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Cardiac interoception in patients accessing secondary mental health services: a transdiagnostic study

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posted on 2023-06-10, 05:58 authored by Hugo CritchleyHugo Critchley, Samantha Sherrill, Donna Ewing, Cassandra Gould van Praag, Haniah Habash-Bailey, Lisa QuadtLisa Quadt, Jessica EcclesJessica Eccles, Frances Meeten, Anna-Marie Jones, Sarah Garfinkel
Background Abnormalities in the regulation of physiological arousal and interoceptive processing are implicated in the expression and maintenance of specific psychiatric conditions and symptoms. We undertook a cross-sectional characterisation of patients accessing secondary mental health services, recording measures relating to cardiac physiology and interoception, to understand how physiological state and interoceptive ability relate transdiagnostically to affective symptoms. Methods Participants were patients (n?=?258) and a non-clinical comparison group (n?=?67). Clinical diagnoses spanned affective disorders, complex personality presentations and psychoses. We first tested for differences between patient and non-clinical participants in terms of cardiac physiology and interoceptive ability, considering interoceptive tasks and a self-report measure. We then tested for correlations between cardiac and interoceptive measures and affective symptoms. Lastly, we explored group differences across recorded clinical diagnoses. Results Patients exhibited lower performance accuracy and confidence in heartbeat discrimination and lower heartbeat tracking confidence relative to comparisons. In patients, greater anxiety and depression predicted greater self-reported interoceptive sensibility and a greater mismatch between performance accuracy and sensibility. This effect was not observed in comparison participants. Significant differences between patient groups were observed for heart rate variability (HRV) although post hoc differences were not significant after correction for multiple comparisons. Finally, accuracy in heartbeat tracking was significantly lower in schizophrenia compared to other diagnostic groups. Conclusions The multilevel characterisation presented here identified certain physiological and interoceptive differences associated with psychiatric symptoms and diagnoses. The clinical stratification and therapeutic targeting of interoceptive mechanisms is therefore of potential value in treating certain psychiatric conditions.

History

Publication status

  • Published

File Version

  • Published version

Journal

Autonomic Neuroscience: Basic and Clinical

ISSN

1566-0702

Publisher

Elsevier

Volume

245

Page range

1-15

Department affiliated with

  • BSMS Neuroscience Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2023-01-16

First Open Access (FOA) Date

2023-02-22

First Compliant Deposit (FCD) Date

2023-01-13

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