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Gender differences in cardiac autonomic modulation during medical internship


  • This study was supported by a grant from Chang Gung Memorial Hospital, two grants from the National Science Council (Taiwan), and a grant from the Ministry of Education Aim for the Top University Plan. Yu-Hsuan Lin and Ching-Yen Chen contributed equally to this work.

Address correspondence to: Cheryl C. H. Yang, Ph.D., Sleep Research Center and Institute of Brain Science, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan. E-mail:


Medical internship is known to be a time of high stress and long working hours, which increases the risk of depression and cardiovascular disease. Gender differences in medical interns' cardiovascular risk have not been reported previously. Thirty-eight medical interns (29 males) were repeatedly tested for depressive symptoms using the Hospital Anxiety and Depression Scale and 5-min spectral analysis of heart rate variability (HRV) at 3-month intervals during their internship. Among the male interns, the variance of the heart rate decreased at 6, 9, 12 months, and a reduced high frequency, which suggests reduced cardiac parasympathetic modulation, was found at 9 and 12 months into their internship. Increased depressive symptoms were also identified at 12 months in the male group. No significant differences in depression or any of the HRV indices were identified among the female interns during their internship.

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