Obsessive Compulsive Disorder Associates With Elevated Resting Heart Rate

Patients with obsessive-compulsive disorder (OCD) were found to have increased sympathetic and decreased parasympathetic activity compared with healthy controls. These findings were published in Clinical Neurophysiology.

Untreated patients (n=51) with OCD were recruited from the University Hospital Leipzig in Germany and age- and gender-matched healthy controls (n=28) were recruited from the university’s psychiatry department between 2009 and 2014. Study participants were evaluated by a 15-minute resting-state electrocardiogram to determine heart rate variability (HRV) and symptoms of OCD were assessed using the Clinical Global Impression (CGI) instrument. Response to treatment was evaluated at 3 to 6 months after serotonin reuptake inhibitor and/or psychological therapy.

The OCD and control cohorts were aged mean 34.0 (SD, 10.5) and 35.2 (SD, 12.5) years and 41.20% and 40.00% were men, respectively. Stratified by treatment response, nonresponders (n=19) were older (P =.01) and had higher CGI severity of illness scores (P =.01) compared with responders to treatment.

The only HRV marker that differed between OCD and control cohorts was mean heart rate, which was elevated among the patients with OCD (mean, 72.7 vs 66.43 bpm; P .001).

Using only HRV markers, OCD could be predicted among 76.6% of study participants. The prediction model had an 88% sensitivity, 57% specificity, and an area under the curve (AUC) of 83%.

Among the OCD group, nonresponders had a lower log of high-frequency power (mean, 2.4 vs 2.77 ms2; P =.03). High-frequency power was correlated with CGI efficacy index scores (r, -0.41; P .01).

Using only HRV parameters, treatment response was predicted correctly among 79.6% of participants in a model with an 87% sensitivity, 67% specificity, and 88.2% AUC.

This study may have been limited by not stratifying patients by OCD symptomology or by OCD treatment.

“In conclusion, this study showed that OCD patients suffer from a higher heart rate during rest in comparison to healthy controls. However, a lowered parasympathetic tone was positively associated with treatment response,” stated the study authors.


Olbrich H, Jahn I, Stengler K, Seifritz E, Colla M. Heart rate variability in obsessive compulsive disorder in comparison to healthy controls and as predictor of treatment response. Clin Neurophysiol. 2022;138:123-131. doi:10.1016/j.clinph.2022.02.029