What is psychomotor retardation, and in which conditions might you see it on the MSE?

• A. Slowed speech and movements.
• B. Slowed speech and movements; seen in major depression, delirium, dementia, and some psychotic disorders or medication effects.
• C. Rapid speech and motor agitation.
• D. Increased motor activity with goal-directed behavior.

Answer: (B)

Psychomotor retardation is a slowing of both thinking and physical action. On the mental status exam you’d look for slowed movements, reduced facial expressiveness, diminished gestures, and notably slowed or sparse speech with longer pauses before answers. This pattern reflects a broad slowdown of neural processing and motor output.

It’s most commonly seen in a major depressive episode, where patients may appear lethargic and speak slowly. It can also appear in delirium, where attention and awareness are impaired and responses are delayed; in dementia, particularly as cognitive decline progresses; and in some psychotic disorders or from medications that depress the central nervous system or cause motor slowing.

So, the description that captures this finding is slowed speech and movements, with the recognition that it can arise in depression, delirium, dementia, psychotic disorders, or medication effects. This helps distinguish it from psychomotor agitation (rapid, restless movement) or other forms of increased activity.