Comparison of depression with anxious distress and melancholic depression from the perspective of psychomotor disturbance.

Aim: In the DSM-5, it is specified that severe cases of major depressive disorder with anxious distress (ANXD) may be accompanied with motor agitation. Agitation, on the other hand, is one of the main characteristics of major depressive disorder with melancholic features (MEL). The purpose of this study was to compare ANXD and MEL in terms of psychomotor disturbance.

Methods: A total of 106 patients with major depressive disorder were included in the study. Psychomotor disturbance was assessed using the CORE measure. The associations of ANXD and MEL with the CORE measure subscales of psychomotor retardation, agitation, and noninteractiveness were analyzed using multivariate logistic analysis.

Results: Retardation scores (odds ratio [OR] = 0.63, 95% confidence interval [CI] = 0.52-0.77) were associated with fewer diagnoses of ANXD, whereas agitation scores (OR = 2.23, 95% CI = 1.60-3.13) were associated with more diagnoses of ANXD. Both noninteractiveness (OR = 1.23, 95% CI = 1.06-1.42) and agitation (OR = 1.27, 95% CI = 1.02-1.58) scores were associated with increased diagnoses of MEL.

Conclusion: Among the characteristics of psychomotor disturbance, agitation is a common feature of both ANXD and MEL, and ANXD and the agitated type of MEL may be overlapping concepts. On the other hand, ANXD is distinguished from the retarded type of MEL by its low level of retardation, whereas MEL but not ANXD is characterized by noninteractiveness.