusion: Changes in CHR are a part of the physiological changes in mental illness. Distinctly different changes in CHR suggest distinctly different physiological changes that may constitute diagnostic discrimination at a physiological level. An analysis of CHR can add objective adjunct information to clinical assessment and the evaluation of treatment but does not predict symptoms or clinical diagnoses reliably. Much the same is likely to apply to all candidate biomarkers of mental illness.
机译：背景：精神病学方面的许多研究一直在寻找精神疾病的诊断生物标志物，但实际上有用的标志物仍然难以捉摸。问题可能是不切实际的期望，本文的目的是表明昼夜节律心率与精神状态之间的关系可以有助于对此方面的有用理解。目的：探讨精神疾病中昼夜节律变化（CHR）对生物标志物的影响。方法：根据《精神障碍诊断和统计手册》第五版（DSM-5）中定义的标准，比较接受不同精神疾病治疗的个体之间和个体内部的CHR。结果：广泛不同的DSM-5疾病与CHR的明显不同有关。一些疾病更常与明显变化相关，但CHR不能可靠地预测症状或特定的临床诊断。 CHR的变化，尤其是在睡眠期间，是取决于状态的。临床改善与CHR正常化有关。结论：CHR的改变是精神疾病生理变化的一部分。 CHR的明显不同暗示着生理上明显不同，这可能构成生理学上的诊断区别。对CHR的分析可以将客观的辅助信息添加到临床评估和治疗评估中，但不能可靠地预测症状或临床诊断。精神疾病的所有候选生物标志物可能都差不多。

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