van Diermen Linda, Schrijvers Didier, Cools Olivia, Birkenhäger Tom K, Fransen Erik, Sabbe Bernard G C
Collaborative Antwerp Psychiatric Research Institute (CAPRI), Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium.
University Department, Psychiatric Hospital Duffel, VZW Emmaüs, Duffel, Belgium.
Neuropsychobiology. 2017;76(4):199-208. doi: 10.1159/000490072. Epub 2018 Jul 4.
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.
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.
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.
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.
迟滞和激越为重度抑郁症（MDD）的症状，它们的存在可能在确定具有临床意义的抑郁亚型（如非忧郁性抑郁症（NMD）和忧郁性抑郁症（MD））方面发挥作用。在本项目中，我们探讨了是否可以基于精神运动功能的客观测量来区分三个抑郁症亚组（NMD、伴有精神病性症状的MD和不伴有精神病性症状的MD）。
69例MDD患者在接受电休克治疗前接受了广泛的临床和精神运动测试。使用精神运动变化核心评估（CORE）主观评估精神运动功能，并通过24小时活动记录仪和精细运动绘图任务表现进行客观评估。
活动记录仪测量的日间活动水平在伴有和不伴有精神病性症状的MD患者中均显著低于NMD患者（F = 7.1，p = 0.0004）。没有客观的精神运动变量能够区分伴有和不伴有精神病性症状的忧郁症患者。
抑郁症亚型NMD、伴有精神病性症状的MD和不伴有精神病性症状的MD并非以精神运动迟滞加重为特征，可能是因为伴有精神病性症状的MD中的精神运动障碍通常由激越而非迟滞或两者混合组成。然而，通过活动记录仪测量的精神运动功能可用于区分NMD患者和MD患者。
