Facial emotion perception in depression and bipolar disorder: a quantitative review

A considerable body of literature has reported on emotion perception deficits and the relevance of these impairments in persons with depression and bipolar disorder. Fifty-one studies published between 1981-February 2009 were examined regarding emotion perception abilities between patient and control groups, and potential methodological, demographic and clinical moderators. Studies were identified through a computerized literature search of the MEDLINE, PsychINFO, and PubMed databases. The Meta-analysis Of Observational Studies in Epidemiology (MOOSE) standard (Stroup et al., 2000) was followed in the extraction of relevant studies and data. Data on emotion perception, methodology, demographic and clinical characteristics were compiled and analyzed using Comprehensive Meta-Analysis version 2.0 (Biostat, 2005). The meta-analysis revealed a moderate deficit in emotion perception in both bipolar disorder and major depressive disorder, irrespective of task type, diagnosis, age of onset/duration of illness, sex, and hospitalization status. Several factors that moderated the observed impairment include self-reported depression, age at time of testing, and years of education. Emotion perception impairment in bipolar disorder and major depressive disorder represents a moderate and stable deficit that appears to be moderated by a limited number of demographic and clinical factors.