An Examination of Psychomotor Disturbance in Current and Remitted MDD: An RDoC Study

Abstract

Major depressive disorder (MDD) is a serious public health problem that has, at best, modest treatment response-potentially due to its heterogeneous clinical presentation. One way to parse the heterogeneity is to investigate the role of particular features of MDD, an endeavor that can also help identify novel and focal targets for treatment and prevention efforts. Our R01 focuses on the feature of psychomotor disturbance (e.g., psychomotor agitation (PmA) and retardation (PmR)), a particularly pernicious feature of MDD, that has not been examined extensively in MDD. Aim 1 is comparing three groups of individuals-those with current MDD (n = 100), remitted MDD (n = 100), and controls (n = 50)-on multiple measures of PmR and PmA (assessed both in the lab and in the subjects' natural environment). Aim 2 is examining the structural (diffusion MRI) and functional (resting state fMRI) connectivity of motor circuitry of the three groups as well as the relation between motor circuitry and the proposed indicators of PmR and PmA. Aim 3 is following up with subjects three times over 18 months to evaluate whether motor symptoms change in tandem with overall depressive symptoms and functioning over time and/or whether baseline PmR/PmA predicts course of depression and functioning. Aim 3 is particularly clinically significant. Finding that motor functioning and overall depression severity co-vary over time, or that motor variables predict subsequent change in overall depression severity, would support the potential clinical utility of these novel, reliable, and easily administered motor assessments.

Actigraphically measured psychomotor slowing in depression: systematic review and meta-analysis

“…Psychomotor disturbance also predicts poorer treatment response and indicates a more severe depression syndrome (Buyukdura, McClintock, & Croarkin, 2011; Parker, 2000; Schrijvers, Hulstijn, & Sabbe, 2008; Ulbricht, Dumenci, Rothschild, & Lapane, 2018; van Diermen et al, 2019). Yet, research characterizing motor symptoms of depression is relatively sparse, although there have been recent initiatives to foster this area of research (Shankman, Mittal, & Walther, 2020; Walther, Bernard, Mittal, & Shankman, 2019). One of the most challenging aspects in such research is operationalized, quantitative measurement of psychomotor disturbance.…”

Walking on the bright side: Associations between affect, depression, and gait

“…This norming does not account for mild-to-moderate symptoms that still cause distress and impairment. Beyond this, measures do not parse the cognitive (e.g., delayed thought processing) and motor components of psychomotor change [ 6 ]. While rated assessments of motor change are undoubtedly ecologic, the biobehavioral nature of motor symptoms requires cross-examination and validation with objective measures.…”

Rethinking the risk for depression using the RDoC: A psychophysiological perspective

“…Psychomotor disturbances (retardation or agitation) are core features of depression and are included as a diagnostic criterion in the DSM-5. Considering that motor activity (e.g., walking) is needed to increase the chances of rewarding and pleasant events (e.g., meeting some friends or a partner), it is not surprising that psychomotor retardation and reduced gross motor activity are core features of depression ( Razavi et al, 2011 ; Bewernick et al, 2017 ; Walther et al, 2019 ; Shankman et al, 2020 ; Wüthrich et al, 2022 ). Indeed, motor processes are strictly related to motivational drive and positive emotionality that support approach actions ( Walther et al, 2019 ).…”