[The features of emotional processing in patients with depressive disorders]

Recognition of Facial Emotion Expressions in Patients with Depressive Disorders: A Prospective, Observational Study

INTRODUCTION

Processing of emotional stimuli is altered in patients with depression. The present feasibility study investigated the features of emotional information recognition in people with depressive disorders and how these differ from individuals without depression to determine whether response times could potentially be used as a diagnostic marker to identify individuals at high risk of depression and as an indicator of antidepressant medication response.

METHODS

The study recruited 32 individuals, 16 with single or recurrent depressive episodes and 16 control subjects without depression. Patients with depression received 8 weeks of antidepressant therapy. The severity of depressive symptoms at baseline and their changes on prescribed therapy were assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS). The processing of emotional information was assessed using the computerized Penn Emotion Recognition Task (ER-40).

RESULTS

The two groups were well matched in terms of age and gender. There was no difference between the groups in their ability to correctly recognize happy or sad emotional facial expressions, but the average time patients with depression took to recognize a happy face was significantly longer than controls. In addition, they were more likely to misinterpret facial expressions as non-emotional. In patients with depression, the mean MADRS total score decreased from 26.3 ± 4.4 at baseline to 11.1 ± 8.9 at 8 weeks, a reduction of 57.8%. The proportion of responders with greater than 50% reduction in their baseline MADRS total score was 64.3%. Antidepressive treatment was associated with a reduction in the mean time required for recognition of a happy face (P < 0.05).

CONCLUSIONS

Patients with depression are slower to identify positive emotions but have a similar time to recognition of negative emotions as patients without depression. The greater time required for recognition of happiness distinguished the patients with depression from control subjects, and was also the only parameter that showed an improvement with antidepressant therapy, suggesting a specific relationship of this parameter with the depressive state.

Recognition of Facial Emotion Expressions in Patients with Depressive Disorders: A Prospective, Observational Study

Introduction

Processing of emotional stimuli is altered in patients with depression. The present feasibility study investigated the features of emotional information recognition in people with depressive disorders and how these differ from individuals without depression to determine whether response times could potentially be used as a diagnostic marker to identify individuals at high risk of depression and as an indicator of antidepressant medication response.

Methods

The study recruited 32 individuals, 16 with single or recurrent depressive episodes and 16 control subjects without depression. Patients with depression received 8 weeks of antidepressant therapy. The severity of depressive symptoms at baseline and their changes on prescribed therapy were assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS). The processing of emotional information was assessed using the computerized Penn Emotion Recognition Task (ER-40).

Results

The two groups were well matched in terms of age and gender. There was no difference between the groups in their ability to correctly recognize happy or sad emotional facial expressions, but the average time patients with depression took to recognize a happy face was significantly longer than controls. In addition, they were more likely to misinterpret facial expressions as non-emotional. In patients with depression, the mean MADRS total score decreased from 26.3 ± 4.4 at baseline to 11.1 ± 8.9 at 8 weeks, a reduction of 57.8%. The proportion of responders with greater than 50% reduction in their baseline MADRS total score was 64.3%. Antidepressive treatment was associated with a reduction in the mean time required for recognition of a happy face (P < 0.05).

Conclusions

Patients with depression are slower to identify positive emotions but have a similar time to recognition of negative emotions as patients without depression. The greater time required for recognition of happiness distinguished the patients with depression from control subjects, and was also the only parameter that showed an improvement with antidepressant therapy, suggesting a specific relationship of this parameter with the depressive state.

[An organic mental disorder and comorbid affective spectrum disturbances: a forensic-psychiatric assessment]

AIM

To identify the influence of combined pathology, an organic personality disorder and affective disturbances, on the regulation of subjects' legally significant behavior in forensic-psychiatric examination in criminal and civil proceedings.

MATERIAL AND METHODS

Two groups of patients with the diagnosis of organic personality disorder (ICD-10 F07) established in the course of forensic-psychiatric examination were studied. The first group included 82 criminally prosecuted men (mean age 40.7±15.8); the second group comprised 50 women (mean age 65.1±15.4) and 28 men (mean age 60.2±14.4), who underwent forensic-psychiatric examination in civil litigation over declaring their contracts null and void. All patients had affective disorders. Standard expertise procedure and data analysis were used.

RESULTS AND CONCLUSION

The modifying influence of a set of psychogenic factors is of great significance in the course of forensic-psychiatric examination of individuals diagnosed with organic personality disorder: in criminal proceedings these are determined by the fact of being prosecuted, and in civil proceedings by the problems of adaptation, deterioration of one's social status, and the somatic ill-being. The unfavorable dynamics of organic mental disorder in these cases manifested itself in decompensation of personality, cognitive disturbances or addition of comorbid depressive disorders (68.3 and 31.7%, respectively). In 48.7% of patients, the addition of affective pathology to organic disorders significantly increased the extent of disturbance of cognitive functions, insight and prognostic capacity, volitional control of activity, which determined the incapacity of patients to understand the significance of their own actions and control them at the time of entering into contract.