From the clinical practice and some experimental studies, it is apparent that paranoid schizophrenia patients tend to assign emotional salience to neutral social stimuli. This aberrant cognitive bias has been conceptualized to result from increased emotional arousal, but direct empirical data are scarce. The aim of the present study was to quantify the subjective emotional arousal (SEA) evoked by emotionally non-salient (neutral) compared to emotionally salient (negative) social stimuli in schizophrenia patients and healthy controls. Thirty male inpatients with paranoid schizophrenia psychosis and 30 demographically matched healthy controls rated their level of SEA in response to neutral and negative social scenes from the International Affective Picture System and the Munich Affective Picture System. Schizophrenia patients compared to healthy controls had an increased overall SEA level. This relatively higher SEA was evoked only by the neutral but not by the negative social scenes. To our knowledge, the present study is the first designed to directly demonstrate subjective emotional over-arousal to neutral social scenes in paranoid schizophrenia. This finding might explain previous clinical and experimental data and could be viewed as the missing link between the primary neurobiological and secondary psychological mechanisms of paranoid psychotic-symptom formation. Furthermore, despite being very short and easy to perform, the task we used appeared to be sensitive enough to reveal emotional dysregulation, in terms of emotional disinhibition/hyperactivation in paranoid schizophrenia patients. Thus, it could have further research and clinical applications, including as a neurobehavioral probe for imaging studies.

Rationale, aims and objectives Psychomotor disturbances have been regarded as cardinal symptoms of depression for centuries, and their objective assessment may have predictive value with respect to the severity of clinical depression, treatment outcome, and prognosis of the depressive disorder. In clinical practice, psychomotor disturbances are evaluated and measured subjectively—through clinical observation and/or by means of rating scales. Our aim is to introduce a novel objective approach for recording and measuring psychomotor activity and reactivity in patients with clinical depression. Method Psychomotor indicators of activity and reactivity were objectively recorded and measured using computerized ultrasonographic cranio‐corpo‐graphy. Results and discussion Objective and quantitative assessment of psychomotor symptoms may have pathophysiological significance as psychomotor disturbances go along with affective dysregulation. It is presumed that common neurotransmitter pathology in the brain structures causes simultaneously psychomotor and affective dysregulation that underlies the pathophysiology of the depressive disorder. Also, psychomotor retardation is thought to be a cardinal depressive symptom in endogenous depressions—unipolar and bipolar. On the other hand, psychomotor agitation may be considered as latent bipolarity, although the presence of manic symptoms within a depressive state and the role of psychomotor agitation in depressive patients are still disputable. Conclusion Integration between different methods is needed to improve the understanding of psychopathology and neurobiology of a disputable diagnosis such as clinical depression. We introduce in the field of psychiatry an objective and quantitative approach, which could permit psychomotor discrimination not only between depressive patients and healthy controls but also between subgroups of depressive patients.

Psychiatry is the only medical specialty that lacks clinically applicable biomarkers for objective evaluation of the existing pathology at a single-patient level. On the basis of an original translational equilibriometric method for evaluation of movement patterns, we have introduced in the everyday clinical practice of psychiatry an easy-to-perform computerized objective quantification of the individual locomotor behaviour during execution of the Unterberger stepping test. For the last 20 years, we have gradually collected a large database of more than 1000 schizophrenic patients, their relatives, and matched psychiatric, neurological, and healthy controls via cross-sectional and longitudinal investigations. Comparative analyses revealed transdiagnostic locomotor similarities among schizophrenic patients, high-risk schizotaxic individuals, and neurological patients with multiple sclerosis and cerebellar ataxia, thus suggesting common underlying brain mechanisms. In parallel, intradiagnostic dissimilarities were revealed, which allow to separate out subclinical locomotor subgroups within the diagnostic categories. Prototypical qualitative (dysmetric and ataxic) locomotor abnormalities in schizophrenic patients were differentiated from 2 atypical quantitative ones, manifested as either hypolocomotion or hyperlocomotion. Theoretical analyses suggested that these 3 subtypes of locomotor abnormalities could be conceived as objectively measurable biomarkers of 3 schizophrenic subgroups with dissimilar brain mechanisms, which require different treatment strategies. Analogies with the prominent role of locomotor measures in some well-known animal models of mental disorders advocate for a promising objective translational research in the so far over-subjective field of psychiatry. Distinctions among prototypical, atypical, and diagnostic biomarkers, as well as between neuromotor and psychomotor locomotor abnormalities, are discussed. Conclusions are drawn about the translational and clinical implications of the new approach and its future perspectives.

IntroductionPsychomotor disturbances are among the core symptoms of endogenous depression. They reflect the underlying pathophysiology of the depressive episode and are sensitive to the neurobiological effects of its pharmacological treatment. Being objectively manifested, the psychomotor functions and dysfunctions are technically recordable and measurable by the available motion analysis systems.AimsTo objectively record and measure the psychomotor dysfunctions in bipolar depression and their dynamics during pharmacological treatment.MethodsWe introduced an original (internationally patented) equilibriometric method for objective and quantitative recording of psychomotor dysfunctions during stepping locomotion in 37 hospitalized patients with bipolar depression and 30 well-matched healthy controls. Two separable psychomotor functions were analyzed in parallel: conscious (voluntary) activity and subconscious (automatic) reactivity. Both patients and controls were examined twice in order to quantify their psychomotor dynamics. Patients were examined at the first day of their hospitalisation and the day before their discharge. The two consecutive examinations of the controls were with equivalent time intervals.ResultsThere was no significant psychomotor dynamics (P > 0.05) in the healthy controls between their first and second equilibriometric recording. Psychomotor activity and/or reactivity of the patients were relatively slower at their first recording and significantly accelerated (P < 0.05) at their second recording after effective pharmacological treatment.ConclusionsObjective recording and quantitative assessment of psychomotor dynamics in patients with bipolar depression during the pharmacological treatment of their current episode could be a sensitive measure of their improvement and might be used as a surrogate pharmacodynamic biomarker for objective treatment monitoring.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionThe basic role of cerebellar dysfunctions in schizophrenia pathophysiology is already well-known. Importantly, cerebellar signs such as gait and balance coordination deficits are objectively manifested and measurable. However, both early detection and treatment monitoring of the illness are still-based mainly on subjective psychopathological symptoms.AimsTo introduce an objective and quantitative approach to the cerebellar gait and balance disorders in schizophrenia.MethodsAn original (internationally patented) method for objective equilibriometric quantification of stepping locomotion (a kind of motion analysis system) was developed and then applied repetitively in 230 schizophrenic patients and 230 well-matched healthy controls.ResultsSubclinical but objectively measurable equilibriometric locomotor ataxia (ELA) was identified in a large proportion of the investigated patients. Its severity fluctuated along with the changes in the clinical state. As a rule, the degree of ELA transiently increases during psychotic exacerbation and gradually returns to its prepsychotic level during therapeutic remission. Data analysis revealed that the basic (prepsychotic and postpsychotic) ELA could be viewed as a new schizotaxic biomarker (trait-marker) for schizophrenia, while the degree of its severity could serve as a new objectively measurable state-marker for psychosis. Besides, its dynamics during antipsychotic treatment might be used as an objective measure of the therapeutic response (a kind of surrogate pharmacodynamic biomarker).ConclusionsObjective quantification of the ELA allows for early detection of subclinical signs of cerebellar ataxia (or schizotaxia) in individuals at high-risk for schizophrenia, whereas in psychotic patients it permits their objective antipsychotic-treatment monitoring.Disclosure of interestThe authors have not supplied their declaration of competing interest.