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

Published online by Cambridge University Press:  13 May 2022

Florian Wüthrich Open the ORCID record for Florian Wüthrich [Opens in a new window] ,
Carver B. Nabb ,
Vijay A. Mittal ,
Stewart A. Shankman  and
Sebastian Walther
Florian Wüthrich*
Affiliation:
Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
Carver B. Nabb
Affiliation:
Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
Vijay A. Mittal
Affiliation:
Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA Department of Psychology, Northwestern University, Evanston, IL, USA Institute for Innovations in Developmental Sciences, Northwestern University, Evanston/Chicago, IL, USA Institute for Policy Research, Northwestern University, Evanston, IL, USA Medical Social Sciences, Northwestern University, Chicago, IL, USA
Stewart A. Shankman
Affiliation:
Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA Department of Psychology, Northwestern University, Evanston, IL, USA
Sebastian Walther
Affiliation:
Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
*
Author for correspondence: Florian Wüthrich, E-mail: florian.wuethrich@upd.unibe.ch
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Abstract

Psychomotor slowing is a key feature of depressive disorders. Despite its great clinical importance, the pathophysiology and prevalence across different diagnoses and mood states are still poorly understood. Actigraphy allows unbiased, objective, and naturalistic assessment of physical activity as a marker of psychomotor slowing. Yet, the true effect-sizes remain unclear as recent, large systematic reviews are missing. We conducted a novel meta-analysis on actigraphically measured slowing in depression with strict inclusion and exclusion criteria for diagnosis ascertainment and sample duplications. Medline/PubMed and Web-of-Science were searched with terms combining mood-keywords and actigraphy-keywords until September 2021. Original research measuring actigraphy for ⩾24 h in at least two groups of depressed, remitted, or healthy participants and applying operationalized diagnosis was included. Studies in somatically ill patients, N < 10 participants/group, and studies using consumer-devices were excluded. Activity-levels between groups were compared using random-effects models with standardized-mean-differences and several moderators were examined. In total, 34 studies (n = 1804 patients) were included. Patients had lower activity than controls [standardized mean difference (s.m.d.) = −0.78, 95% confidence interval (CI) −0.99 to −0.57]. Compared to controls, patients with unipolar and bipolar disorder had lower activity than controls whether in depressed (unipolar: s.m.d. = −0.82, 95% CI −1.07 to −0.56; bipolar: s.m.d. = −0.94, 95% CI −1.41 to −0.46), or remitted/euthymic mood (unipolar: s.m.d. = −0.28, 95% CI −0.56 to 0.0; bipolar: s.m.d. = −0.92, 95% CI −1.36 to −0.47). None of the examined moderators had any significant effect. To date, this is the largest meta-analysis on actigraphically measured slowing in mood disorders. They are associated with lower activity, even in the remitted/euthymic mood-state. Studying objective motor behavior via actigraphy holds promise for informing screening and staging of affective disorders.

Keywords

Actigraphybipolar disorderdepressioneuthymic statemajor depressive disordermeta-analysispsychomotor disturbancepsychomotor retardationremission
Type
Review Article
Information
Psychological Medicine , Volume 52 , Issue 7 , May 2022 , pp. 1208 - 1221
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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