Facial emotion recognition in major depressive disorder: A meta-analytic review

Background: Major depressive disorder (MDD) has been associated with difficulties in social and interpersonal functioning. Deficits in emotion processing may contribute to the development and maintenance of interpersonal difficulties in MDD. Although some studies have found that MDD is associated with deficits in recognition of emotion in faces, other studies have failed to find any impairment. Methods: The present meta-analysis of 23 studies, with 516 dysthymic/depressed participants and 614 euthymic control participants, examined facial emotion recognition accuracy in MDD. Several potential moderators were investigated, including type of emotion, symptom severity, patient status, method of diagnosis, type of stimulus, and stimulus duration. Results: Results showed that participants with MDD in inpatient settings (Hedges' g =-0.35) and with severe levels of symptom severity (g =-0.42) were less accurate in recognizing happy facial expressions of emotion (g =-0.25) compared to participants in outpatient settings (g =-0.24) and with mild symptoms of depression (g =-0.17). Studies that presented stimuli for longer durations (g =-0.26) tended to find lower accuracy levels in dysthymic/depressed, relative to euthymic, participants. Limitations: Limitations include a lack of studies which examined gender identity, as well as other potential moderators. Conclusions: Results of the current study support the existence of a broad facial emotion recognition deficit in individuals suffering from unipolar depression. Clinicians should be mindful of this and other research which suggests broad-based deficits in various forms of information processing, including attention, perception, and memory in depression.