Psychomotor Semiology in Depression: a Standardized Clinical Psychomotor Approach

Overview

Journal BMC Psychiatry

Publisher Biomed Central

Specialty Psychiatry

Date 2022 Jul 15

PMID 35841086

Authors

A Paquet

A Lacroix

B Calvet

M Girard

Affiliations

Soon will be listed here.

Abstract

Background: Although psychomotor symptoms are associated with the clinical symptomatology of depression, they are rarely assessed and standardized clinical evaluation tools are lacking. Psychomotor retardation is sometimes assessed through direct patient observations by clinicians or through a clinical observation grid, in the absence of a standardized psychomotor assessment. In this pilot study, we evaluated the feasibility of standardized psychomotor examination of patients with major depressive disorder (MDD) and detailed a psychomotor semiology in these patients.

Methods: We used a standardized psychomotor assessment to examine 25 patients with MDD and 25 age- and sex-matched healthy controls (HC) and compared their psychomotor profiles. Using standardized tests, we assessed muscle tone and posture, gross motor skills, perceptual-motor skills, and body image/organization. Clinical assessments of depressive symptoms (levels of psychomotor retardation, anxiety, and self-esteem) comprised this detailed psychomotor examination.

Results: All participants were examined using the standardized psychomotor assessment. The main results of the psychomotor examination highlighted low body image of MDD participants (p < 0.001). Significant differences between groups were found in passive muscle tone, posture, emotional control, jumping, manual dexterity, walking, and praxis. Among these psychomotor variables, body image, passivity, jumping and rhythm scores predicted an MDD diagnosis.

Conclusions: Beyond the psychomotor retardation known to be present in MDD patients, this examination revealed an entire psychomotor symptomatology characterized by elevated muscle tone, poor body image associated with poor self-esteem, slowness in global motor skills and manual praxis, and poor rhythmic adaptation. In light of these results, we encourage clinicians to consider using a standardized tool to conduct detailed psychomotor examination of patients with depressive disorders.

Trial Registration: ClinicalTrials.gov identifier: NCT04031937 , 24/07/2019.

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References

Michalak J, Troje N, Fischer J, Vollmar P, Heidenreich T, Schulte D . Embodiment of sadness and depression--gait patterns associated with dysphoric mood. Psychosom Med. 2009; 71(5):580-7. DOI: 10.1097/PSY.0b013e3181a2515c. View

Zimmerman M, Martinez J, Young D, Chelminski I, Dalrymple K . Severity classification on the Hamilton Depression Rating Scale. J Affect Disord. 2013; 150(2):384-8. DOI: 10.1016/j.jad.2013.04.028. View

Pier M, Hulstijn W, Sabbe B . Differential patterns of psychomotor functioning in unmedicated melancholic and nonmelancholic depressed patients. J Psychiatr Res. 2004; 38(4):425-35. DOI: 10.1016/j.jpsychires.2003.11.008. View

Aquil A, El Kherchi O, El Azmaoui N, Mouallif M, Guerroumi M, Chokri A . Body image dissatisfaction and lower self-esteem as major predictors of poor sleep quality in gynecological cancer patients after surgery: cross-sectional study. BMC Womens Health. 2021; 21(1):229. PMC: 8173912. DOI: 10.1186/s12905-021-01375-5. View

Venkatraman A, Edlow B, Immordino-Yang M . The Brainstem in Emotion: A Review. Front Neuroanat. 2017; 11:15. PMC: 5343067. DOI: 10.3389/fnana.2017.00015. View

Dubois B, Slachevsky A, Litvan I, Pillon B . The FAB: a Frontal Assessment Battery at bedside. Neurology. 2000; 55(11):1621-6. DOI: 10.1212/wnl.55.11.1621. View

Vinkers C, Kuzminskaite E, Lamers F, Giltay E, Penninx B . An integrated approach to understand biological stress system dysregulation across depressive and anxiety disorders. J Affect Disord. 2021; 283:139-146. DOI: 10.1016/j.jad.2021.01.051. View

de AJURIAGUERRA , ANGELERGUES R . [Body psycho-motoricity in relations with others. Apropos of Henri WALLON's work]. Evol Psychiatr (Paris). 1962; 27:13-25. View

Janssens S, Moens H, Coppens V, Vandendriessche F, Hulstijn W, Sabbe B . Psychomotor assessment as a tool to differentiate schizophrenia from other psychotic disorders. Schizophr Res. 2017; 200:92-96. DOI: 10.1016/j.schres.2017.06.047. View

10.

Lohr J, May T, Caligiuri M . Quantitative assessment of motor abnormalities in untreated patients with major depressive disorder. J Affect Disord. 2012; 146(1):84-90. PMC: 4283485. DOI: 10.1016/j.jad.2012.08.043. View

11.

Bennabi D, Vandel P, Papaxanthis C, Pozzo T, Haffen E . Psychomotor retardation in depression: a systematic review of diagnostic, pathophysiologic, and therapeutic implications. Biomed Res Int. 2013; 2013:158746. PMC: 3830759. DOI: 10.1155/2013/158746. View

12.

Sobin C, Sackeim H . Psychomotor symptoms of depression. Am J Psychiatry. 1997; 154(1):4-17. DOI: 10.1176/ajp.154.1.4. View

13.

Parker G, Hadzi-Pavlovic D, Boyce P, Wilhelm K, Brodaty H, Mitchell P . Classifying depression by mental state signs. Br J Psychiatry. 1990; 157:55-65. DOI: 10.1192/bjp.157.1.55. View

14.

Damme K, Park J, Vargas T, Walther S, Shankman S, Mittal V . Motor abnormalities, depression risk, and clinical course in adolescence. Biol Psychiatry Glob Open Sci. 2022; 2(1):61-69. PMC: 9000199. DOI: 10.1016/j.bpsgos.2021.06.011. View

15.

Caligiuri M, Ellwanger J . Motor and cognitive aspects of motor retardation in depression. J Affect Disord. 2000; 57(1-3):83-93. DOI: 10.1016/s0165-0327(99)00068-3. View

16.

Rock P, Roiser J, Riedel W, Blackwell A . Cognitive impairment in depression: a systematic review and meta-analysis. Psychol Med. 2013; 44(10):2029-40. DOI: 10.1017/S0033291713002535. View

17.

Razavi N, Horn H, Koschorke P, Hugli S, Hofle O, Muller T . Measuring motor activity in major depression: the association between the Hamilton Depression Rating Scale and actigraphy. Psychiatry Res. 2011; 190(2-3):212-6. DOI: 10.1016/j.psychres.2011.05.028. View

18.

Hausdorff J, Peng C, Goldberger A, Stoll A . Gait unsteadiness and fall risk in two affective disorders: a preliminary study. BMC Psychiatry. 2004; 4:39. PMC: 538754. DOI: 10.1186/1471-244X-4-39. View

19.

Takakusaki K, Oohinata-Sugimoto J, Saitoh K, Habaguchi T . Role of basal ganglia-brainstem systems in the control of postural muscle tone and locomotion. Prog Brain Res. 2003; 143:231-7. DOI: 10.1016/S0079-6123(03)43023-9. View

20.

Parker G . Classifying depression: should paradigms lost be regained?. Am J Psychiatry. 2000; 157(8):1195-203. DOI: 10.1176/appi.ajp.157.8.1195. View