Mild motor signs in major depressive disorder: prevalence and clinical profile

• Antonina Luca ^[1] ; Alessandro Serretti ^[1] ; Stefano Barlati ^[2] ; Lisa Buson ^[3] ; Valentina Menesello ^[4] ; Anna Magistrali ^[2] ; Rosana Carvalho Silva ^[2] ; Giulia Perusi ^[3] ; Gabriele Nibbio ^[2] ; Stefano Bignotti ^[5] ; Giovanni Battista Tura ^[5] ; Raffaele Ferri ^[6] ; Massimo Gennarelli ^[4] ; Antonio Vita ^[2] ; Alessandra Minelli ^[4]
  1. [1] Università degli Studi di Enna Kore

     Università degli Studi di Enna Kore

     Enna, Italia

     
  2. [2] Università degli Studi di Brescia

     Università degli Studi di Brescia

     Brescia, Italia

     
  3. [3] Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
  4. [4] Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
  5. [5] Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
  6. [6] Oasi Research Institute-IRCCS, Troina, Italy

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• Localización: European journal of psychiatry, ISSN 0213-6163, Vol. 40, Nº 1, 2026
• Idioma: inglés
• DOI: 10.1016/j.ejpsy.2026.100342
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  • Background and objectives Motor abnormalities are recognized features of major depressive disorder (MDD). However, subtle forms of motor dysfunction are still largely unexamined in adults with MDD. The aims of the present study were to: 1) assess the prevalence of mild motor signs (MMS) in adults with moderate to severe depression, and 2) evaluate whether patients with MMS exhibit specific depressive symptom profiles.

    Methods Two-hundred forty-four participants (172 (70.5 %) women, mean age 46.8 ± 14.5, mean education 12.5 ± 3.6 years) from the PANDORA trial were enrolled. All the participants were assessed using the Hamilton Depression Rating Scale (HAM-D). MMS were assessed using the UKU Side Effects Rating Scale.

    Results Out of the 244 participants, 34 (13.9 %) were MMS+: 20 (58.8 %) had myoclonus, 11 (32.3 %) hyperkinesia, 7 (20.6 %) rigidity, 6 (17.6 %) tremor, and 3 (8.8 %) hypokinesia. The percentage of patients reaching a ≥ 20 % improvement in the HAM-D total score was higher in the MMS- group than in the MMS+ (95.1 % vs. 75.0 %, respectively). MMS+ participants had higher HAM-D total score and sub-items exploring work and abilities, psychomotor retardation, agitation, and hypochondriasis. These associations between MMS and depression severity, as well as the specific symptomatology profile, were confirmed in the multivariate analysis, adjusted for age and sex.

    Conclusions Our findings suggest that MMS may reflect a distinct subgroup within MDD, potentially characterized by greater sensitivity to motor adverse effects and subtle differences in treatment response.

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