Psychomotor Retardation in Elderly Untreated Depressed Patients

Beheydt, Lieve; Schrijvers, Didier; Docx, Lise; Bouckaert, Filip; Hulstijn, Wouter; Sabbe, Bernard

doi:10.3389/fpsyt.2014.00196

Cited by 28 publications

(27 citation statements)

References 73 publications

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“…2, measures 22-25 and 29-32 and Fig. S2B) along with poor olfactory function and slow gait, known correlates of depression (35,36), as well as voiding dysfunction (Fig. 2, measures 39, 43, and 53).…”

Section: Medical Model Health Classesmentioning

confidence: 99%

Empirical redefinition of comprehensive health and well-being in the older adults of the United States

McClintock

Dale

Laumann

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

115

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The World Health Organization (WHO) defines health as a "state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." Despite general acceptance of this comprehensive definition, there has been little rigorous scientific attempt to use it to measure and assess population health. Instead, the dominant model of health is a disease-centered Medical Model (MM), which actively ignores many relevant domains. In contrast to the MM, we approach this issue through a Comprehensive Model (CM) of health consistent with the WHO definition, giving statistically equal consideration to multiple health domains, including medical, physical, psychological, functional, and sensory measures. We apply a data-driven latent class analysis (LCA) to model 54 specific health variables from the National Social Life, Health, and Aging Project (NSHAP), a nationally representative sample of US community-dwelling older adults. We first apply the LCA to the MM, identifying five health classes differentiated primarily by having diabetes and hypertension. The CM identifies a broader range of six health classes, including two "emergent" classes completely obscured by the MM. We find that specific medical diagnoses (cancer and hypertension) and health behaviors (smoking) are far less important than mental health (loneliness), sensory function (hearing), mobility, and bone fractures in defining vulnerable health classes. Although the MM places two-thirds of the US population into "robust health" classes, the CM reveals that one-half belong to less healthy classes, independently associated with higher mortality. This reconceptualization has important implications for medical care delivery, preventive health practices, and resource allocation.comprehensive health | aging | disease | well-being | health policy I n 1946, the World Health Organization (WHO) defined health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (1). In 1977, George Engel (2) built on this definition, calling for a new biopsychosocial model. It integrated traditional medicine with psychosocial factors, which stimulated the field of psychosomatic medicine. These ideas have been honored more as an ideal than in practice.Here, we seek to apply this comprehensive definition to characterize the health of US older adults living in their homes. Studying a representative sample of the US population ages 57-85 y old [the National Social Life, Health and Aging Project (NSHAP)], we gathered wide-ranging information on the diseases of the traditional "Medical Model" (MM) and also, psychological well-being and physical function in a "Comprehensive Model" (CM) informed by the approach by Engel (2, 3). We empirically determined if these health measures formed distinct constellations, characterizing groups of people with different patterns of health and well-being. Our large survey of 3,005 community-dwelling older adults ages 57-85 y old was not a clinical sample or a sample of con...

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Section: Medical Model Health Classesmentioning

confidence: 99%

Empirical redefinition of comprehensive health and well-being in the older adults of the United States

McClintock

Dale

Laumann

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

115

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“…Fine motor skills, on the other hand, are involved in fine movements such as writing and drawing. Previous research has applied drawing tasks in depressed subjects to reveal substantial fine motor retardation in patients with MDD [14-18]. Several studies have measured gross motor activity in psychiatric disorders by means of wrist actimetry [19, 20] and found lower gross psychomotor activity in depressed patients than in healthy controls [21-24].…”

Section: Introductionmentioning

confidence: 99%

Distinguishing Subgroups Based on Psychomotor Functioning among Patients with Major Depressive Disorder

et al. 2017

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Background: Retardation and agitation are symptoms of major depressive disorder (MDD), and their presence could play a role in determining clinically meaningful depressive subtypes such as nonmelancholic depression (NMD) and melancholic depression (MD). In this project, we explored whether three depression subgroups (NMD, MD with psychotic symptoms, and MD without psychotic symptoms) could be distinguished based on objective measures of psychomotor functioning. Methods: Sixty-nine patients with MDD underwent extensive clinical and psychomotor testing prior to treatment with electroconvulsive therapy. Psychomotor functioning was assessed subjectively using the Core Assessment of Psychomotor Change (CORE) and objectively by means of both 24-h actigraphy and performance on a fine motor drawing task. Results: The daytime activity levels measured by actigraphy were significantly lower (F = 7.1, p = 0.0004) in MD patients both with and without psychotic symptoms than in those with NMD. No objective psychomotor variable was able to distinguish between melancholic patients with and those without psychotic symptoms. Conclusions: The depression subtypes NMD, MD with psychotic symptoms, and MD without psychotic symptoms are not marked by increasing psychomotor retardation, possibly because psychomotor disturbance in MD with psychotic symptoms often consists of agitation rather than retardation, or a mixture of the two. However, psychomotor functioning as measured by actigraphy can be used to distinguish between NMD patients and MD patients.

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“…Summarily, these studies have aimed to uncover the influences of depression on motor control in young adults, despite that some of them omitted the medication status of the sample 20,26 or were under medication 22 , which might have biased the intended behavior. To our knowledge, Beheydt, Schrijvers, Docx, Bouckaert, Hulstijn and Sabbe 27 were the only who demonstrated that unmedicated depressive older adults presented motor control impairments in comparison to their nondepressed peers. Promising results were observed as they revealed that the execution and initiation times were significantly impaired according to the manipulation of the cognitive load of a figure copying task 27 .…”

Section: Introductionmentioning

confidence: 80%

“…To our knowledge, Beheydt, Schrijvers, Docx, Bouckaert, Hulstijn and Sabbe 27 were the only who demonstrated that unmedicated depressive older adults presented motor control impairments in comparison to their nondepressed peers. Promising results were observed as they revealed that the execution and initiation times were significantly impaired according to the manipulation of the cognitive load of a figure copying task 27 . The distinction of motor control aspects, on the other hand, is extremely relevant to understand the issues related to the interaction between aging and depression since it can provide an indirect measure of different brain dysfunctions 28 .…”

Section: Introductionmentioning

confidence: 80%

“…Therefore, by manipulating different motor control requirements, we may, indirectly, reveal impairments specifically linked to different brain areas. Further, the estimation of the intensity of depression is also of fundamental concern to the understanding of the interaction between aging and depression since it has been reported as one possible source of variation in the degree of cognitive impairment 27,34 . Sex is another factor that might influence the movement planning and control of depressed elderlies.…”

Section: Introductionmentioning

confidence: 99%

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Motor control assessment of community-dwelling older adults with depressive symptoms

Bicalho

Albuquerque

Paula

et al. 2017

Motriz: rev. educ. fis.

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-Aims:The purpose of this study was to investigate how depressive symptoms mediate different motor control requirements in elderlies and to assess the concurring effects fomented by the interaction between aging and depressive symptoms, providing indirect measures of brain functionality. Methods: Sixty-eight elderlies were paired in terms of age and gender and were equally distributed into depressed and nondepressed groups, according to their score on the Beck Depression Questionnaire. The participants performed the Grooved Pegboard Test placing and withdrawing pegs while execution time and error rate were measured. Results: This investigation revealed that depressive symptoms exert a broad effect upon motor control, although that the symptom intensity, as well as the interaction between aging and depression intensity, were exclusively correlated with withdrawal task, suggesting that there is a greater effect upon motor acts with higher frontal lobe requirements. Conclusion: The discrimination of motor control aspects provides a valuable contribution for the understanding of the underlying neurophysiology of the interaction between aging and depression as it represents an indirect measure of cerebral dysfunction. Further, these findings may still have clinical implications, as they can promote more rational approaches to the elaboration of preventive measures that help maintain the functional capability of depressed elderlies.

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Psychomotor Retardation in Elderly Untreated Depressed Patients

Cited by 28 publications

References 73 publications

Empirical redefinition of comprehensive health and well-being in the older adults of the United States

Empirical redefinition of comprehensive health and well-being in the older adults of the United States

Distinguishing Subgroups Based on Psychomotor Functioning among Patients with Major Depressive Disorder

Motor control assessment of community-dwelling older adults with depressive symptoms

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