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Introduction
Psychomotor disturbance (PMD) in major depressive disorder (MDD) is a complex clinical state characterized by changes in movement, speech, thinking, and cognition (Schrijvers, Hulstijn, & Sabbe, 2008). PMD is more common in severe depression and has been proposed as the core feature of melancholic depression (Parker & Hadzi-Pavlovic, 1996a). There is substantial overlap between melancholic depression and psychotic depression, and not surprisingly PMD is common in psychotic depression (Brodaty et al., 1997; Parker, Hickie, & Hadzi-Pavlovic, 1996).
Naturalistic follow-up studies found that PMD was associated with poorer long-term outcome of depression (Duggan, Lee, & Murray, 1991; Parker, Hickie, & Mason, 1996). Over several decades, studies have examined whether PMD predicts response to pharmacologic treatment of MDD. For the most part, PMD has been found to predict favorable response to tricyclic antidepressants (TCA) (Laakmann, Blaschke, Engel, & Schvjarz, 1998; Navarro, Gasto, Torres, Marcos, & Pintor, 2001; Sobin & Sackeim, 1997). In contrast, PMD predicted poorer response or no difference in response to selective serotonin reuptake inhibitors (SSRIs) in nearly all studies that examined this issue (Bondareff et al., 2000; Burns et al., 1995; Chekroud et al., 2016; Flament, Lane, Zhu, & Ying, 1999; Joyce et al., 2002; Laakmann et al., 1998; Navarro et al., 2001; Sechter et al., 2004; Taylor et al., 2006; Ulbricht, Dumenci, Rothschild, & Lapane, 2018). We know of only one study that has examined the relationship between PMD and relapse of MDD: in a secondary analysis of data from the STAR*D study, Sakurai, Suzuki, Yoshimura, Mimura, and Uchida (2017) found that both self-reported and observed restlessness at the time of remission of MDD with citalopram predicted relapse during the 12-month follow-up.
To our knowledge, only one study has examined the relationship of PMD with treatment outcome of psychotic depression (Janzing et al., 2020). In this randomized controlled trial (RCT) that compared imipramine, venlafaxine, and venlafaxine plus quetiapine in the acute treatment of psychotic depression, psychomotor retardation at baseline was associated with a lower frequency of remission in the sample as a whole. The study found no relationship between PMD, treatment arm, and remission, but it was not powered to examine this issue (Janzing et al., 2020).
The goal of the current analysis was to determine whether PMD is associated with remission...