Facial emotion processing in acutely ill and euthymic patients with pediatric bipolar disorder.
OBJECTIVE
Past investigations indicate facial emotion-processing abnormalities in pediatric bipolar disorder (PBD) subjects. However, the extent to which these deficits represent state- and trait-related factors is unclear. We investigated facial affect processing in acutely ill and clinically stabilized children with PBD and matched healthy subjects.


METHODS
Subjects (N = 86) consisted of unmedicated/acutely ill (n = 29) and medicated/clinically stabilized (n = 29) PBD youths and matched healthy subjects (n = 28) who completed tasks of facial affect identification and differentiation.


RESULTS
Subjects with PBD, regardless of clinical and treatment status, showed marked impairments in the ability to correctly identify emotionally intense happy and sad facial expressions, with both groups tending to misjudge extreme facial expressions as being moderate to mild in intensity. However, when differentiating subtle variations of happy or sad expressions, only unmedicated/acutely ill PBD patients performed more poorly than healthy subjects. Younger age at onset was associated with more impaired emotion processing only in the PBD sample. PBD subjects with comorbid attention-deficit/hyperactivity disorder (ADHD) performed more poorly than subjects without ADHD when processing sad facial expressions, but not happy ones.


CONCLUSIONS
This study found evidence of both state-of-illness and trait-related deficits in emotion processing in PBD. Treatments are needed to better reduce this impairment and to reduce its developmental impact on interpersonal functioning.
All of the authors are with the Department of Psychiatry, University of Illinois at Chicago; Dr. Pavuluri is also with the Pediatric Mood Disorders Clinic, Institute for Juvenile Research, Chicago; and Dr. Sweeney is also with the Center for Cognitive Medicine, Chicago.. Electronic address: mpavuluri@psych.uic.edu.
Lindsay S
LS
Schenkel
All of the authors are with the Department of Psychiatry, University of Illinois at Chicago; Dr. Pavuluri is also with the Pediatric Mood Disorders Clinic, Institute for Juvenile Research, Chicago; and Dr. Sweeney is also with the Center for Cognitive Medicine, Chicago.
Mani N
MN
Pavuluri
All of the authors are with the Department of Psychiatry, University of Illinois at Chicago; Dr. Pavuluri is also with the Pediatric Mood Disorders Clinic, Institute for Juvenile Research, Chicago; and Dr. Sweeney is also with the Center for Cognitive Medicine, Chicago.
Ellen S
ES
Herbener
All of the authors are with the Department of Psychiatry, University of Illinois at Chicago; Dr. Pavuluri is also with the Pediatric Mood Disorders Clinic, Institute for Juvenile Research, Chicago; and Dr. Sweeney is also with the Center for Cognitive Medicine, Chicago.
Erin M
EM
Harral
All of the authors are with the Department of Psychiatry, University of Illinois at Chicago; Dr. Pavuluri is also with the Pediatric Mood Disorders Clinic, Institute for Juvenile Research, Chicago; and Dr. Sweeney is also with the Center for Cognitive Medicine, Chicago.
John A
JA
Sweeney
D000208:Acute Disease; D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy / Q000523:psychology*; D002648:Child; D004359:Drug Therapy, Combination; D019263:Dysthymic Disorder / Q000523:psychology*; D019260:Expressed Emotion; D005149:Facial Expression; D005260:Female; D006801:Humans; D016651:Lithium Carbonate / Q000627:therapeutic use; D008297:Male; D018967:Risperidone / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use
D014150:Antipsychotic Agents; D016651:Lithium Carbonate; D014635:Valproic Acid; D018967:Risperidone