Author: Hugo D Critchley1, Samantha P Sherrill2, Donna L Ewing3, Cassandra Gould van Praag4, Haniah Habash-Bailey5, Lisa Quadt2, Jessica A Eccles6, Fran Meeten5, Anna-Marie Jones7, Sarah N Garfinkel8
Affiliation: <sup>1</sup> Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; Sussex Partnership NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland; Sussex Neuroscience, University of Sussex, United Kingdom of Great Britain and Northern Ireland. Electronic address: h.critchley@bsms.ac.uk.
<sup>2</sup> Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; Sussex Neuroscience, University of Sussex, United Kingdom of Great Britain and Northern Ireland.
<sup>3</sup> Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; School of Humanities and Social Science, University of Brighton, United Kingdom of Great Britain and Northern Ireland.
<sup>4</sup> Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; Department of Psychiatry, University of Oxford, United Kingdom of Great Britain and Northern Ireland.
<sup>5</sup> Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; School of Psychology, University of Sussex, United Kingdom of Great Britain and Northern Ireland.
<sup>6</sup> Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; Sussex Partnership NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland; Sussex Neuroscience, University of Sussex, United Kingdom of Great Britain and Northern Ireland.
<sup>7</sup> Sussex Partnership NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland.
<sup>8</sup> Institute of Cognitive Neuroscience, University College London, United Kingdom of Great Britain and Northern Ireland.
Conference/Journal: Auton Neurosci
Date published: 2023 Jan 13
Other:
Volume ID: 245 , Pages: 103072 , Special Notes: doi: 10.1016/j.autneu.2023.103072. , Word Count: 259
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.
Keywords: Anxiety; Cardiac physiology; Interoception; Psychosis; Transdiagnostic.
PMID: 36709619 DOI: 10.1016/j.autneu.2023.103072