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

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World Journal of Psychiatry

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2220-3206

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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

Table 1 General characteristics of adolescents with depressive disorders (n = 269), n (%)/mean ± SD/median (interquartile range)

Item	Classification	Statistic
Gender	Male	95 (35.32)
Gender	Female	174 (64.68)
Diagnose	Depressive episode	156 (57.99)
Diagnose	Recurrent depressive disorder	113 (42.01)
Medical-seeking status	Initial onset	170 (63.20)
Medical-seeking status	Recurrent episodes	99 (36.80)
Place of residence	City proper	101 (37.55)
	Town	71 (26.39)
	Rural area	97 (36.06)
Payment method	At one’s own expense	126 (46.84)
Payment method	Medical insurance	143 (53.16)
Per capita monthly household income	< 3000	89 (33.09)
	3000-8000	109 (40.52)
	> 8000	71 (26.39)
Caregiver status	Parents	103 (38.29)
	Single parent (mother)	102 (37.92)
	Single parent (father)	64 (23.79)
Family relationships	Intimate	88 (32.71)
	Same as	91 (33.83)
	Drift apart	90 (33.46)
Adverse experiences	No	163 (60.59)
Adverse experiences	Yes	106 (39.41)
Body mass index	Normal	121 (44.98)
	Too light	74 (27.51)
	Excess weight	38 (14.13)
	Fat	36 (13.38)
SAS scores	Normal	86 (31.97)
	Mild	94 (34.94)
	Moderate	55 (20.45)
	Severe	34 (12.64)
SDS scores	Normal	59 (21.93)
	Mild	87 (32.34)
	Moderate	78 (29.00)
	Severe	45 (16.73)
LF:HF ratio	Normal	117 (43.49)
	Markedly sympathetic bias	82 (30.49)
	Markedly biased toward the parasympathetic system	70 (26.02)
Age		15.18 ± 1.35
Disease duration factors (year)		0 (0-0.50)

SDS: Self-rating Depression Scale; SAS: Self-rating Anxiety Scale; LF:HF: Low-frequency:high-frequency.

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Table 2 Univariate analysis of Self-rating Depression Scale in adolescents with depressive disorders (n = 269), n (%)/median (interquartile range)

Item	Classification	SDS scores				P value
Item	Classification	Normal (n = 59)	Mild (n = 87)	Moderate (n = 78)	Severe (n = 45)	P value
Gender	Male	17 (28.81)	42 (48.28)	23 (29.49)	13 (28.89)	0.02^a
Gender	Female	42 (71.19)	45 (51.72)	55 (70.51)	32 (71.11)	0.02^a
Medical-seeking status	Initial onset	28 (47.46)	57 (65.52)	54 (69.23)	31 (68.89)	0.04^a
Medical-seeking status	Recurrent episodes	31 (52.54)	30 (34.48)	24 (30.77)	14 (31.11)	0.04^a
Place of residence	City proper	26 (44.07)	38 (43.68)	23 (29.49)	14 (31.11)	0.04^a
	Town	20 (33.90)	22 (25.29)	20 (25.64)	9 (20.00)
	Rural area	13 (22.03)	27 (31.03)	35 (44.87)	22 (48.89)
Payment method	At one’s own expense	38 (64.41)	35 (40.23)	36 (46.15)	17 (37.78)	0.02^a
Payment method	Medical insurance	21 (35.59)	52 (59.77)	42 (53.85)	28 (62.22)	0.02^a
Per capita monthly household income	< 3000	12 (20.34)	24 (27.59)	33 (42.31)	20 (44.44)	0.04^a
	3000-8000	25 (42.37)	39 (44.82)	28 (35.90)	17 (37.78)
	> 8000	22 (37.29)	24 (27.59)	17 (21.79)	8 (17.78)
Caregiver status	Parents	39 (66.10)	24 (27.59)	23 (29.49)	17 (37.78)	< 0.01^a
	Single parent (mother)	16 (27.12)	38 (43.68)	34 (43.59)	14 (31.11)
	Single parent (father)	4 (6.78)	25 (28.73)	21 (26.92)	14 (31.11)
Family relationships	Intimate	32 (54.24)	27 (31.03)	18(23.08)	11(24.44)	< 0.01^a
	Same as	12 (20.34)	30 (34.48)	30(38.46)	19(42.22)
	Drift apart	15 (25.42)	30 (34.48)	30 (38.46)	15 (33.34)
Adverse experiences	No	38 (64.41)	59 (67.82)	49 (62.82)	17 (37.78)	< 0.01^a
Adverse experiences	Yes	21 (35.59)	28 (32.18)	29 (37.18)	28 (62.22)	< 0.01^a
Body mass index	Normal	31 (52.54)	38 (43.68)	32 (41.03)	20 (44.44)	0.04^a
	Too light	15 (25.42)	28 (32.18)	20 (25.64)	11(24.44)
	Excess weight	10 (16.95)	10 (11.50)	16 (20.51)	2 (4.44)
	Fat	3 (5.09)	11 (12.64)	10 (12.82)	12 (26.63)
SAS scores	Normal	26 (44.07)	33 (37.93)	19 (24.36)	8 (17.78)	< 0.01^a
	Mild	26 (44.07)	34 (39.08)	28 (35.90)	6 (13.33)
	Moderate	6 (10.17)	17 (19.54)	19 (24.36)	13 (28.89)
	Severe	1 (1.69)	3 (3.45)	12 (15.38)	18 (40.00)
LF:HF ratio	Normal	35 (59.32)	43 (49.42)	21 (26.92)	18 (40.00)	< 0.01^a
	Markedly sympathetic bias	12 (20.34)	21 (24.14)	33 (42.31)	16 (35.56)
	Markedly biased toward the parasympathetic system	12 (20.34)	23 (26.44)	24 (30.77)	11 (24.44)
Disease duration factors (years)		0.2 (0-1.00)	0 (0-0.40)	0 (0-0.20)	0 (0-0.25)	0.02^b

^aχ² test.

^bRank sum test.

SAS: Self-rating Anxiety Scale; LF:HF: Low-frequency:high-frequency.

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Table 3 Variable assignment methods for multiple linear regression

Project	Value assignment method
Gender	Male = 1, female = 2
Medical-seeking status	Initial onset = 1, recurrent episodes = 2
Place of residence	Urban area = 1, town = 2, rural area = 3
Payment method	Out-of-pocket expense = 1, medical insurance = 2
Per capita monthly household income (yuan)	< 3000 = 1, 3000-8000 = 2, > 8000 = 3
Caregiver status	Parents = 1, single parent (mother) = 2, single parent (father) = 3
Family relationships	Intimate = 1, neutral = 2, distant = 3
Adverse experiences	No = 1, yes = 2
Body mass index (kg/m²)	18.5-23.9 = 1, < 18.5 = 2, 24.0-27.9 = 3, ≥ 28.0 = 4
SAS scores	< 50 = 1, 50-59 = 2, 60-69 = 3, ≥ 70 = 4
SDS scores	< 53 = 1, 53-62 = 2, 63-72 = 3, ≥ 73 = 4
LF:HF ratio (autonomic bias)	1.0-2.0 (normal autonomic function) = 1, > 2.0 (severely sympathetic autonomic function) = 2, < 1.0 = 3 (severely parasympathetic autonomic function)
Disease duration factors (years)	Original value carryover

SDS: Self-rating Depression Scale; SAS: Self-rating Anxiety Scale; LF:HF: Low-frequency:high-frequency.

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Table 4 Multivariate analysis of the Self-rating Depression Scale for adolescent patients with depressive disorders

Variable	β	SE	P value	OR	95%CI
Constant	-10.01	2.42
Place of residence	0.78	0.304	0.01	2.18	1.20-3.96
Payment method	1.49	0.51	< 0.01	4.42	1.63-11.99
Per capita monthly household income	-1.16	0.35	< 0.01	0.32	0.16-0.62
Caregiver status	1.34	0.37	< 0.01	3.81	1.84-7.90
Family relationships	0.77	0.32	0.02	2.12	1.16-4.01
Adverse experiences	1.03	0.52	0.04	2.81	1.03-7.72
SAS scores	1.43	0.28	< 0.01	4.17	2.39-7.26
LF:HF ratio	0.66	0.32	0.04	1.94	1.04-3.63

SAS: Self-rating Anxiety Scale; LF:HF: Low-frequency:high-frequency.

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Citation: Zhao YQ, Wang T, Liu N, Zhao P, Sun JJ, Peng AQ, Hu QC, Li J, Tang XW. Autonomic function characteristics and stratification analysis of adolescent patients with depressive disorders based on the low-frequency:high-frequency ratio. World J Psychiatry 2026; 16(10): 122815
URL: https://www.wjgnet.com/2220-3206/full/v16/i10/122815.htm
DOI: https://dx.doi.org/10.5498/wjp.122815

Zhao YQ, Wang T, Liu N, Zhao P, Sun JJ, Peng AQ, Hu QC, Li J, Tang XW. Autonomic function characteristics and stratification analysis of adolescent patients with depressive disorders based on the low-frequency:high-frequency ratio. World J Psychiatry 2026; 16(10): 122815 [DOI: 10.5498/wjp.122815]

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