Identification and Perceived Intensity of Facial Expressions of Emotion in Bipolar Disorder and Major Depression

This study aimed to examine the accuracy in identifying facial expressions and the perceived intensity of emotions of happiness, sadness, disgust, anger, fear, surprise in bipolar disorder (BD), and major depressive disorder (MDD).

Ninety-three adult participants (n = 30 BD, 80% female; n = 18 MDD, 72.2% female; n = 45 C, 46.7% female) completed a facial expression task. Stimuli in the task were first presented for 200 ms, followed by 500 ms, and 1000 ms. Participants were asked to identify the emotion expressed by each face and judge its intensity on a Likert scale. Accuracy and perceived intensity of expressions corresponding to each emotion were compared between groups using a repeated measures ANCOVA, with length of stimulus presentation as a within-subjects variable.

Expressions of sadness were rated more intensely by patients with BD, and expressions of anger by those with MDD, than control participants. Subjects with BD were less accurate than control participants in identifying expressions of disgust. An interaction effect was also identified for the detection of sadness, whereby patients with BD were significantly less accurate when expressions were shown for 200 ms.

The increased intensity with which emotions were perceived by patients with BD and MDD has important repercussions for patient functioning and clinical practice. A tendency to overestimate the intensity of certain facial expressions in mood disorders may lead patients to interpret social cues erroneously and engage in dysfunctional behaviors and cognitive patterns. Future studies should focus on this variable in addition to the accuracy of emotion identification.