title: Hypoesthesia of the malleolus as a soft sign in depression.
abstract: BACKGROUND
  Physical signs often are present in many psychiatric conditions, making up a fundamental part of them and accompanying the psychiatric manifestations themselves. Identifying minor neurological signs is especially of interest due to they are easily accessible through simple neurological examination and could be a useful if underused tool for the diagnostic process and patient therapy.
  
  
  METHODS
  A group of depressed patients (n=85) and group of healthy individuals (n=101) that served as control were examined using the Wartenberg wheel, a medical device for neurological use, in order to determine the presence of hypoesthesia on both sides of their ankles.
  
  
  RESULTS
  The data revealed: (i) patients with depression are generally more likely to present malleolar hypoesthesia than healthy participants; and (ii) participants who presented malleolar hypoesthesia presented greater depressive symptomatology as well as greater anxiety symptomatology at the time of assessment.
  
  
  CONCLUSIONS
  Although all patients in this study were taking psychotropic medication, anxiolytics and antidepressants are not associated with skin sensitivity. As is usual, the categorization of hypoesthesia is based on participant subjectivity. However, this subjectivity cannot explain the differences between depressed patients and healthy individuals.
  
  
  CONCLUSIONS
  The present findings corroborate that localized tactile sensitivity is altered in depression and correlates with anxiety-depressive symptomatology, even on a subclinical level. The observation of neurological soft signs such as the detection of malleolar hypoesthesia in patients with depressive symptomatology is easily accessible using a simple neurological examination, and it could became a powerful tool that could provide objective information on affective disorders.
authors.affiliation: Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain; University of Valencia, Department of Medicine, Valencia, Spain; CIBERESP, Spain.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Livianos
authors.affiliation: Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain.
authors.forename: Pablo I
authors.initials: PI
authors.lastname: González-Valls
authors.affiliation: Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain. Electronic address: ana.garcia-blanco@uv.es.
authors.forename: Ana C
authors.initials: AC
authors.lastname: García-Blanco
authors.affiliation: Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain.
authors.forename: Helena
authors.initials: H
authors.lastname: Tobella
authors.affiliation: Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Díaz-Alonso
authors.affiliation: Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Alberola
authors.affiliation: Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: García-Aznar
authors.affiliation: Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Bellot
authors.affiliation: Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Saiz
authors.affiliation: Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Ros
mesh_terms: D000328:Adult; D000842:Ankle; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology; D003863:Depression; D003866:Depressive Disorder / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D006987:Hypesthesia / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D009460:Neurologic Examination / Q000379:methods; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013030:Spain
keywords: Depression; Hypoesthesia; Neurological soft signs; Tactile sensitivity