Clin Psychopharmacol Neurosci.  2016 May;14(2):168-176. 10.9758/cpn.2016.14.2.168.

Heart Rate Variability and the Efficacy of Biofeedback in Heroin Users with Depressive Symptoms

  • 1Department of Psychology, College of Humanities and Social Science, Kaohsiung Medical University, Kaohsiung, Taiwan.
  • 2Kaohsiung Drug Abuser Treatment Center, Agency of Corrections, Ministry of Justice, Kaohsiung, Taiwan.
  • 3Institute of Gerontology, National Cheng Kung University, Tainan, Taiwan.
  • 4Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
  • 5Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.


OBJECTIVE: Low heart rate variability (HRV) has been confirmed in heroin users, but the effects of heart-rate-variability-biofeedback in heroin users remain unknown. This study examined (1) correlations between depression and HRV indices; (2) group differences in HRV indices among a heroin-user group, a group with major depressive disorder but no heroin use, and healthy controls; and (3) the effects of heart-rate-variability-biofeedback on depressive symptoms, HRV indices, and respiratory rates within the heroin group.
All participants completed a depression questionnaire and underwent electrocardiogram measurements, and group differences in baseline HRV indices were examined. The heroin group underwent electrocardiogram and respiration rate measurements at baseline, during a depressive condition, and during a happiness condition, before and after which they took part in the heart-rate-variability-biofeedback program. The effects of heart-rate-variability-biofeedback on depressive symptoms, HRV indices, and respiration rates were examined.
There was a negative correlation between depression and high frequency of HRV, and a positive correlation between depression and low frequency to high frequency ratio of HRV. The heroin group had a lower overall and high frequency of HRV, and a higher low frequency/high frequency ratio than healthy controls. The heart-rate-variability-biofeedback intervention increased HRV indices and decreased respiratory rates from pre-intervention to post-intervention.
Reduced parasympathetic and increased sympathetic activations were found in heroin users. Heart-rate-variability-biofeedback was an effective non-pharmacological intervention to restore autonomic balance.


Autonomic nervous system; Depression; Heart-rate-variability-biofeedback; Heroin
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