Psychomotor symptoms of depression.
Psychomotor symptoms of depression.
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DOI：
10.1176/ajp.154.1.4
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
C. Sobin;H. Sackeim
中科院分区：
文献类型：
--
作者：
C. Sobin;H. Sackeim
目的总结目前有关抑郁症精神运动性症状的知识。方法回顾客观量化精神运动症状的发现，并考虑方法学问题。本文总结了有关精神运动性症状的诊断、预后和潜在病理生理意义的当代经验文献。结果抑郁症患者在客观量化的大运动活动、身体运动、言语和运动反应时间方面不同于正常和精神对照组。病程、日变化、用药状况、性别和年龄与躁动和发育迟缓有关，在研究精神运动症状时应加以控制。抑郁症的精神运动性症状可能具有独特的意义。它们具有很高的判别效度，可能是区分抑郁症亚型的唯一抑郁症症状，并且可以预测三环类抗抑郁药的良好反应。脑成像和生化研究的结果将抑郁和运动症状与基底神经节和基底神经节/丘脑-皮质回路的异常联系起来。结论抑郁症精神运动性障碍的调查与新kraepelinian精神障碍研究标准是一致的。我们目前对精神运动症状的认识在概念上是模糊的，然而大量的证据明确了它们的表现形式并支持它们的重要性。识别抑郁症患者异常运动行为的发生率，评估伴随并决定其表现的组成过程，可能是抑郁症精神运动症状研究的重要进展。
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.