Cited by 662Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesDeep Brain Stimulation and Movement Disorders

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Psychomotor symptoms of depression

Christina A. Sobin, Harold A. Sackeïm·1997·American Journal of Psychiatry

DOI 10.1176/ajp.154.1.4

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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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Hueng, T., Lee, I. H., Guog, Y., Chen, K. C., Chen, S. S., Chuang, S. P., Yeh, T. L., & Yang, Y. K. (2011) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2010.02166.x · Cited by 15
“There is a growing body of evidence of a significant reduction in neurocognitive functions in major depressive disorder (MDD),(1) and depressionrelated disturbances of cognitive function have been demonstrated in a range of domains, including attention, memory,(5,6) executive functions, and psychomotor functions.(11)…”
Background
Audioverbal cognitive dysfunction in depression. Factors involved
Garcı́a-Toro, M., Talavera, J. A., Gonzalez, E., Tejada, P., Blanco, C., Gonzalez, A., & Sáiz, P. A. (2003) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/s0278-5846(02)00312-3 · Cited by 15
“Thus, its has been suggested that these cognitive dysfunctions are only important in those clinical presentations (less common) with clear psychomotor abnormalities, such as melancholic and bipolar depression (Sobin and Sackeim, 1997; Ferrier et al., 1999; Austin et al., 1999).”
Background
Depressed mood, index finger force and motor cortex stimulation: A transcranial magnetic stimulation (TMS) study
Oathes, D. J., & Ray, W. J. (2005) · Biological Psychology · doi:10.1016/j.biopsycho.2005.11.007 · Cited by 15
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Machine Learning-Based Prediction of Depressive Disorders via Various Data Modalities: A Survey
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Frontostriatal circuitry as a target for fMRI-based neurofeedback interventions: A systematic review
Orth, L., Meeh, J., Gur, R. C., Neuner, I., & Sarkheil, P. (2022) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2022.933718 · Cited by 14
Applying prosodic speech features in mental health care: An exploratory study in a life-review intervention for depression
Lamers, S. M. A., Truong, K. P., Steunenberg, B., de Jong, F. M. G., & Westerhof, G. J. (2014) · Workshop on Computational Linguistics and Clinical Psychology (CLPsych) · doi:10.3115/v1/w14-3208 · Cited by 14
“A review by Sobin and Sackeim (1997) showed that depressed people differ from normal and other psychiatric groups on psychomotor symptoms such as speech.”
Background
Dysfunction of the neural network associated with sustained attention in cancer patients with clinically significant depressive symptoms
Kim, L. S., Hwang, H. S., Jon, D., Ham, B., & Seok, J. (2008) · Neuroscience Letters · doi:10.1016/j.neulet.2008.09.077 · Cited by 14
Language Technologies for Suicide Prevention in Social Media
Gomez, J. M. (2014) · doi:10.3115/v1/w14-6903 · Cited by 15
“Some clinical studies observed that depressed patients frequently speech slow, uniform, monotonous and with a low voice (Kuny and Stassen, 1993) or to have psychomotor symptoms and this is reflected in the speech (Sobin and Sackeim, 1997).”
Background
Observer-rated retardation but not agitation corresponds to objective motor measures in depression
van Diermen, L., Walther, S., Cools, O., Fransén, E., Birkenhäger, T. K., Sabbe, B., & Schrijvers, D. L. (2018) · Acta Neuropsychiatrica · doi:10.1017/neu.2018.21 · Cited by 15
“However, reports of assessments across all psychomotor domains are scarce (2,7).”
Background
Differences in psychomotor activity and heart rate variability in patients with newly diagnosed bipolar disorder, unaffected relatives, and healthy individuals
Freyberg, J., Brage, S., Kessing, L. V., & Faurholt‐Jepsen, M. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.110 · Cited by 14
“A central feature in BD is abnormalities in psychomotor activity, and psychomotor retardation during depression as well as increased motor activity during mania have been described in the literature (Beigel and Murphy, 1971; Goldberg et al., 2009; Goodwin and Jamison, 1996; Judd et al., 2012; Kuhs and Reschke, 1992; K…”
Background
Psychomotor Symptoms in Depression
Lemke, M. R., & Hesse, A. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.5.709 · Cited by 14
Habenula and ADHD: Convergence on time
Lee, Y.-A., & Goto, Y. (2013) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2013.07.006 · Cited by 14
Subcortical morphometry and psychomotor function in euthymic bipolar disorder with a history of psychosis
Liberg, B., Ekman, C. J., Sellgren, C. M., Johansson, A. G. M., & Landén, M. (2014) · Brain Imaging and Behavior · doi:10.1007/s11682-014-9313-0 · Cited by 13
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“Individuals with MDD may display distinct non-verbal behaviors, given the psychomotor symptoms of the illness (Sobin and Sackeim, 1997).”
BackgroundResultInfluential
Unbalanced amygdala communication in major depressive disorder
Wen, X., Han, B., Li, H., Dou, F., Wei, G., Hou, G., & Wu, X. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.02.091 · Cited by 15
The mediating role of processing speed in the relationship between depressive symptoms and cognitive function in multiple sclerosis
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“…deficits (cognitive and psychomotor speed) are a common sequelae of depression (Christensen, Griffiths, MacKinnon, & Jacomb, 1997; Schrijvers, Hulstijn, & Sabbe, 2008; Sobin & Sackeim, 1997), with reduced processing speed associated with worsening depression (McDermott & Ebmeier, 2009).”
Background
Mobile footprinting: linking individual distinctiveness in mobility patterns to mood, sleep, and brain functional connectivity
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“Such observation concurs with the known clinical associations of psychomotor disturbances with mood and sleep disorders [50].”
Result
Motor activity in depressed children
Aronen, E. T., Simola, P. E., & Soininen, M. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.04.013 · Cited by 15
Measuring spatial proximity in mother–infant interaction: A kinematic approach for an examination of the effects of maternal postpartum depression
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“Depressed patients are found to differ from normal groups with regard to quantiﬁed gross motor activity level, movements of the limbs, trunk and head, speech and motor reaction time (Sobin & Sackheim, 1997).”
Background
Central CRF and acute stress differentially modulate probabilistic reversal learning in male and female rats
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Pure-tone auditory thresholds are decreased in depressed people with post-traumatic stress disorder
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“The third limitation could be that decision and motor responses are slower in depressed patients, as compared to normal groups, in response to visual, auditory, and tactile stimuli in both simple and choice paradigm (see review from Sobin and Sackeim, 1997).”
Influential
Volumetric assessment of individual thalamic nuclei in patients with drug-naïve, first-episode major depressive disorder
Chibaatar, E., Watanabe, K., Okamoto, N., Orkhonselenge, N., Natsuyama, T., Hayakawa, G., Ikenouchi, A., Kakeda, S., & Yoshimura, R. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1151551 · Cited by 16
Depression detection using virtual avatar communication and eye tracking system
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“The lack of eye contact, for example, is induced in the depression symptoms group (Elmer and Stadtfeld, 2020; Jones and Pansa, 1979; Sobin and Sackeim, 1997).”
Background
Data-Driven Analysis Identifies Novel Modulation of Social Behavior in Female Mice Witnessing Chronic Social Defeat Stress
Schuler, H., Eid, R. S., Wu, S. S., Tse, Y. C., Cvetkovska, V., Lopez, J., Quinn, R., Zhou, D., Meccia, J., Dion‐Albert, L., et al. (2024) · Biological Psychiatry · doi:10.1016/j.biopsych.2024.11.017 · Cited by 20
“This hyperlocomotion phenotype is reminiscent of psychomotor symptoms in depression and other stress-related psychiatric disorders, wherein evidence exists of gender differences (47,48).”
Vertex-based morphometry in euthymic bipolar disorder implicates striatal regions involved in psychomotor function
Liberg, B., Ekman, C. J., Sellgren, C. M., Johansson, A. G. M., & Landén, M. (2014) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2014.01.007 · Cited by 12
“Psychomotor disturbance is a classic feature of bipolar disorder and has been the focus of numerous investigations over the years (Cornell et al., 1984; Sobin and Sackeim, 1997; Caligiuri and Ellwanger, 2000; Buyukdura et al., 2011).”
Background
A longitudinal study of the association between basal ganglia volumes and psychomotor symptoms in subjects with late life depression undergoing ECT
Cauwenberge, M. G. A. V., Bouckaert, F., Vansteelandt, K., Adamson, C. L., Winter, F. D., Sienaert, P. A., den Stock, J. V., Dols, A., Rhebergen, D., Stek, M. L., et al. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01314-w · Cited by 12
Evaluation of emotional arousal level and depression severity using voice-derived sound pressure change acceleration
Shinohara, S., Toda, H., Nakamura, M., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-92982-7 · Cited by 12
Comorbidity of anxiety disorders in major depressive disorder: A clinical trial to evaluate neuropsychological deficit
Herrera‐Guzmán, I., Gudayol‐Ferré, E., Jarne-Esparcia, A. J., Herrera‐Abarca, J. E., Herrera-Guzmán, D., Peró, M., & Guàrdia‐Olmos, J. (2009) · The European Journal of Psychiatry · doi:10.4321/s0213-61632009000100001 · Cited by 11
Differentiation between depression and bipolar disorder in child and adolescents by voice features
Luo, J., Wu, Y., Liu, M., Li, Z., Wang, Z., Zheng, Y., Feng, L., Lu, J., & He, F. (2024) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-024-00708-0 · Cited by 14
“While the voices of depressed patients often exhibit characteristics of dull-ness, reduced speech rate, monotony, and lifelessness [7], the voices of patients developing bipolar disorder symptoms may be characterized by increased speaking rate [8].”
Background
Design and Evaluation of Virtual Human Mediated Tasks for Assessment of Depression and Anxiety
Egede, J., Price, D., Krishnan, D. B., Jaiswal, S., Elliott, N. A., Morriss, R. K., Trigo, M. J. G., Nixon, N. L., Liddle, P. F., Greenhalgh, C., et al. (2021) · ACM International Conference on Intelligent Virtual Agents (IVA) · doi:10.1145/3472306.3478361 · Cited by 13
“into virtual technologies that exploit changes in established biomarkers such as stress levels [26], head movements [1, 18], psychomotor symptoms [29], facial expressions [33] , voice inflexion [30] and personality traits [6, 7] for early detection and treatment of mental”
Background

Authors: Sobin, C. A., & Sackeïm, H. A.
Affiliations: Columbia University (US)
ORCID: Christina A. Sobin
Harold A. Sackeïm
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 1997-01-01
Volume: 154
Issue: 1
Pages: 4-17
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/ajp.154.1.4
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 (medical) › Treatment of Major Depression
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
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

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