B Sabbe

Fine motor retardation and depression

New computerized techniques allow the precise measurement of psychomotor retardation in patients with a major depressive episode (MDE). One such technique is the analysis of writing and drawing behaviour during figure copying tasks. In the present study, 22 inpatients with an MDE were compared to 22 normal controls. Three tasks were used: the drawing of lines and simple figures, the copying of complex figures and a task in which figures had to be rotated. Objectives were to provide support for earlier findings that the patients were slower than the controls and to explore the cognitive and motor processes involved. Two strategies were applied: analysis of the reaction time and movement time and their different components, and manipulation of the cognitive and motor demands. Patients showed considerable retardation with most of the kinematic variables. Motor deficits and cognitive slowing down contributed to this retardation. Cognitive difficulties increased with increasing complexity of the task.

Retardation in depression: assessment by means of simple motor tasks

BACKGROUND Psychomotor retardation in depression has mostly been assessed with tasks requiring both cognitive and motor processes. This study tested whether retardation could be measured if the cognitive demands of the task were minimal. METHODS 30 inpatients with a major depressive episode were compared one week after the start of antidepressant treatment, to 30 healthy control persons, matched for age, sex and educational level. Tests consisted of ten simple drawing tasks. The kinematics of drawing movements were recorded using a specially designed pen, a graphics tablet and a personal computer. RESULTS Patients showed marked motor slowing on all the tasks: longer movement durations, longer pauses and lower velocities. CONCLUSIONS Psychomotor retardation in depressed patients treated with antidepressants occurs during drawing tasks, in which the cognitive demands are minimal and less than those required in the figure copying tasks used in our previous studies. LIMITATIONS The use of co-medication can have influenced the results, although no correlations were found between the use of medication and the kinematic variables. CLINICAL RELEVANCE Detailed registration and analysis of drawing movements enable a more precise diagnosis of psychomotor disturbances in depressed patients.

Differentiation of cognitive and motor slowing in the Digit Symbol Test (DST): differences between depression and schizophrenia

Abstract Schizophrenia and depression have an overlap in symptomatology, namely a slowing in both motor and mental activities, denoted in depression as ‘psychomotor retardation’ and in schizophrenia as ‘psychomotor poverty’. By means of a new technique that allows the measurement of psychomotor speed and the computerized analysis of writing movements recorded during the performance of the Digit Symbol Test, it indeed proved to be possible to observe a slowing in both disorders. In addition, a different structure of slowing in the two patient groups could be identified.

Changes in fine motor retardation in depressed patients treated with fluoxetine.

Changes in psychomotor slowing were studied in 21 inpatients with a Major Depressive Episode. Fine motor retardation was measured and analysed using computer-aided drawing and figure-copying tasks at T0 (the start of 6 weeks treatment with fluoxetine 20 mg/day) and 5 weeks later (T1). The differences in reaction time between the patients and a group of healthy, matched controls at T0 had disappeared at T1. The initial motor deficit, expressed in longer movement times, had not improved at T1. These findings combined with the effect of manipulation of cognitive and motor demands, suggested that only cognitive processes had accelerated.

Depressive retardation and treatment with fluoxetine: Assessment of the motor component

Changes in motor slowing between the start and end of treatment were studied in 22 inpatients with a Major Depressive Episode and 22 normal, healthy control persons. The degree and pattern of motor slowing were measured and analysed using computer-aided simple drawing tasks that did not require any higher order cognitive processing. The patients were treated with fluoxetine 20 mg/day for 6 weeks. Tests took place after 1 week (T0) and 6 weeks (T1). At T0 patients showed marked slowing, apparent in longer movement times and lower velocities than their controls. The differences between groups increased as the size of the movement increased or the accuracy demands increased. In all the trials, patients showed clear initiation difficulties. At T1 the motor slowing of the depressed patients had improved, but not disappeared. Significant differences remained between the two groups.

Fast psychomotor functioning in underweight anorexia nervosa patients

To explore whether underweight anorexia nervosa patients show psychomotor differences relative to normal controls, 32 female hospitalised patients, aged between 14 and 25 years, were compared with 32 healthy, normal weight controls, matched for sex, age and educational level. Using computerised analysis of writing and drawing behaviour, reaction times and movement times and their different components were analysed, while cognitive and motor demands were manipulated in five drawing and copying tasks. Anorexia nervosa patients were, compared to normal weight controls, significantly faster in a drawing task and showed shorter reaction times in copying tasks. Movement times did not differ significantly between the two groups. In the most complex copying task, a significant group x complexity interaction for reaction time (patients shorter) and reinspection time (patients longer) was found. Patients also made more errors than controls. The finding of a consistent pattern of shorter reaction times in underweight anorexia nervosa patients seems to run contrary to previous findings of disturbed cognitive functioning (i.e. impaired attention) in these patients. The differences seem to be related to cognitive factors more than to motor (executive) components.

Psychomotor slowing, neuroendocrine responses, and behavioral changes after oral administration of meta-chlorophenylpiperazine in normal volunteers

The mixed 5-HT receptor agonist/antagonist meta-chlorophenylpiperazine (mCPP) is known to suppress locomotor activity in mice and rats. This study aimed: (1) to determine whether mCPP induces cognitive and motor changes in normal human volunteers and how these changes relate to the neuroendocrine effects of mCPP; and (2) to compare these cognitive and motor changes to the known cognitive and motor slowing patterns in depression and schizophrenia. A computerized method (used in previous research) analyzed fine motor behavior during figure-copying tasks. In 14 normal male volunteers behavioral responses, body temperature, plasma levels of prolactin and cortisol, and cognitive and motor performance during figure-copying tasks were measured after a single oral dose of mCPP (0.5 mg/kg). mCPP-induced prolongation of the reaction times in all copying tasks, parallel to increases in cortisol and prolactin and some self-reported behavioral effects. There were no changes in the movement times or the velocities of the writing movements. In conclusion, mCPP induced cognitive, but not motor slowing, in normal male volunteers. This indicates that the human serotonin system is also implicated in psychomotor behavior. This pattern of slowing was different from that in depressed and schizophrenic patients.

The assessment of creativity in creativity/psychopathology research – a systematic review

Introduction The possible link between creativity and psychopathology has been a long time focus of research up to the present day. However, this research is hampered by methodological problems, especially the definition and assessment of creativity. This makes interpretation and comparison of studies difficult and possibly accounts for the contradictory results of this research. Methods In this systematic review of the literature, research articles in the field of creativity and psychopathology were searched for creativity assessment tools. The tools used in the collected articles are presented and discussed. Results The results indicate that a multitude of creativity assessment tools were used, that many studies only used one tool to assess creativity and that most of these tools were only used in a limited number of studies. A few assessment tools stand out by a more frequent use, also outside psychopathological research, and more solid psychometric properties. Conclusion Most scales used to evaluate creativity have poor psychometric properties. The scattered methodology to assess creativity compromises the generalizability and validity of this research. The field should creatively develop new validated instruments.

Creativity and psychiatric illness: the search for a missing link--an historical context for current research.

Creativity is an important human quality upon which many achievements of humankind are based. Defined as the ability to produce something that is novel and useful or meaningful, it is difficult to operationalize for research. This text provides an overview of the historical and cultural context of this research. The assumption that creativity is related to psychiatric vulnerability dates back to antiquity. The modern interest in the subject stems from the romantic era and gained a scientific aura in the 19th century. In the 20th century, a further entanglement of creativity and psychopathology came about through the influence of patient artists on regular art. Psychometric, psychodiagnostic and genetic research supports a connection between creativity and psychiatric illness within the bipolar-psychotic continuum, with schizotypy/thymotypy as prototypes of creativity-related disorders. Evolutionary hypotheses link the schizophrenia paradox to a survival advantage through enhanced creative ability. The relevance of scientific research in this complex and heterogeneous area can be increased if creativity and psychopathology are further operationalized and if underlying art concepts are made explicit and placed in a broader cultural context. There is a continuing need for meaningful definitions and measures, as well as a multidisciplinary collaboration.

Psychomotor, neuroendocrine and behavioural effects after oral administration of levodopa in normal volunteers

The oral administration of a single dose of levodopa (L-dopa) in 10 healthy human male subjects induced cognitive, not motor, changes during figure-copying tasks that were unrelated to the neuroendocrine and behavioural effects of levodopa. Results point to a decrease in alertness induced by levodopa.