Autonomic function characteristics and stratification analysis of adolescent patients with depressive disorders based on the low-frequency:high-frequency ratio

doi:10.5498/wjp.122815

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 16, Issue 10

This Article

(5)

(4)

(0)

(18)

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Journal Information of This Article

Publication Name

World Journal of Psychiatry

ISSN

2220-3206

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Oct 19, 2026; 16(10): 122815
Published online Oct 19, 2026. doi: 10.5498/wjp.122815

Autonomic function characteristics and stratification analysis of adolescent patients with depressive disorders based on the low-frequency:high-frequency ratio

Ya-Qin Zhao, Ting Wang, Nan Liu, Ping Zhao, Jiao-Jiao Sun, Ai-Qin Peng, Qiu-Chen Hu, Jia Li, Xiao-Wei Tang

Ya-Qin Zhao, Ai-Qin Peng, Xiao-Wei Tang, Department of Psychiatry, Yangzhou Wutaishan Hospital of Jiangsu Province, Teaching Hospital of Yangzhou University, Yangzhou 225003, Jiangsu Province, China

Ting Wang, Ping Zhao, Jiao-Jiao Sun, Jia Li, Department of Outpatient, Yangzhou Wutaishan Hospital of Jiangsu Province, Teaching Hospital of Yangzhou University, Yangzhou 225003, Jiangsu Province, China

Nan Liu, Department of Nursing, Yangzhou Wutaishan Hospital of Jiangsu Province, Yangzhou 225003, Jiangsu Province, China

Qiu-Chen Hu, Science and Education Section, Yangzhou Wutaishan Hospital of Jiangsu Province, Teaching Hospital of Yangzhou University, Yangzhou 225003, Jiangsu Province, China

Co-first authors: Ya-Qin Zhao and Ting Wang.

Co-corresponding authors: Jia Li and Xiao-Wei Tang.

Author contributions: Zhao YQ, Liu N, Zhao P contributed to investigation, writing-original draft; Wang T, Sun JJ, Hu QC, Li J, Tang XW contributed to writing-original draft, methodology; Peng AQ contributed to writing-original draft, conceptualization; Zhao YQ and Wang T have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper; Li J and Tang XW played important and indispensable roles in the manuscript preparation as the co-corresponding authors.

AI contribution statement: This article does not utilize AI.

Supported by 2021 Annual “Hu Xin Fund” of the Jiangsu Provincial Key Laboratory of Zoonotic Diseases, No. HX2112; Youth Talent Support Project of Jiangsu Provincial 333 Project, No. (2022)3-29-052; Elderly Health Research Project of Jiangsu Commission of Health, No. LR2022015 and No. LKZ2023020; Yangzhou City Basic Research Program (Joint Special Project)-Health and Wellness Category, No. 2025-4-24 and No. 2025-3-33; Special Research Project of National Health Commission Capacity Building and Continuing Education Center, No. GWJJZX20251001078; Yangzhou Key Research and Development Project (Social Development) Special Program, No. YZ2025083; Key Project of Medical Research Program, Jiangsu Provincial Health Commission, No. K2025051; 2025 Yangzhou Social Development Project Special Fund, No. YZ2025084; and Jiangsu Yangzhou Wutai Mountain Hospital 2025 Hospital Research Fund Grant, No. WTS2025009.

Institutional review board statement: This study earned the approval of the Ethics Committee of the Yangzhou Wutai Mountain Hospital (approval No. WTSLL2025009).

Informed consent statement: All participants signed the informed consent form before entering the study, and all procedures performed in this study involving human participants were in accordance with the Declaration of Helsinki Ethics approval and consent to.

Conflict-of-interest statement: The authors declare that they have no competing interests.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.

Data sharing statement: The datasets generated and/or analysed during the current study are not publicly available due to individual privacy but are available in summary/group level form from the corresponding author on reasonable request.

Corresponding author: Xiao-Wei Tang, MD, Chief Physician, Department of Psychiatry, Yangzhou Wutaishan Hospital of Jiangsu Province, Teaching Hospital of Yangzhou University, No. 2 Wutaishan Road, Yangzhou 225003, Jiangsu Province, China. 15062790442@163.com

Received: April 29, 2026
Revised: July 16, 2026
Accepted: August 10, 2026
Published online: October 19, 2026
Processing time: 165 Days and 1.8 Hours

Abstract

BACKGROUND

Autonomic nervous system imbalance can mediate an individual’s physiological response to psychological stress and play a role in the progression of depression; conversely, social factors such as academic stress and family environment may serve as key external risk factors for adolescent depression. To investigate the symptoms and autonomic nervous function characteristics of adolescents with depressive disorders and the correlation with sociologic data.

AIM

To explore the associations of autonomic function and psychosocial factors with adolescent depressive severity and determine the independent predictors.

METHODS

Adolescents with DDs who were treated at Wutaishan Hospital from November 2025 to March 2026 were enrolled and classified into four groups based on depressive symptoms: Normal group (59 cases); mild depression group (87 cases); moderate depression group (78 cases); and severe depression group (45 cases). Autonomic nervous function characteristics were assessed using a heart rate variability monitor, while psychological status was evaluated with the Zung Self-rating Anxiety Scale (SAS) and the Zung Self-rating Depression Scale.

RESULTS

Among the 269 adolescents with DDs, significant statistical differences existed in gender, treatment status, place of residence, payment method, per capita monthly household income, caregivers, family relationships, adverse experiences, body mass index, SAS scores, autonomic nervous function [low-frequency (LF):high-frequency (HF) ratio], and disease duration (all P values < 0.05). The independent risk factors included place of residence [odds ratio (OR) = 2.18], payment method (OR = 4.42), per capita monthly household income (OR = 0.32), presence of caregivers (OR = 3.81), family relationships (OR = 2.12), adverse experiences (OR = 2.81), SAS scores (OR = 4.17), and LF:HF ratio (OR = 1.94) with per capita monthly household income having a protective effect.

CONCLUSION

These findings suggest that clinical practice should integrate the LF:HF ratio with psychosocial factors to achieve early identification, disease stratification, and targeted intervention for adolescent DDs.

Keywords: Adolescents; Depressive disorder; Autonomic nervous function; Stratified analysis

Core Tip: Adolescent depressive disorder (DDs) severity is independently correlated with the low-frequency (LF):high-frequency (HF) ratio (reflecting autonomic nervous imbalance), anxiety symptoms, and various socio-familial factors. Per capita monthly household income is a protective factor. Integrating the LF:HF ratio with psychosocial factors can facilitate early identification, severity stratification, and precise intervention for adolescent DDs.