Facial emotion recognition in bipolar disorder: a critical review.
OBJECTIVE
Literature review of the controlled studies in the last 18 years in emotion recognition deficits in bipolar disorder.


METHODS
A bibliographical research of controlled studies with samples larger than 10 participants from 1990 to June 2008 was completed in Medline, Lilacs, PubMed and ISI. Thirty-two papers were evaluated.


RESULTS
Euthymic bipolar disorder presented impairment in recognizing disgust and fear. Manic BD showed difficult to recognize fearful and sad faces. Pediatric bipolar disorder patients and children at risk presented impairment in their capacity to recognize emotions in adults and children faces. Bipolar disorder patients were more accurate in recognizing facial emotions than schizophrenic patients.


CONCLUSIONS
Bipolar disorder patients present impaired recognition of disgust, fear and sadness that can be partially attributed to mood-state. In mania, they have difficult to recognize fear and disgust. Bipolar disorder patients were more accurate in recognizing emotions than depressive and schizophrenic patients. Bipolar disorder children present a tendency to misjudge extreme facial expressions as being moderate or mild in intensity.


CONCLUSIONS
Affective and cognitive deficits in bipolar disorder vary according to the mood states. Follow-up studies re-testing bipolar disorder patients after recovery are needed in order to investigate if these abnormalities reflect a state or trait marker and can be considered an endophenotype. Future studies should aim at standardizing task and designs.
Rocca
Cristiana Castanho de Almeida
CC
Psychology and Neuropsychology Unit, Institute of Psychiatry, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil. crisrocca@uol.com.br
Heuvel
Eveline van den
Ev
Caetano
Sheila C
SC
Lafer
Beny
B
D001714:Bipolar Disorder / Q000235:genetics / Q000503:physiopathology / Q000523:psychology*; D018849:Controlled Clinical Trials as Topic; D003866:Depressive Disorder / Q000235:genetics / Q000503:physiopathology; D004644:Emotions; D019317:Evidence-Based Medicine; D005149:Facial Expression; D005239:Fear; D006801:Humans; D010641:Phenotype; D021641:Recognition, Psychology; D012559:Schizophrenia / Q000235:genetics / Q000503:physiopathology