Deficits in recognition, identification, and discrimination of facial emotions in patients with bipolar disorder

Objective: To analyze the recognition, identification, and discrimination of facial emotions in a sampleof outpatients with bipolar disorder (BD).Methods: Forty-four outpatients with diagnosis of BD and 48 matched control subjects were selected.Both groups were assessed with tests for recognition (Emotion Recognition-40 –– ER40), identification(Facial Emotion Identification Test –– FEIT), and discrimination (Facial Emotion Discrimination Test ––FEDT) of facial emotions, as well as a theory of mind (ToM) verbal test (Hinting Task). Differencesbetween groups were analyzed, controlling the influence of mild depressive and manic symptoms.Results: Patients with BD scored significantly lower than controls on recognition (ER40), identification(FEIT), and discrimination (FEDT) of emotions. Regarding the verbal measure of ToM, a lower scorewas also observed in patients compared to controls. Patients with mild syndromal depressivesymptoms obtained outcomes similar to patients in euthymia. A significant correlation between FEDTscores and global functioning (measured by the Functioning Assessment Short Test, FAST) wasfound.Conclusions: These results suggest that, even in euthymia, patients with BD experience deficits inrecognition, identification, and discrimination of facial emotions, with potential functional implications.Keywords: Social cognition; bipolar disorder; impairment; face emotion recognition; emotionprocessing