Psychomotor symptoms of depression
Abstract
OBJECTIVE: The authors summarize current knowledge regarding the psychomotor symptoms of depression. METHOD: Findings from the objective quantification of psychomotor symptoms are reviewed, and methodological issues are considered. The contemporary empirical literature regarding the diagnostic, prognostic, and potential pathophysiologic significance of psychomotor symptoms is summarized. RESULTS: It has been repeatedly shown that depressed patients differ from normal and psychiatric comparison groups with regard to objectively quantified gross motor activity, body movements, speech, and motor reaction time. Course of illness, diurnal variation, medication status, sex, and age are associated with agitation and retardation and should be controlled when one is studying psychomotor symptoms. Psychomotor symptoms in depression may have unique significance. They have high discriminative validity, may be the only symptoms of depression that distinguish depression subtypes, and are predictive of good response to tricyclic antidepressants. Results of brain imaging and biochemical studies link depression and motor symptoms to abnormalities in the basal ganglia and basal ganglia/thalamo-cortical circuits. CONCLUSIONS: The investigation of psychomotor disturbance in depression is specifically consistent with neo-Kraepelinian standards for the study of psychiatric disorders. Our current knowledge of psychomotor symptoms is conceptually obscure, yet a large body of evidence specifies their manifestation and supports their significance. Identifying the incidence of abnormal motor behaviors in depressed patients and assessing the component processes that accompany and determine their manifestation may be important advances in the study of psychomotor symptoms in depression.
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Generalized psychomotor slowing can impact performance across several cognitive processes and domains.
“generalized psychomotor slowing [4, 5] can also impact performance across several cognitive processes and domains.”
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“Both depressive and anxiety disorders can affect psychomotor functioning, such as gross and fine motor activity, speech characteristics, and motor speed[1,2].”
BackgroundDoes Antidepressant Therapy Improve Cognition in Elderly Depressed Patients?
Doraiswamy, P. M., Krishnan, K., Oxman, T. E., Jenkyn, L. R., Coffey, D., Burt, T., & Clary, C. M. (2003) · The Journals of Gerontology Series A · doi:10.1093/gerona/58.12.m1137 · Cited by 134 · see citing works
“Cognitive domains reported to be affected include short-term memory (2), executive functioning (3), information processing (4,5), and psychomotor speed (6).”
Serretti, A., Artioli, P., Lorenzi, C., Pirovano, A., Tubazio, V., & Zanardi, R. (2004) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145704004687 · Cited by 131 · see citing works
“A decrease in HAMD scores to f8, with Delusion factor equal to 0 (items 2, 15, 20) (Bech et al., 1993 ; Bellini et al., 1992; Sobin and Sackeim, 1997), was considered the response criterion.”
BackgroundCaligiuri, M. P., Brown, G. G., Meloy, M. J., Eberson, S., Kindermann, S. S., Frank, L. R., Zorrilla, L. T. E., & Lohr, J. B. (2003) · Psychiatry Research Neuroimaging · doi:10.1016/s0925-4927(03)00075-1 · Cited by 130 · see citing works
“It has been reported that approximately 50% of bipolar disorder patients exhibit either motor agitation or motor retardation (Sobin et al., 1998; Sobin and Sackeim, 1997).”
BackgroundPrefrontal and Cerebellar Abnormalities in Major Depression: Evidence from Oculomotor Studies
Sweeney, J. A., Strojwas, M., Mann, J. J., & Thase, M. E. (1998) · Biological Psychiatry · doi:10.1016/s0006-3223(97)00485-x · Cited by 130 · see citing works
“The intact saccade latency was somewhat unexpected, because prolonged response latencies are a common observation in manual reaction times in depressed patients (Sobin and Sackeim 1997).”
BackgroundPaus, T., & Barrett, J. (2004) · Journal of Psychiatry and Neuroscience · doi:10.1139/jpn.0428 · Cited by 129 · see citing works
“In terms of motor function, the speech of depressed patients is often slow, quiet and monotonous and infrequently initiated.(5) Analyses of speech acoustics have revealed the presence of quantitative and qualitative differences between the speech of depressed patients and control subjects, including speech pitch, loud…”
Scherer, S. J., Lucas, G., Gratch, J. S., Rizzo, A., & Morency, L. (2015) · IEEE Transactions on Affective Computing · doi:10.1109/taffc.2015.2440264 · Cited by 122 · see citing works
“…depression, an affective disorder that is one of that the novel measure reveals a signifcantly reduced vowel the leading causes of disability worldwide 1 , has received space in subjects that reported symptoms of depression and considerable attention in the past [9], [10], [11]; a detailed re-PTSD.”
BackgroundSego, C., Gonçalves, L., Lima, L. B., Furigo, I. C., Donato, J., & Metzger, M. (2013) · The Journal of Comparative Neurology · doi:10.1002/cne.23533 · Cited by 126 · see citing works
Depressive symptoms in early pregnancy disrupt attentional processing of infant emotion
Pearson, R. M., Cooper, R. M., Penton‐Voak, I. S., Lightman, S. L., & Evans, J. (2009) · Psychological Medicine · doi:10.1017/s0033291709990961 · Cited by 128 · see citing works
“As depression is generally associated with slower motor responses (Sobin & Sackeim, 1997) our data suggest that distressed infant faces speeded up disengagement in the depressive symptom group.”
BackgroundBlood, A. J., Iosifescu, D. V., Makris, N., Perlis, R. H., Kennedy, D. N., Dougherty, D. D., Kim, B. W., Lee, M. J., Wu, S., Lee, S., et al. (2010) · PLoS ONE · doi:10.1371/journal.pone.0013945 · Cited by 126 · see citing works
“We designed the study to take into consideration potential heterogeneity within the MDD cohort [33,37,49,50,51,52,53, 54,55,56,57], given that this is a potential confound in group designs [58].”
MethodVocal-source biomarkers for depression: a link to psychomotor activity
Quatieri, T. F., & Malyska, N. (2012) · Interspeech (USB) · doi:10.21437/interspeech.2012-311 · Cited by 126 · see citing works
“A hypothesis in the voice quality study of this paper is that neuro-physiological change in depression generally affects motor coordination including laryngeal control and dynamics [6][8][14].”
BackgroundYu, Y. W. ‐., Tsai, S., Liou, Y., Hong, C., & Chen, T. (2006) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.12.004 · Cited by 124 · see citing works
“dRemittersT were defined as subjects in HAM-D scores to 8 points or less, with delusion factor equal to 0 (items 2, 15, 20) (Bech et al., 1993; Bellini et al., 1992; Sobin and Sackeim, 1997)).”
BackgroundExecutive Dysfunction and Disability in Elderly Patients With Major Depression
Kiosses, D. N., Klimstra, S., Murphy, C., & Alexopoulos, G. S. (2001) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200108000-00011 · Cited by 129 · see citing works
Herrera-Guzmán, I., Herrera-Abarca, J. E., Gudayol-Ferré, E., Herrera-Guzmán, D., Gómez-Carbajal, L., Peña-Olvira, M., Villuendas-González, E., & Joan, G.-O. (2010) · Psychiatry Research · doi:10.1016/j.psychres.2010.03.006 · Cited by 120 · see citing works
“Neuropsychological deficits in depressed patients may be detected in mental processing speed, (Sobin and Sackeim, 1997; Gualtieri et al., 2006), memory (Austin et al.”
BackgroundAnalysis of acoustic space variability in speech affected by depression
Cummins, N., Sethu, V., Epps, J., Schnieder, S., & Krajewski, J. (2015) · Speech Communication · doi:10.1016/j.specom.2015.09.003 · Cited by 120 · see citing works
“Speech affected by depression is often characterised by decreases in verbal activity; decreases in utterance length, and a reduction in speech rate and long silent pauses (Balsters et al., 2012; Hall et al., 1995; Sobin and Sackeim, 1997).”
BackgroundSpeech‐based markers for posttraumatic stress disorder in US veterans
Marmar, C. R., Brown, A. D., Qian, M., LASKA, E. M., Siegel, C., Li, M., Amara, D. A., Tsiartas, A., Richey, C., Smith, J. G., et al. (2019) · Depression and Anxiety · doi:10.1002/da.22890 · Cited by 129 · see citing works
“…(Newman & Mather, 1938) and routinely use impressions of voice quality as an element of mental status examination, including “pressured” speech in bipolar disorder or “monotone,” “lifeless,” and “metallic” speech in depression (Hall, Harrigan, & Rosenthal, 1995; Moses, 1954; Sobin & Sackeim, 1997).”
BackgroundExecutive Dysfunction, Heart Disease Burden, and Remission of Geriatric Depression
Alexopoulos, G. S., Kiosses, D. N., Murphy, C., & Heo, M. (2004) · Neuropsychopharmacology · doi:10.1038/sj.npp.1300557 · Cited by 117 · see citing works
“Neurological disorders leading to executive dysfunction, including Parkinson’s disease, supranuclear palsy, and Huntington’s disease, are often complicated by depression and accompanied by executive dysfunction (Sobin and Sackeim, 1997).”
Motor activity and autonomic cardiac functioning in major depressive disorder
Volkers, A. C. W. (2002) · Journal of Affective Disorders · doi:10.1016/s0165-0327(02)00066-6 · Cited by 116 · see citing works
D-vlog: Multimodal Vlog Dataset for Depression Detection
Yoon, J., Kang, C., Kim, S., & Han, J. (2022) · Proceedings of the AAAI Conference on Artificial Intelligence · doi:10.1609/aaai.v36i11.21483 · Cited by 126 · see citing works
“Scholars have shown that depressed and non-depressed groups can be distinguished by non-verbal signals such as facial expressions, body movements, and vocal intensity (Edition et al. 2013; Sobin and Sackeim 1997).”
BackgroundJiang, H., Hu, B., Liu, Z., Yan, L., Wang, T., Liu, F., Kang, H., & Li, X. (2017) · Speech Communication · doi:10.1016/j.specom.2017.04.001 · Cited by 115 · see citing works
Profiles of “manic” symptoms in bipolar I, bipolar II and major depressive disorders
Serretti, A., & Olgiati, P. (2003) · Journal of Affective Disorders · doi:10.1016/j.jad.2003.09.011 · Cited by 115 · see citing works
Schultebraucks, K., Yadav, V., Shalev, A. Y., Bonanno, G. A., & Galatzer-Levy, I. R. (2022) · Psychological Medicine · doi:10.1017/s0033291720002718 · Cited by 108 · see citing works
“…2004; Cohn et al., 2009; Eichstaedt et al., 2018; Gaebel & Wölwer, 1992; Gehricke & Shapiro, 2000; He et al., 2012; Kleim et al., 2018; Lu et al., 2012; Pestian et al., 2010; Quatieri & Malyska, 2012; Renneberg et al., 2005; Sobin & Sackeim, 1997; van den Broek et al., 2010; Yang et al., 2013).”
BackgroundZou, B., Han, J., Wang, Y., Liu, R., Zhao, S., Feng, L., Lyu, X., & Ma, H. (2022) · IEEE Transactions on Affective Computing · doi:10.1109/taffc.2022.3181210 · Cited by 114 · see citing works
“Depressed speech has found several distinguishing acoustic features as indicators of disease severity and treatment efficacy [101].”
BackgroundHalvarsson, A., Olsson, E., Farén, E., Pettersson, A. F., & Ståhle, A. (2011) · Clinical Rehabilitation · doi:10.1177/0269215511411937 · Cited by 109 · see citing works
Depression, Anhedonia, and Psychomotor Symptoms:The Role of Dopaminergic Neurocircuitry
Stein, D. J. (2008) · CNS Spectrums · doi:10.1017/s1092852900016837 · Cited by 110 · see citing works
Detecting Depression Using an Ensemble Logistic Regression Model Based on Multiple Speech Features
Jiang, H., Hu, B., Liu, Z., Wang, G., Zhang, L., Li, X., & Kang, H. (2018) · Computational and Mathematical Methods in Medicine · doi:10.1155/2018/6508319 · Cited by 107 · see citing works
“Depressed speech is distinguished invariably by clinicians as monotone, uninteresting, and spiritless [5].”
BackgroundHarrington, M., Lelliott, P. T., Paton, C., et al. (2002) · Psychiatric Bulletin · doi:10.1192/pb.26.11.414 · Cited by 106 · see citing works
Gait unsteadiness and fall risk in two affective disorders: a preliminary study
Hausdorff, J. M., Peng, C., Goldberger, A. L., & Stoll, A. L. (2004) · BMC Psychiatry · doi:10.1186/1471-244x-4-39 · Cited by 106 · see citing works
“Psychomotor studies have revealed deficits in the motor performance of persons with major depression similar to some of the motor disturbances observed in Parkinson's disease [14,15].”
Influential
- Authors
- Sobin, C. A., & Sackeïm, H. A.
- Affiliations
- Columbia University (US)
- Venue
- American Journal of Psychiatry
- Published
- 1997-01-01
- Volume
- 154
- Issue
- 1
- Pages
- 4-17
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W160287770
- Cited by
- 662
- References
- 0
- Citations by year
- 2026: 20 · 2025: 30 · 2024: 26 · 2023: 28 · 2022: 29 · 2021: 39 · 2020: 34 · 2019: 29 · 2018: 21 · 2017: 12 · 2016: 25 · 2015: 28 · 2014: 27 · 2013: 36 · 2012: 32
- FWCI
- 12.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- scholarworks - UTEP (The University of Texas at El Paso) (submittedVersion)
- American Journal of Psychiatry
- Funders
- National Institutes of Health (5r01mh047739-02)
- National Institute of Mental Health (MH-47739, MH35636)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- psychomotor symptoms, depression, agitation, retardation, motor reaction time, speech, gross motor activity, diurnal variation, depression subtypes, basal ganglia, thalamocortical circuits, depression pathophysiology
- MeSH terms
- Antidepressive Agents, Tricyclic, Circadian Rhythm, Depressive Disorder, Female, Humans, Male, Middle Aged, Motor Activity, Prognosis, Psychomotor Agitation, Psychomotor Disorders, Reaction Time, Speech, Incidence, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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