Review Article

Psychomotor Retardation in Depression: A Systematic Review of Diagnostic, Pathophysiologic, and Therapeutic Implications

Table 1

Studies exploring experimental assessments of psychomotor retardation.

AuthorsSample (criteria)TreatmentsMeasureVariables

Szabadi et al. 1976 [28] Depressed = 4 (NS)
Controls = 4
AmitriptylineAutomatic speech
HDRS
Speech pause time
Phonation time
Greden et al. 1981 [29] MDD = 36 (RDC)
24 UP/12 BP
Controls = 19
NSAutomatic speech
HDRS
Speech pause time
Phonation time
Hardy et al. 1984 [22] MDD = 16 (DSM III)Clomipramine
Mianserin ECT
Automatic speech
HDRS
SRRS
Speech pause time
Phonation time
Hoffmann et al. 1985 [23] MDD = 22 (RDC)
12 UP/10 BP
Controls = 15
Drug-freeAutomatic speech
SRRS
DST/REM
Speech pause time
Phonation time
Cortisol levels
REM latency
Nilsonne 1987 [30] MEL = 8 (RDC)
non-MEL = 8
Antidepressant
Neuroleptics
Lithium
Automatic speech
CPRS
Speech pause time
Phonation time
FO
Nilsonne 1988 [31] MEL = 21 (DSM III)
non-MEL = 7
Antidepressant
Neuroleptics
Automatic speech
Free speech
Speech pause time
Phonation time
FO
5P
Kuny St. and Stassen 1993 [32] MDD = 30 (ICD)
Controls = 30
AntidepressantAutomatic speech
HDRS
Speak flow
Prosody
Flint et al. 1993 [33] MDD = 30 (DSM III-R)
+aged > 60
Controls = 30
Parkinsonian = 30
AntidepressantAutomatic speech
HDRS
F2
Spirantization
Voice onset time
Alpert et al. 2001 [34] MDD = 12 (DSM III-R)
+aged over 60
+HDRS ≥ 20
Sertraline
Nortriptyline
Automatic speech
Free speech
HDRS
Fluency and prosody at day 0 and week 12
Cannizzaro et al. 2004 [35] Depressed = 7 (NS)
+ HDRS ≥ 17
NSFree speech
HDRS
Speech pause time
Phonation time
FO
Hergueta et al. 1996 [36]MDD = 40 (DSM IV)
Controls = 40
Tricyclics
IMAO
SRRI
Gait analysisSpatial and temporal parameters of gait
Lemke et al. 2000 [37] MDD = 12 (DSM IV)
Controls = 16
Amitriptyline
Paroxetine
Doxepin
Gait analysisStride length
Gait velocity
Double limb support
Hausdorff et al. 2004 [38] MDD = 32 (DSM IV)
Controls = 18
NSGait analysisStride time variability
Swing time variability
Lecrubier 2006 [39] Depressed = 26 (NS)
Controls = 18
AntidepressantGait Analysis before and after treatmentSpeed of propulsion of heel
Stride length
Royant-Parola et al. 1986 [26] UP = 12 (DSM III)Tricyclics
Mianserin
Benzodiazepine
ActimetrySRRSLevel of activity
Index of immobility
Dantchev et al. 1992 [25] MDD = 13
(DSM III-R)
Trimipramine ActimetrySRRS
MADRS
Level of activity
Index of immobility
Raoux 1994 [24] MDD = 26
(DSM III-R)
+MADRS > 25
Tricyclics ActimetrySRRSLevel of activity
Index of immobility
Volkers et al. 2003 [40] MDD = 67 UP (DSM IV)
Controls = 67
Drug-free ActimetrySADSLevel of activity
Fragmentation index
Iverson 2004 [41] MDD = 48 (DSM IV)
Controls = 25
NS ActimetryLevel of activity
Lemke et al. 1997 [13] MEL = 16 (DSM IV)Antidepressant
Benzodiazepine
ActimetryMAACLLevel of activity
Lemke and Schleidt 1999 [42] MDD = 12 (DSM IV)
Controls = 30
AmitriptylineVideo analysis of limb movements Unit of action
Aybek et al. 2008 [43]MDD = 4 (DSM IV)
Controls = 7
NSMovements of the limbsVelocity and amplitude of the movements
van Hoof et al. 1993 [44] MDD = 20
(DSM III-R)
Controls = 20
Clomipramine
Amitriptyline
Neuroleptics
Drawing tasks
SRRS
Movement time
Reaction time
Reinspection time
Sabbe et al. 1996 [45] MDD = 22
(DSM III-R)
Controls = 22
Fluoxetine
Benzodiazepine
Neuroleptic
Drawing tasks
SRRS
Movement time
Reaction time
Sabbe et al. 1999 [46] MDD = 30
(DSM III-R)
Controls = 30
Fluoxetine
Benzodiazepine
Neuroleptic
Drawing tasksMovement time
Velocity
Pier et al. 2004 [47] MEL = 20 (DSM IV)
non-MEL = 18
Controls = 38
HypnoticDrawing tasks
SRRS
Movement time
Reaction time
Reinspection time
Pier et al. 2004b [48] MDD = 12 (DSM IV)
+age > 65
Controls = 12
Antidepressant
Neuroleptic
Mood stabilizer
Drawing tasks
SRRS
Movement time
Reaction time
Reinspection time
Mergl et al. 2004 [49] MDD = 37 (ICD 10)Antidepressant
Mood stabilizer
Drawing tasks
Writing tasks
Kinematic parameters
Hoffstaedter et al. 2012 [50]MDD = 20 (ICD 10)
Controls = 20
Antidepressant
Mood stabilizer
Antipsychotic
Motor tasks
Combined motor and cognitive measures
Reaction time
Movement time
Error rates
Schwartz et al. 1976 [51] Depressed = 12 (NS)
Controls = 12
NoneFacial EMG during the generation of affective imageryEMG patterns
Sweeney et al. 1998 [52] MDD = 29
(DSM III-R)
None Eye trackingLatency of eye movements
Mahlberg et al. 2001 [53] Depressed = 32 (NS)
Controls = 42
NSEye trackingPro-saccades
Predictive saccades
Winograd-Gurvich et al. 2006 [54] MEL = 10 (DSM IV)
non-MEL = 9
NSEye trackingLatency of eye movements
Blackburn 1975 [55] Depressive UP and BP: 106 (NS)NSNufferno speed test
Gibson spiral maze
Reaction time
Cornell et al. 1984 [56] MEL = 14 (DSM III)
non-MEL = 14
(DSM III)
Controls = 14
NoneReaction choice test“Motor” RT
“Cognitive” RT
Smith et al. 1994 [57] MDD = 36 (DSM III)
Controls = 36
AntidepressantSignal detection time
SRRS
MADRS
False alarms
Omissions
Moffot et al. 1994 [12] MEL = 20
(DSM III-R)
Controls = 20
Antidepressant
Mood stabilizer
Tests at 8 PM and AM
DSST
CANTAB
Strength
Reaction time
Movement time
Smith et al. 1995 [58] MEL = 32
(DSM III-R)
+MADRS > 22
Controls = 32
Antidepressant
Benzodiazepine
Modified version of the Posner test
SRRS
Reaction time
Brebion et al. 1995 [59]MDD = 29
(DSM III-R)
Controls = 26
Antidepressant
Anxiolytic
Reaction time task
SRRS
MADRS
Reaction time
Brébion et al. 1997 [60]MDD = 26
(DSM III-R)
+MADRS > 20
Controls = 26
Antidepressant
Benzodiazepine
Recognition memory task
SRRS
Index of response bias
Index of discrimination
Lemelin et al. 1996 [61] MDD = 30 (DSM IV)
Controls = 30
NoneStroop test
SRRS
Reaction time
Interference score
Lemelin and Baruch 1998 [62] MDD = 30 (DSM IV)
Controls = 34
NoneStroop test
SRRS
Reaction time
Interference score
Bonin-Guillaume et al. 2008 [63] MDD = 16 (DSM IV)
+GDS > 11
+age > 65
Controls = 16
NSReaction time task
SRRS
Reaction time
Chen et al. 2013 [64]MDD = 33 (DSM IV)
Controls = 30
Antidepressant
Ego-rotation and object-rotation tasksReaction time
Error rates
Caligiuri and Ellwanger 2000 [65] MDD = 36 (DSM IV)
Controls = 22
Antidepressant
Neuroleptic
Benzodiazepine
Wrist movementsReaction Time
Movement time
van Hoof et al. 1998 [66] MDD = 20
(DSM III-R)
Schizophrenic = 20
Antidepressant
Neuroleptic
Benzodiazepine
DSST
SRRS
Observation time
Writing time
Rogers et al. 1987 [67] MDD = 30 (RDC)
Parkinson = 20
Controls 30
Antidepressant
Benzodiazepine
Mood stabilizer
Neuroleptic
DSST
WBS
Reaction time
Movement time
Rogers et al. 2000 [68] MEL = 12 (DSM IV)
non-MEL = 12
Controls = 24
Antidepressant
Benzodiazepine
Mood stabilizer
Reaction time task
CORE
Reaction time
El Massioui et al. 1996 [69] MDD = 8
(DSM III-R)
+score SRRS > 27
Controls = 9
NoneEvent-related potentialReaction time
Amplitude and latency of P3, N1, and N2
Bange and Bathien 1998 [70] MDD = 23 (DSM III-R)
Controls = 20
Antidepressant
Mood stabilizer
Event-related potentialReaction tme
Amplitude and latency of P3, N1, and N2
Schrijvers et al. 2009 [71]MDD = 26 (DSM IV)
Controls = 26
NSEEG
Drawing tasks
Error Negativity (Ne)
Reaction time

BP: bipolar; UP: unipolar; CPRS: Comprehensive Psychopathological Rating Scale; CANTAB: computerised psychometric testing battery; DSM: Diagnostic and Statistic Manual of Mental Disorders; DST: suppression dexamethasone Test; DSST: digit symbol substitution test; EEG: electroencephalography; EMG: Electromyography; F0: Fundamental Frequency; HDRS: Hamilton Depression Rating Scale; ICD: International Statistical Classification of Diseases and Related Health Problems; MAACL: multiple affective adjective checklist; IMAO: monoamine oxydase inhibitor; GDS: Geriatric Depression Scale; MADRS: Montgomery Asberg Depression Rating Scale; MDD: major depressive disorder; MEL: melancholic; non-MEL: nonMelancholic; MT: movement time; NS: not specified; PMR: psychomotor retardation; PT: phonation time; RDC: Research Diagnosis Criteria; REM: rapid eye Movements; RT: reaction time; SADS: Schedule for Affective Disorders and Schizophrenia; SPT: speech pause time; SRRI: selective serotonin reuptake inhibitor; SRRS: Salpetrière Retardation Rating Scale; WBS: Webster Rating Scale.