Biased emotional recognition in depression: Perception of emotions in music by depressed patients

Background: Depression is a highly prevalent mood disorder, that impairs a person's social skills and also their quality of life. Populations affected with depression also suffer from a higher mortality rate. Depression affects person's ability to recognize emotions. We designed a novel experiment to test the hypothesis that depressed patients show a judgment bias towards negative emotions. Methods: To investigate how depressed patients differ in their perception of emotions conveyed by musical examples, both healthy (n = 30) and depressed (n = 79) participants were presented with a set of 30 musical excerpts, representing one of five basic target emotions, and asked to rate each excerpt using five Likert scales that represented the amount of each one of those same emotions perceived in the example. Results: Depressed patients showed moderate but consistent negative self-report biases both in the overall use of the scales and their particular application to certain target emotions, when compared to healthy controls. Also, the severity of the clinical state (depression, anxiety and alexithymia) had an effect on the self-report biases for both positive and negative emotion ratings, particularly depression and alexithymia. Limitations: Only musical stimuli were used, and they were all clear examples of one of the basic emotions of happiness, sadness, fear, anger and tenderness. No neutral or ambiguous excerpts were included. Conclusions: Depressed patients' negative emotional bias was demonstrated using musical stimuli. This suggests that the evaluation of emotional qualities in music could become a means to discriminate between depressed and non-depressed subjects. The practical implications of the present study relate both to diagnostic uses of such perceptual evaluations, as well as a better understanding of the emotional regulation strategies of the patients. (C) 2010 Elsevier B.V. All rights reserved.