Objective quantification of psychomotor disturbances in patients with a major depressive episode

Abstract

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.

Gait disorders in unipolar and bipolar depression

“…The clinical findings are in line with data from previous studies [ 26 , 30 , 39 , 41 ]. The results of current analyses show that the overall effect of cognitive tasks of varying complexity is noticeable mainly in gait speed.…”

Figure 3 from: Dimitrov R, Haralanova E, Milanov I, Ognianov S, Parvova I, Milushev E (2024) A new approach for objective monitoring of the pharmacological-treatment response in recurrent depressions. Pharmacia 71: 1-6. https://doi.org/10.3897/pharmacia.71.e125942

“…Analogous data regarding PMR have been established by other methods for objective measurement of the depressive gait (locomotion) (e.g., Wendorf et al 2002;Aybek et al 2008). They are also consistent with previous studies with the method we used in patients with endogenous (unipolar and bipolar) depressions (Terziivanova et al 2018;Haralanov et al 2021). A conclusion could be drawn that the objective and quantitative measurement of the stepping-test LMB by Comp-US-CCG enables reliable intergroup differentiation between DP, PMR, and HC.…”

“…The computer program automatically measures some standard CCG parameters, thus quantifying the individual LMB, which could serve as an objective measure of PMD at the single-patient level. Previously, it was discovered that optimal equilibriometric quantification of PMR in depressive patients might be achieved by two essential CCG parameters: "lateral sway" and "number of steps per minute " (Terziivanova et al 2018;Haralanov et al 2021). Their numerical values are displayed on the computer screen, along with a visual comparison with the limits of normative data.…”

“…Psychomotor disturbances (PMD) are cardinal features of endogenous (melancholic) depressions with important diagnostic, pathophysiological, and therapeutic implications (Schrijvers et al 2008). They are the only objectively measurable dimension of depressive psychopathology (Faurholt-Jepsen et al 2015;Terziivanova et al 2018) and could be informative on underlying neurobiological mechanisms (Wüthrich et al 2023).…”

Editorial introduction: The implications of translational neuroscience for clinical practice and its evaluation

“…Neuroscience operates validation procedures on an essentially similar basis, in search for post hoc correlations with the associated psychological scores and several papers in this Special Section exemplify an attempt to methodologically integrate the data from neuroscience with those from clinical psychological and neuropsychiatric evaluation. Here, the works by Kandilarova and colleagues, Haralanov, Terziivanova, and associates, Iancheva and co‐workers, and Gaberova, Yordanova, and colleagues are noteworthy and should be read alongside the contribution by Matanova et al who discuss the importance of brain‐based therapeutic strategies, although the identification of various inconsistencies calls for further investigations within the frameworks outlined.…”