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抑郁的精神运动症状学:一种标准化的临床精神运动方法。

Psychomotor semiology in depression: a standardized clinical psychomotor approach.

机构信息

Department of research and innovation, Centre Hospitalier Esquirol, Limoges, France.

INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.

出版信息

BMC Psychiatry. 2022 Jul 15;22(1):474. doi: 10.1186/s12888-022-04086-9.

Abstract

BACKGROUND

Although psychomotor symptoms are associated with the clinical symptomatology of depression, they are rarely assessed and standardized clinical evaluation tools are lacking. Psychomotor retardation is sometimes assessed through direct patient observations by clinicians or through a clinical observation grid, in the absence of a standardized psychomotor assessment. In this pilot study, we evaluated the feasibility of standardized psychomotor examination of patients with major depressive disorder (MDD) and detailed a psychomotor semiology in these patients.

METHODS

We used a standardized psychomotor assessment to examine 25 patients with MDD and 25 age- and sex-matched healthy controls (HC) and compared their psychomotor profiles. Using standardized tests, we assessed muscle tone and posture, gross motor skills, perceptual-motor skills, and body image/organization. Clinical assessments of depressive symptoms (levels of psychomotor retardation, anxiety, and self-esteem) comprised this detailed psychomotor examination.

RESULTS

All participants were examined using the standardized psychomotor assessment. The main results of the psychomotor examination highlighted low body image of MDD participants (p < 0.001). Significant differences between groups were found in passive muscle tone, posture, emotional control, jumping, manual dexterity, walking, and praxis. Among these psychomotor variables, body image, passivity, jumping and rhythm scores predicted an MDD diagnosis.

CONCLUSIONS

Beyond the psychomotor retardation known to be present in MDD patients, this examination revealed an entire psychomotor symptomatology characterized by elevated muscle tone, poor body image associated with poor self-esteem, slowness in global motor skills and manual praxis, and poor rhythmic adaptation. In light of these results, we encourage clinicians to consider using a standardized tool to conduct detailed psychomotor examination of patients with depressive disorders.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT04031937 , 24/07/2019.

摘要

背景

尽管精神运动症状与抑郁症的临床症状有关,但它们很少被评估,也缺乏标准化的临床评估工具。精神运动迟滞有时通过临床医生对患者进行直接观察或通过临床观察网格进行评估,但缺乏标准化的精神运动评估。在这项初步研究中,我们评估了对重度抑郁症(MDD)患者进行标准化精神运动检查的可行性,并详细描述了这些患者的精神运动症状。

方法

我们使用标准化的精神运动评估检查了 25 名 MDD 患者和 25 名年龄和性别匹配的健康对照者(HC),并比较了他们的精神运动特征。我们使用标准化测试评估了肌肉张力和姿势、粗大运动技能、知觉运动技能和身体形象/组织。详细的精神运动检查包括对抑郁症状(精神运动迟滞、焦虑和自尊水平)的临床评估。

结果

所有参与者均接受了标准化精神运动评估。精神运动检查的主要结果突出了 MDD 参与者的低身体形象(p<0.001)。组间存在显著差异的项目包括被动肌肉张力、姿势、情绪控制、跳跃、手灵巧性、行走和动作。在这些精神运动变量中,身体形象、被动性、跳跃和节奏评分预测了 MDD 的诊断。

结论

除了已知存在于 MDD 患者中的精神运动迟滞外,这项检查还揭示了一种完整的精神运动症状,其特征是肌肉张力升高、与低自尊相关的不良身体形象、整体运动技能和手动动作缓慢以及节律适应不良。鉴于这些结果,我们鼓励临床医生考虑使用标准化工具对抑郁障碍患者进行详细的精神运动检查。

试验注册

ClinicalTrials.gov 标识符:NCT04031937,2019 年 7 月 24 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/693f/9287955/b7107abecc6c/12888_2022_4086_Fig1_HTML.jpg

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