Confusion Effects of Facial Expression Recognition in Patients With Major Depressive Disorder and Healthy Controls

Facial expression recognition plays a crucial role in understanding the emotion of people, as well as in social interaction. Patients with major depressive disorder (MDD) have been repeatedly reported to be impaired in recognizing facial expressions. This study aimed to investigate the confusion effects between two facial expressions that presented different emotions and to compare the difference of confusion effect for each emotion pair between patients with MDD and healthy controls. Participants were asked to judge the emotion category of each facial expression in a two-alternative forced choice paradigm. Six basic emotions (i.e., happiness, fear, sadness, anger, surprise, and disgust) were examined in pairs, resulting in 15 emotion combinations. Results showed that patients with MDD were impaired in the recognition of all basic facial expressions except for the happy expression. Moreover, patients with MDD were more inclined to confuse a negative emotion (i.e., anger and disgust) with another emotion as compared to healthy controls. These findings highlight the importance that patients with MDD show a deficit of sensitivity in distinguishing specific two facial expressions.