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Am J Psychiatry 1997; 154:4-17
Copyright © 1997 by American Psychiatric Association
Psychomotor symptoms of depression
C Sobin and HA Sackeim
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
OBJECTIVE: The authors summarize current knowledge regarding the
psychomotor symptoms of depression. METHOD: Findings from the objective
quantification of psychomotor symptoms are reviewed, and methodological
issues are considered. The contemporary empirical literature regarding the
diagnostic, prognostic, and potential pathophysiologic significance of
psychomotor symptoms is summarized. RESULTS: It has been repeatedly shown
that depressed patients differ from normal and psychiatric comparison
groups with regard to objectively quantified gross motor activity, body
movements, speech, and motor reaction time. Course of illness, diurnal
variation, medication status, sex, and age are associated with agitation
and retardation and should be controlled when one is studying psychomotor
symptoms. Psychomotor symptoms in depression may have unique significance.
They have high discriminative validity, may be the only symptoms of
depression that distinguish depression subtypes, and are predictive of good
response to tricyclic antidepressants. Results of brain imaging and
biochemical studies link depression and motor symptoms to abnormalities in
the basal ganglia and basal ganglia/thalamo-cortical circuits. CONCLUSIONS:
The investigation of psychomotor disturbance in depression is specifically
consistent with neo-Kraepelinian standards for the study of psychiatric
disorders. Our current knowledge of psychomotor symptoms is conceptually
obscure, yet a large body of evidence specifies their manifestation and
supports their significance. Identifying the incidence of abnormal motor
behaviors in depressed patients and assessing the component processes that
accompany and determine their manifestation may be important advances in
the study of psychomotor symptoms in depression.
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