Older adults with both active and remitted major depressive disorder (MDD) may have a tougher time processing happy faces than do their counterparts without depression, a cross-sectional study of 59 veterans suggests.

“Sensitivity recognition of moderately intense happy expression appears to reflect a perceptual bias in major depression among older adults,” report Paulo R. Shiroma, MD , of the Minneapolis Veterans Affairs Medical Center, and his associates.

The researchers recruited the subjects from October 2011 to September 2013, from primary care practices. The participants were divided into three groups – one with active major depressive disorder, another with MDD in remission, and one with no history of depression. Most of the veterans were white and married, and all were aged 55 years and older. Only veterans who were free of antidepressants or other psychotropic medications for at least 2 weeks were included in the study. They were compensated monetarily for participating in the study, reported Dr. Shiroma ( Psychiatry Res. 2016 Sep 30;243;287-91 ).

Dr. Shiroma and his associates assessed the participants using several scales, including the 15-item Geriatric Depression Scale ( GDS-15 ) and the 17-item Hamilton Depression Rating Scale ( HDRS-17 ). The veterans also were asked to complete a facial emotional recognition task, which involved looking at facial images depicting 12 neutral expressions and 48 happy expressions on a computer in a quiet room. Among other things, the participants were asked to respond as quickly as possible to the question: “Do you see a happy face?”

The researchers found a significant correlation between GDS-15 (P = .02) and HDRS-17 (P = .05) scores, and emotion recognition. Specifically, they found that the mean sensitivity among the never-depressed patients was 83.9%, compared with a mean sensitivity of 75.5% among the participants with active MDD and 75.4% among those with MDD that was in remission. No significant different differences were found in reaction time.

They cited several limitations. Veterans made up the entire study sample, and the results might not be generalizable. In addition, the prevalence of MDD in VA populations is 12%, compared with 7% in the general U.S. population, Dr. Shiroma and his associates wrote. Also, studies suggest that women may be more accurate in recognizing subtle facial displays of emotion.

Previous studies suggest that reducing “emotion-related negative bias” is associated with an improvement in depressive symptoms after 3 months of treatment with antidepressants. A recent trial analyzed the impact of emotion recognition training on mood among people with depressive symptoms using technology such as computers and smartphones ( Trials. 2013 Jun 1;14:161 ). In light of those findings, Dr. Shiroma and his associates wrote, “similar intervention within the specific social and psychological aspects of the aging process could also be attempted.”

Dr. Shiroma reported having no conflicts of interest.

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