Abstract
Major depressive disorder (MDD) is a heterogeneous disorder. Our hypothesis is that neurological symptoms correlate with the severity of MDD symptoms. One hundred eighty-four outpatients with MDD completed a self-report questionnaire on past and present medical history. Patients were divided into three roughly equal depression severity levels based on scores from the APA Severity Measure for Depression—Adult (n = 66, 58, 60, for low, medium, high severity, respectively). We saw a significant and gradual increase in the frequency of “muscular paralysis” (1.5–5.2–16.7%) and “balance problems” (21.2–36.2–46.6%) from low to medium to high severity groups. We repeated the analysis using only the two most extreme severity categories: low severity (66 samples) vs. high severity (60 samples). High severity patients were also found to experience more “angina” symptoms than low severity patients (27.3 vs. 50%). The three significant clinical variables identified were introduced into a binary logistic regression model as the independent variables with high or low severity as the dependent variable. Both “muscular paralysis” and “balance problems” were significantly associated with increased severity of depression (odds ratio of 13.5 and 2.9, respectively), while “angina” was associated with an increase in severity with an odds ratio of 2.0, albeit not significantly. We show that neurological exam or clinical history could be useful biomarkers for depression severity. Our findings, if replicated, could lead to a simple clinical scale administered regularly for monitoring patients with MDD.
Highlights
Major depressive disorder (MDD) is characterized by one or more major depressive episodes (MDEs) and the absence of mania and hypomania throughout an individual’s lifetime [1]
This study explores whether any findings in non-psychiatric past medical history correlate with depression severity, potentially allowing their use as biomarkers for the prognosis and monitoring of patients with depression
For the three severity categories analysis, a significant difference between observed and expected frequencies was found for the “muscular paralysis” and “balance problems” variables
Summary
Major depressive disorder (MDD) is characterized by one or more major depressive episodes (MDEs) and the absence of mania and hypomania throughout an individual’s lifetime [1]. For an individual to be diagnosed with MDD, at least five symptoms need to be present within a period of 2 weeks Of these five symptoms, depressed mood or loss of interest and pleasure must be present for a diagnosis of MDE to be made. Very mild depressive symptoms have been shown to be associated with gait disturbance in early Parkinson’s disease (PD) and it has been hypothesized that depression may influence mechanisms of gait disturbance [13]. This hypothesis is in line with the results of a multicenter randomized study showing that gait instability (freezing of gait), in patients with PD, responds to treatment with antidepressants [14]. This study explores whether any findings in non-psychiatric past medical history correlate with depression severity, potentially allowing their use as biomarkers for the prognosis and monitoring of patients with depression
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