Tamada Yu, Inoue Takeshi, Sekine Atsushi, Toda Hiroyuki, Takeshima Minoru, Sasaki Masaaki, Fujimura Yota, Ohmae Susumu
Department of Psychiatry Tokyo Medical University Hachioji Medical Center, Hachioji Tokyo Japan.
Department of Psychiatry Toranomon Hospital Tokyo Japan.
PCN Rep. 2024 Oct 14;3(4):e70022. doi: 10.1002/pcn5.70022. eCollection 2024 Dec.
In the DSM-5, it is specified that severe cases of major depressive disorder with anxious distress (ANXD) may be accompanied with motor agitation. Agitation, on the other hand, is one of the main characteristics of major depressive disorder with melancholic features (MEL). The purpose of this study was to compare ANXD and MEL in terms of psychomotor disturbance.
A total of 106 patients with major depressive disorder were included in the study. Psychomotor disturbance was assessed using the CORE measure. The associations of ANXD and MEL with the CORE measure subscales of psychomotor retardation, agitation, and noninteractiveness were analyzed using multivariate logistic analysis.
Retardation scores (odds ratio [OR] = 0.63, 95% confidence interval [CI] = 0.52-0.77) were associated with fewer diagnoses of ANXD, whereas agitation scores (OR = 2.23, 95% CI = 1.60-3.13) were associated with more diagnoses of ANXD. Both noninteractiveness (OR = 1.23, 95% CI = 1.06-1.42) and agitation (OR = 1.27, 95% CI = 1.02-1.58) scores were associated with increased diagnoses of MEL.
Among the characteristics of psychomotor disturbance, agitation is a common feature of both ANXD and MEL, and ANXD and the agitated type of MEL may be overlapping concepts. On the other hand, ANXD is distinguished from the retarded type of MEL by its low level of retardation, whereas MEL but not ANXD is characterized by noninteractiveness.
在《精神疾病诊断与统计手册》第5版（DSM - 5）中明确指出，伴有焦虑痛苦的重度抑郁症（ANXD）严重病例可能伴有运动性激越。另一方面，激越是伴有抑郁特征的重度抑郁症（MEL）的主要特征之一。本研究的目的是比较ANXD和MEL在精神运动障碍方面的情况。
本研究共纳入106例重度抑郁症患者。使用CORE量表评估精神运动障碍。采用多因素逻辑分析，分析ANXD和MEL与CORE量表中精神运动迟缓、激越和无交互性分量表之间的关联。
迟缓得分（优势比[OR] = 0.63，95%置信区间[CI] = 0.52 - 0.77）与ANXD诊断较少相关，而激越得分（OR = 2.23，95% CI = 1.60 - 3.13）与ANXD诊断较多相关。无交互性得分（OR = 1.23，95% CI = 1.06 - 1.42）和激越得分（OR = 1.27，95% CI = 1.02 - 1.58）均与MEL诊断增加相关。
在精神运动障碍的特征中，激越是ANXD和MEL的共同特征，ANXD和激越型MEL可能是重叠的概念。另一方面，ANXD与迟缓型MEL的区别在于其迟缓程度较低，而MEL而非ANXD的特征是无交互性。
