title: Facial emotion recognition and its correlation with executive functions in bipolar I patients and healthy controls.
abstract: BACKGROUND
  The ability to recognize facial emotions is altered in patients with Bipolar Disorder (BD) during mood episodes and even in euthymia, while cognitive functioning is similarly impaired. This recognition is considered a fundamental skill for successful social interaction. However, it is unclear whether the ability to recognize facial emotions is correlated with the cognitive deficits observed in BD.
  
  
  OBJECTIVE
  The objective of this study was to evaluate Facial Emotion Recognition (FER) and its correlation with executive function (EF) in BD I patients during mania, depression and euthymia compared to healthy controls.
  
  
  METHODS
  A total of 110 patients with BD I, 18-40 years old were included (41 in manic episode; 31 in depressive episode and 38 euthymic). Patients were assessed for FER and EF (Wisconsin card sorting test - WCST), along with 96 healthy volunteers (18-40 years old) recruited from the University of São Paulo.
  
  
  RESULTS
  The results showed that BD I patients had lower FER performance compared to controls on fear subtests, happiness, the surprise test, and FER total scores. Moreover, BD I manic patients showed poorer performance for EF compared to controls. Six out of the seven variables of the WCST correlated with FER in both healthy controls and BD euthymic subjects but not in BD patients during mood episodes.
  
  
  CONCLUSIONS
  Cognitive deficits and difficulties recognizing facial emotions are present in all mood episodes in BD I patients, even during remission. Although FER is not considered a cognitive domain, these results suggest that, along with EF, it has a complementary function. Hence, further studies should investigate this issue in larger samples and verify whether these similarities also occur at a neurobiological level.
authors.affiliation: Mood Disorders Unit (GRUDA), Department and Institute of Psychiatry, School of Medicine, University of São Paulo (IPQ HC-FMUSP), Brazil. Electronic address: depetresco@gmail.com.
authors.forename: Denise Petresco
authors.initials: DP
authors.lastname: David
authors.forename: Márcio Gerhardt
authors.initials: MG
authors.lastname: Soeiro-de-Souza
authors.forename: Ricardo Alberto
authors.initials: RA
authors.lastname: Moreno
authors.forename: Danielle Soares
authors.initials: DS
authors.lastname: Bio
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology*; D016022:Case-Control Studies; D056348:Emotional Intelligence; D056344:Executive Function; D005149:Facial Expression; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D055815:Young Adult
keywords: Bipolar disorder; Depression; Euthymia; Executive function; Facial emotion recognition; Mania