1 Clinical Research Unit, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
2 Specialist Mental Health Services, Hillmorton Hospital, Christchurch, New Zealand.
Aust N Z J Psychiatry. 2018 Jul;52(7):652-659. doi: 10.1177/0004867417753549. Epub 2018 Feb 8.
Monitoring clinical response to treatment in depressed inpatients, particularly identifying early improvement, may be sub-optimal. This may impact adversely on patients through longer admissions and sub-optimal pharmacotherapy. Psychomotor speed is a prominent neuropsychological function which changes as recovery occurs. This study examines simple techniques used to quantify psychomotor change and their potential to contribute to monitoring recovery.
Activity levels were continuously monitored in patients diagnosed with a major depressive episode from four acute psychiatric wards using two actigraphs (commercial and scientific) for 3 weeks and linear regression used to calculate a gradient to express rate of change. Psychomotor speed was assessed using the simple Coin Rotation Task. Mood and functioning were rated using the Quick Inventory of Depressive Symptoms, Clinical Global Impression Scale and Functioning Assessment Short Test. The assessments were completed at baseline and follow-up (3 weeks), and correlations were calculated for all change measures.
In all, 24 inpatients were recruited but not all completed baseline and follow-up measures. Change in activity count ( N = 16) and psychomotor speed ( N = 13) correlated significantly with improvement in clinical measures of depressive symptoms. Actigraphs were acceptable to hospital inpatients.
The limited size of this pilot study precludes the analysis of predictive power or the influence of other variables such as depression subtypes, age, gender or variations related to medications.
Early change in simple activity and psychomotor speed warrant further investigation for utility in measuring treatment response in depressed inpatients.
监测住院抑郁症患者的治疗临床反应，特别是识别早期改善情况，可能并不理想。这可能会通过延长住院时间和药物治疗效果不佳对患者产生不利影响。精神运动速度是一种突出的神经心理学功能，随着恢复而变化。本研究探讨了用于量化精神运动变化的简单技术及其对监测恢复的潜在贡献。
使用两个活动记录仪（商业和科学）连续监测来自四个急性精神病病房的患有重度抑郁症发作的患者的活动水平，持续 3 周，并使用线性回归计算梯度以表达变化率。使用简单的硬币旋转任务评估精神运动速度。使用快速抑郁症状清单、临床总体印象量表和功能评估简短测试评估情绪和功能。在基线和随访（3 周）时完成评估，计算所有变化测量的相关性。
共招募了 24 名住院患者，但并非所有人都完成了基线和随访测量。活动计数（ N = 16）和精神运动速度（ N = 13）的变化与抑郁症状的临床改善指标显著相关。活动记录仪被住院患者接受。
这项初步研究规模有限，无法分析预测能力或其他变量（如抑郁亚型、年龄、性别或与药物相关的变化）的影响。
简单活动和精神运动速度的早期变化值得进一步研究，以衡量住院抑郁症患者的治疗反应。
