Heart rate variability and its ability to detect worsening suicidality in adolescents: A pilot trial of wearable technology

David C. Sheridan, Steven Baker, Ryan Dehart, Amber Lin, Matthew Hansen, Larisa G. Tereshchenko, Nancy Le, Craig D. Newgard, Bonnie Nagel

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objective Suicide is the 2nd leading cause of death in adolescence, and acute pediatric mental health emergency department (ED) visits have doubled in the past decade. The objective of this study was to evaluate physiologic parameters relationship to suicide severity. Methods This was a prospective, observational study from April 2018 thru November 2019 in a tertiary care pediatric emergency department (ED) and inpatient pediatric psychiatric unit enrolling acutely suicidal adolescent patients. Patients wore a wrist device that used photoplethysmography for 7 days during their acute hospitalization to measure heart rate variability (HRV). During that time, Columbia Suicide Severity Scores (CSSRS) were assessed at 3 time points. Results There was complete device data and follow-up for 51 patients. There was an increase in the high frequency (HF) component of HRV in patients that had a 25% or greater decrease in their CSSRS (mean difference 11.89 ms/ Hz; p-value 0.005). Patients with a CSSRS≥15 on day of enrollment had a lower, although not statistically significant, HF component (mean difference-8.34 ms/ Hz; p-value 0.071). Conclusion We found an inverse correlation between parasympathetic activity measured through the HF component and suicidality in an acutely suicidal population of adolescents. Wearable technology may have the ability to improve outpatient monitoring for earlier detection and intervention.

Original languageEnglish (US)
Pages (from-to)928-935
Number of pages8
JournalPsychiatry Investigation
Issue number10
StatePublished - Oct 2021


  • Child and adolescence psychiatry
  • Depressive disorder
  • Suicide

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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