P wave dispersion in obsessive-compulsive disorder

Relationship between the early repolarization pattern and a history of suicide attempts among drug-free psychiatric patients

Aim

Suicide attempts are an important severe psychiatric symptom and a clear outcome for mental disorders. Although the relationship between the early repolarization pattern in electrocardiogram and psychiatric disorders has recently been reported, these reports have not been able to exclude the influence of psychiatric drugs. This study aimed to investigate the relationship between the early repolarization pattern and a history of suicide attempts among patients not receiving psychiatric medication.

Methods

A total of 71 patients with a history of suicide attempts were investigated, 38 of whom were analyzed for this study. We compared the frequency of the early repolarization pattern between a suicide attempt group and a control group. Then, we investigated the association between the early repolarization pattern and the suicide attempt group by logistic regression analysis, including electrocardiographic findings associated with psychiatric disorders.

Results

The findings indicated that the frequency of the early repolarization pattern was significantly higher in the suicide attempt group (n = 20; 52.6%) than in the control group (n = 4; 10.5%) (P < 0.001), and the results of the logistic regression analysis indicated that the early repolarization pattern was associated with suicide attempts.

Conclusions

These findings suggest that the early repolarization pattern is associated with a history of suicide attempts.

Electrocardiographic Evaluation of the Ventricular Arrhythmia Risk in Patients Diagnosed With Schizophrenia

OBJECTIVE

The purpose of this study was to examine electrocardiographic ventricular arrhythmia predictors in patients with schizophrenia by comparing with healthy controls.

METHODS

The study included 100 patients with schizophrenia and 100 healthy controls. Electrocardiography (ECG) was performed on all participants in resting position. T-wave peak to end (Tp-e), QT ranges, P-wave dispersion (Pd), and R-R range were measured. Then, the Schizophrenia Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS) were applied to the schizophrenia group.

RESULTS

The PANSS positive symptom subscale was calculated as 10.41 (SD = 2.27), the negative symptom subscale was calculated as 14.44 (SD = 5.42), and the overall functionality level was calculated as 27.04 (SD = 5.43). The mean CDSS score was determined to be 3.74 (SD = 2.15). No differences were detected in the heart rate measurements of the patient and control groups in ECG results (P = .427). The minimum QT interval and minimum Tp-e wave times were found to be low in the patient group (P < .001 for both intervals). Corrected QTc dispersion, Pd, Tp-e dispersion, and QT dispersion were found to be higher in the patient group than in healthy controls (P < .001 for all intervals).

DISCUSSION

Based on our results, it is possible to speculate that patients with schizophrenia are at a risk of developing cardiac arrhythmia and cardiac dysfunction if they do not receive treatment. For this reason, clinicians should pay attention to cardiac transmission problems when organizing the treatment of patients. Further studies should be conducted to determine cardiac problems in patients with schizophrenia.

QT and P-wave dispersion during the manic phase of bipolar disorder

BACKGROUND AND AIM

Patients with bipolar disorder (BD) are at increased risk for cardiovascular diseases and complications. This increased risk is considered to be associated with the autonomic nervous system (ANS) abnormalities. However, there is little or no documentation of the relationship between this increased risk and the phases of BD. In this study, we aimed to compare the changes in the QT dispersion (QTd) and P-wave dispersion (Pd), which are predictors of sudden cardiac death and atrial fibrillation, between the patients with manic BD and healthy controls.

PARTICIPANTS AND METHODS

The study included a patient group of 44 patients (26 female and 18 male) that were hospitalized due to a diagnosis of manic BD and met the inclusion criteria, and a control group of 34 age- and gender-matched healthy individuals (21 female and 13 male) with no history of psychiatric and neurological disorders. The QTd and Pd values were determined in each participant by performing the standard 12-lead body surface electrocardiography (ECG).

RESULTS

The principal electrocardiographic indicators including corrected maximum QT interval, corrected QT dispersion, and minimum P-wave duration significantly increased in the patient group compared to the control group (t=2.815, p<0.01; t=4.935, p<0.001; t=3.337, p<0.001, respectively).

CONCLUSION

The results indicated that patients with manic BD are at increased risk for cardiovascular autonomic dysfunction. Therefore, clinicians should be more careful about ECG changes and related possible cardiac conduction problems such as cardiac arrthythmias in patients with manic BD. Further longitudinal studies are needed to investigate BD and its phases (depression, mania, and hypomania) with regard to ANS and cardiac abnormalities.