Facial emotion recognition and its relationship to subjective and functional outcomes in remitted patients with bipolar I disorder.
OBJECTIVE
Outcome in bipolar disorder (BD) is multidimensional and consists of clinical and psychosocial domains. Difficulties in affect recognition and in emotional experience are a hallmark of BD, but there is little research investigating the consequences of this deficit on the psychosocial status of patients who are in remission.


METHODS
This cross-sectional study examined the relationship of facial affect recognition and treatment outcomes in terms of psychopathology, quality of life, and psychosocial functioning in remitted BD patients compared to healthy volunteers.


RESULTS
Altogether, 47 outpatients meeting diagnostic criteria for bipolar I disorder according to DSM-IV and 45 healthy control subjects were included in the study. Patients were particularly impaired in the recognition of facial expressions depicting disgust and happiness. For patients, the most frequently observed misidentifications included disgusted faces misrecognized as angry expressions, fearful faces misrecognized as disgusted or surprised expressions, surprised faces misrecognized as fearful expressions, and sad faces misrecognized as fearful or angry expressions. Regarding emotional experience, shame, guilt, sadness, fear, lifelessness, loneliness, and existential fear were experienced more intensely by patients.


CONCLUSIONS
These findings demonstrate deficits in experiencing and recognizing emotions in BD patients who are in remission and underscore the relevance of these deficits in the psychosocial context.
General and Social Psychiatry Division, Medical University Innsbruck, Anichstrasse 35, Innsbruck, Austria. christine.hoertnagl@i-med.ac.at
Christine M
CM
Hoertnagl
Moritz
M
Muehlbacher
Falko
F
Biedermann
Nursen
N
Yalcin
Susanne
S
Baumgartner
Georg
G
Schwitzer
Eberhard A
EA
Deisenhammer
Armand
A
Hausmann
Georg
G
Kemmler
Cord
C
Benecke
Alex
A
Hofer
D000328:Adult; D001714:Bipolar Disorder / Q000150:complications*; D004644:Emotions; D005149:Facial Expression; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D010045:Outpatients; D010364:Pattern Recognition, Visual; D010775:Photic Stimulation; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D021641:Recognition, Psychology / Q000502:physiology*; D012919:Social Behavior; D055815:Young Adult