Little evidence for the graphical markers of depression

The purpose was to test whether specific characteristics of handwriting can distinguish patients diagnosed with major depression from healthy controls and patients with bipolar disorder. Handwriting samples from 30 patients with major depressive disorder and 30 patients in the bipolar depressive phase were compared to samples from 30 patients in the bipolar manic phase and 60 healthy controls. Forensic document experts examined all 150 written samples of the same text and empirically measured graphical aspects potentially related to depression, such as direction of the baseline, pen pressure, tremor, forms of the letters 'm', 'n', 'a', and 'o', sizes of the letters and writing zones, the initial and final shapes of letters, slant, and impulse. Three handwriting parameters of 32 examined differed significantly between controls and patients with depression (major depression or depressed bipolar patients). However, there were no statistically significant differences in these parameters between depressed patients and bipolar patients in the manic phase, indicating that these handwriting characteristics cannot distinguish depressed patients from manic patients. The main hypothesis, that psychomotor slowing is visible in handwriting, was not confirmed.