Relationship between heart rate variability and aggressive behavior among patients with schizophrenia hospitalized in acute wards

Wang, Hsiao-Tzu; Yang, Chien‐Ming; Chen, Kai‐Ren; Chueh, Ke‐Hsin

doi:10.1111/ppc.12433

Cited by 8 publications

(4 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In previous studies of patients with schizophrenia in acute psychiatric wards, 84.85% of patients took their medicine regularly before hospitalization. 40 The proportion of patients who had taken their medicine regularly during the preceding month was slightly higher in the present study than that in previous studies.…”

Section: Resultscontrasting

confidence: 76%

An exploration of the sleep quality and potential violence among patients with schizophrenia in community

Chen

Wang

Chueh

et al. 2020

Perspect Psychiatr Care

Self Cite

View full text Add to dashboard Cite

Purpose: Sleep quality in patients with schizophrenia is correlated with potential violence. However, few studies have conducted in-depth discussions on community patients with schizophrenia. The purpose of this study was to explore the influences of demographic characteristics, psychiatric symptom severity, and sleep quality in community patients with schizophrenia on the risks of potential violence and its subdimensions (ie, physical aggression, verbal aggression, anger, and hostility).Design and Methods: This study adopted a cross-sectional research design. Using convenience sampling, 78 community patients with schizophrenia were recruited from psychiatric outpatient clinics, day wards, and those who received home-care services.Findings: This study discovered that sleep quality is a crucial factor that influences the risks of potential violence. Analysis on the subdimensions revealed that having a violence history during the preceding month and sleep quality are crucial factors that influence physical aggression. In addition, sleep quality is a crucial factor that influences the occurrence of anger. Age and sleep quality substantially influence hostility. However, this study did not identify any crucial factors that influenced verbal aggression.Practice Implications: In the future, community nursing professionals should collect data on the patients' age, whether the patients exhibited violence behavior during the preceding month, and their sleep quality to prevent risks of potential violence, physical aggression, anger, or hostility.

show abstract

Section: Resultscontrasting

confidence: 76%

An exploration of the sleep quality and potential violence among patients with schizophrenia in community

Chen

Wang

Chueh

et al. 2020

Perspect Psychiatr Care

Self Cite

View full text Add to dashboard Cite

show abstract

“… 50 Another study by Wang et al found that SDNN was significantly associated with increased aggression in hospitalized patients with schizophrenia, suggesting utility in HRV as a monitoring tool for inpatient episodes of both verbal and physical aggression. 51 Prognosis and prediction of symptom severity in patients with schizophrenia remains a current limitation that clinicians face while managing acute inpatient episodes, as well as preventing future episodes. As discussed previously in the management of patients with depression and PTSD, HRV may also be useful in monitoring treatment response in schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

Heart Rate Variability in Psychiatric Disorders: A Systematic Review

Ramesh,

Nayak,

Beestrum

et al. 2023

NDT

View full text Add to dashboard Cite

Introduction Heart rate variability (HRV) is a measure of the fluctuation in time interval between consecutive heart beats. Decreased heart rate variability has been shown to have associations with autonomic dysfunction in psychiatric conditions such as depression, substance abuse, anxiety, and schizophrenia, although its use as a prognostic tool remains highly debated. This study aims to review the current literature on heart rate variability as a diagnostic and prognostic tool in psychiatric populations. Methods A literature search was conducted using the MEDLINE, EMBASE, Cochrane, and PsycINFO libraries to identify full-text studies involving adult psychiatric populations that reported HRV measurements. From 1647 originally identified, 31 studies were narrowed down through an abstract and full-text screen. Studies were excluded if they enrolled adolescents or children, used animal models, enrolled patients with another primary diagnosis other than psychiatric as outlined by the diagnostic and statistical manual of mental disorders (DSM) V, or if they assessed HRV in the context of treatment rather than diagnosis. Study quality assessment was conducted using a modified Downs and Blacks quality assessment tool for observational rather than interventional studies. Data were reported in four tables: 1) summarizing study characteristics, 2) methods of HRV detection, 3) key findings and statistics, and 4) quality assessment. Results There is significant variability between studies in their methodology of recording as well as reporting HRV, which makes it difficult to meaningfully interpret data that is clinically applicable due to the presence of significant bias in existing studies. The presence of an association between HRV and the severity of various psychiatric disorders, however, remains promising. Conclusion Future studies should be done to further explore how HRV parameters may be used to enhance the diagnosis and prognosis of several psychiatric disorders.

show abstract

“…During a traditional, nonwearable biofeedback paradigm consisting of multiple on-site sessions, patients are trained to regulate their physiological reactions by consciously alternating their responses to the given feedback. Rapid developments in noninvasive, wearable technology (eg, breast bands, wrist sensors, smart fibers, and interactive textiles) have opened opportunities for biocueing, which combines real-time measurement in everyday life and just-in-time behavioral support [ 27 - 29 ].…”

Section: Introductionmentioning

confidence: 99%

Development of a Wearable Biocueing App (Sense-IT) Among Forensic Psychiatric Outpatients With Aggressive Behavior: Design and Evaluation Study

et al. 2021

View full text Add to dashboard Cite

Background The ability to regulate anger is often impaired in forensic psychiatric patients, frequently resulting in aggressive behavior. Although some treatment programs are partially successful in enhancing aggression regulation and reducing recidivism among specific subgroups, generalizable conclusions on the effectiveness of these interventions cannot be drawn to date. In forensic outpatient care, low treatment adherence and a predominant focus on cognitive control in most treatment programs may entail some of the factors impeding treatment. Technology-based interventions may address some of these treatment challenges. Objective The aim of this study is to explore whether a new technology-based biocueing intervention, the Sense-IT app, can be a valuable addition to aggression regulation treatment programs in forensic outpatient care. The Sense-IT app, which provides the user with real-time physiological feedback and behavioral support, is developed to strengthen emotional awareness and facilitate real-life practice. In this study, we aim to develop and evaluate an updated version of the Sense-IT app that is suitable for forensic outpatients with aggressive behavior. Methods First, we conducted a design study to assess the attitudes of forensic professionals and patients toward biocueing and to collect requirements for a biocueing app for this specific population. On the basis of this information, we developed an updated version of the Sense-IT app. In an evaluation study, 10 forensic outpatients used the app for 2 weeks. The app’s acceptability, usability, and clinical outcomes (aggression, anger, and recognition of bodily signals related to anger) were measured before and after the intervention using both quantitative and qualitative measures. Results The design study revealed a cautiously positive attitude toward the use of biocueing as an addition to aggression regulation therapy. The evaluation study among forensic outpatients demonstrated moderate acceptability and adequate usability for the new version of the Sense-IT app. Exploratory analysis revealed a significant decrease in trait aggression postintervention; no significant changes were found in other anger-related clinical outcomes. To further increase acceptability and usability, a stable functioning app with self-adjustable settings, the use of smartwatches with a longer battery life, and the use of the patient’s own smartphone devices were recommended. Conclusions This study, which is one of the first attempts to enroll and evaluate the real-life use of a biocueing intervention among forensic outpatients, emphasized the importance of involving both patients and therapists throughout the development and implementation process. In the future, experimental studies, including single-case experimental designs using ecological momentary assessment, should be performed to evaluate the effectiveness of the Sense-IT intervention on clinical outcomes. An open attitude toward new technology, allowing exploration of the potential benefits of the Sense-IT app case-by-case, and training of therapists in using the app are expected to facilitate its integration in therapy.

show abstract

Relationship between heart rate variability and aggressive behavior among patients with schizophrenia hospitalized in acute wards

Cited by 8 publications

References 26 publications

An exploration of the sleep quality and potential violence among patients with schizophrenia in community

An exploration of the sleep quality and potential violence among patients with schizophrenia in community

Heart Rate Variability in Psychiatric Disorders: A Systematic Review

Development of a Wearable Biocueing App (Sense-IT) Among Forensic Psychiatric Outpatients With Aggressive Behavior: Design and Evaluation Study

Contact Info

Product

Resources

About