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Decreased heart rate variability (HRV) has been proposed in bipolar disorder. To date, there has been no adequate study that has investigated resting HRV in unmedicated patients with bipolar disorder in the manic state.

To examine whether bipolar mania is associated with decreased HRV, 61 unmedicated patients with bipolar mania and 183 healthy volunteers aged 20–65 years were recruited for this case–control analysis. The Young Mania Rating Scale (YMRS), Clinical Global Impression‐Severity, Hamilton Depression Rating Scale (HAM‐D), and Hamilton Anxiety Rating Scale (HAM‐A) were used for the clinical ratings. Cardiac autonomic function was evaluated by measuring HRV parameters and the frequency‐domain indices of HRV were obtained.

Patients with bipolar mania exhibited significantly lower mean RR interval, variance, low‐frequency (LF)‐HRV, and high‐frequency …