Heart Rate Variability in Schizophrenia and Shizoaffective Disorder

Objective of the Review: To analyze and systematize the results of the studies of heart rate variability in schizophrenia and schizoaffective disorder. Key points. Most studies demonstrate a reduction in total heart rate variability and a decrease in parasympathetic tone and reactivity in patients with schizophrenia and schizoaffective disorder, including in response to a cognitive or stress load. And also the baroreflex sensitivity decrease was revealed. Autonomic cardiac dysregulation detected in unmedicated patients with schizophrenia, as well as in healthy first-line relatives. The extent of these changes correlates with the severity of productive, negative and affective symptoms, as well as with the presence of metabolic syndrome. Autonomic cardiac dysregulation is much more pronounced in psychotic states. Antipsychotics with anticholinergic and/or α1-adrenolytic activity can exacerbate these changes. Reductions in total heart rate variability and vagal activity are detected not only in schizophrenia, but also in other mental and somatic disorders, in the pathogenesis of which distress is involved. Conclusion. The possibility of using heart rate variability indicators as additional criteria for assessing the severity of psychosis, predicting the effectiveness of therapy, as well as for early stratification of cardiovascular risks requires further study in scientific research. Keywords: heart rate variability, autonomic nervous system, schizophrenia, schizoaffective disorder, antipsychotics, biomarkers.