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W45

PSYCHOMOTOR DISTURBANCE AS A PREDICTOR OF TREATMENT RESPONSE IN MOOD DISORDERS: A SYSTEMATIC REVIEW

Sara Di Luch — Gabrielle Lovell1, Lily Jiang1, Diana Orsini1, Shreya Vasudeva1, Gia Han Le1, Sabrina Wong1, Rachel Ospalak2, Rodrigo Mansur1, Alastair Flint1, Joshua Rosenblat1 1University of Toronto, 2University Health Network

2026 ASCP Annual Meeting

Background

Psychomotor disturbance (PMD) is a discrete symptom domain of mood disorders such as major depressive disorder (MDD) and bipolar disorder (BD). Despite PMD’s association with greater depressive symptom severity, its potential utility as a clinical biomarker for therapeutic efficacy remains underinvestigated. Herein, we aim to evaluate whether scalebased assessments of PMD are associated with clinical efficacy across pharmacological and nonpharmacological interventions for mood disorders.

Methods

Following PRISMA guidelines, a systematic search was conducted from inception to July 2025 on Ovid and PubMed databases to retrieve randomized controlled trials, open-label trials, and observational studies reporting treatment efficacy and scale-based assessments of PMD. Studies were screened, methodological quality was assessed, and data extraction was conducted by three independent reviewers.

Results

A total of 29 studies were included, evaluating antidepressants (monoaminergic and glutamate modulators), electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), OnabotulinumtoxinA (OnA), and psychotherapy. Findings from this study indicate that PMD, specifically psychomotor retardartion (PmR), was consistently associated with improved treatment response for ECT. PMD was shown to predict worse clinical efficacy or no difference in clinical efficacy to SSRIs. Mixed results were found for TCAs, with limited results found for other evaluated interventions, including rTMS, OnA, and psychotherapy.

Conclusions

To our knowledge, this is the first systematic review to comprehensively and critically evaluate PMD as a predictor of response, remission, and relapse to various interventions in persons with MDD and bipolar depression. Although studies were largely confined to smaller sample sizes and MDD populations, PMD appears to be a promising, lowcost clinical marker underutilized in precision psychiatry. Integrating PMD into multimodal predictive models remains a scalable approach that, if properly validated with prospective studies, holds hope advancing personalized and optimized treatment approaches to navigate the complex heterogeneity of mood disorders.