Abstract
Bipolar disorder (BD) impacts around 1–2.4% of the world’s citizens, causing significant declines in life quality and psychosocial functioning for many individuals. The primary objective of our research was to assess facial emotion recognition by employing a unique collection of dynamic virtual faces (DVFs). Data from one-hundred and ten participants were analysed, consisting of fifty-five BD patients and an equally large number of healthy matched controls. Each participant completed a single session comprising sociodemographic and clinical assessments, as well as a task for the recognition of emotions. The task involved virtual non-immersive reality, where participants viewed DVFs displaying the neutral expression and the six basic emotions on a 27" computer screen. After each DVF presentation, enrollees had to identify the underlying emotion by choosing from seven possible responses that were displayed at the bottom of the screen. Patients with BD demonstrated impaired facial emotion recognition skills, exhibiting lower accuracy rates and longer reaction times compared to their healthy counterparts. The most substantial differences were observed in recognising fear, disgust and sadness. Interestingly, individuals with BD exhibited better recognition of positive emotions than negative ones. Notably, factors such as psychopathology (including bipolar symptomology and affectivity), level of functioning and life quality did not show significant correlations with emotion recognition in BD patients. The recognition of the most dynamic faces was superior in healthy controls, and the presentation angle had no discernible impact on either group. This study confirmed that people with BD have trouble recognising affect across the entire spectrum. While our validation of the DVFs tool was successful, it is worth noting that research employing virtual reality in this domain remains relatively scarce. Therefore, further investigations using virtual reality tools are encouraged to enhance the methodological consistency of studies and yield more conclusive findings.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The data that support the findings of this study are available on request from the corresponding author.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5.
Aparicio, A., Santos, J. L., Jiménez-López, E., Bagney, A., Rodríguez-Jiménez, R., & Sánchez-Morla, E. M. (2017). Emotion processing and psychosocial functioning in euthymic bipolar disorder. Acta Psychiatrica Scandinavica, 135(4), 339–350. https://doi.org/10.1111/acps.12706
Arman, S., Golmohammadi, F., Maracy, M., & Molaeinezhad, M. (2018). Efficacy of group cognitive–behavioral therapy in maintenance treatment and relapse prevention for bipolar adolescents. Advanced Biomedical Research, 7(1), 41. https://doi.org/10.4103/abr.abr_168_16
Borentain, S., Gogate, J., Williamson, D., Carmody, T., Trivedi, M., Jamieson, C., Cabrera, P., Popova, V., Wajs, E., DiBernardo, A., & Daly, E. J. (2022). Montgomery‐Åsberg Depression Rating Scale factors in treatment‐resistant depression at onset of treatment: Derivation, replication, and change over time during treatment with esketamine. International Journal of Methods in Psychiatric Research, 31(4). https://doi.org/10.1002/mpr.1927
Bozikas, V., Tonia, T., Fokas, K., Karavatos, A., & Kosmidis, M. (2006). Impaired emotion processing in remitted patients with bipolar disorder. Journal of Affective Disorders, 91(1), 53–56. https://doi.org/10.1016/j.jad.2005.11.013
Brito, H. C., & Vicente, B. P. (2018). Realidad virtual y sus aplicaciones en trastornos mentales: Una revisión. Revista Chilena de Neuro-Psiquiatría, 56(2), 127–135. https://doi.org/10.4067/s0717-92272018000200127
Brodie, M. J., McPhail, E., Macphee, G. J. A., Larkin, J. G., & Gray, J. M. B. (1987). Psychomotor impairment and anticonvulsant therapy in adult epileptic patients. European Journal of Clinical Pharmacology, 31(6), 655–660. https://doi.org/10.1007/BF00541291
Brotman, M. A., Skup, M., Rich, B. A., Blair, K. S., Pine, D. S., Blair, J. R., & Leibenluft, E. (2008). Risk for bipolar disorder is associated with face-processing deficits across emotions. Journal of the American Academy of Child & Adolescent Psychiatry, 47(12), 1455–1461. https://doi.org/10.1097/CHI.0b013e318188832e
Calvo, M. G., & Nummenmaa, L. (2016). Perceptual and affective mechanisms in facial expression recognition: An integrative review. Cognition and Emotion, 30(6), 1081–1106. https://doi.org/10.1080/02699931.2015.1049124
Colom, F., Vieta, E., Martínez-Arán, A., Garcia-Garcia, M., Reinares, M., Torrent, C., Goikolea, J. M., Banús, S., & Salamero, M. (2002). Versión española de una escala de evaluación de la manía: Validez y fiabilidad de la Escala de Young. Medicina Clínica, 119(10), 366–371. https://doi.org/10.1016/S0025-7753(02)73419-2
Darke, H., Sundram, S., Cropper, S. J., & Carter, O. (2021). Dynamic face processing impairments are associated with cognitive and positive psychotic symptoms across psychiatric disorders. npj Schizophrenia, 7(1), 36. https://doi.org/10.1038/s41537-021-00166-z
de Almeida Rocca, C. C., van den Heuvel, E., Caetano, S. C., & Lafer, B. (2009). Facial emotion recognition in bipolar disorder: A critical review. Revista Brasileira de Psiquiatria, 31(2), 171–180. https://doi.org/10.1590/S1516-44462009000200015
Dehelean, L., Romosan, A. M., Bucatos, B. O., Papava, I., Balint, R., Bortun, A. M. C., Toma, M. M., Bungau, S., & Romosan, R. S. (2021). Social and neurocognitive deficits in remitted patients with schizophrenia, schizoaffective and bipolar disorder. Healthcare, 9(4), 365. https://doi.org/10.3390/healthcare9040365
Derntl, B., Seidel, E.-M., Kryspin-Exner, I., Hasmann, A., & Dobmeier, M. (2009). Facial emotion recognition in patients with bipolar I and bipolar II disorder. British Journal of Clinical Psychology, 48(4), 363–375. https://doi.org/10.1348/014466509X404845
Dyck, M., Winbeck, M., Leiberg, S., Chen, Y., Gur, R. C., & Mathiak, K. (2008). Recognition profile of emotions in natural and virtual faces. PLoS One, 3(11), e3628. https://doi.org/10.1371/journal.pone.0003628
Ekman, P., & Friesen, W. V. (1978). Facial action coding system: A technique for the measurement of facial movement. Consulting Psychologists Press.
El-Qirem, F. A., Malak, M. Z., Bani Salameh, A. K., Ali, R., & Alsswey, A. (2023). Effect of virtual reality therapy on stress and anxiety symptoms, and physiological measures among University students: An experimental study in Jordan. Current Psychology, 42(22), 18997–19005. https://doi.org/10.1007/s12144-022-02939-w
Elsass, P., Mellerup, E. T., Rafaelsen, O. J., & Theilgaard, A. (1981). Effect of lithium on reaction time ? A study of diurnal variations. Psychopharmacology, 72(3), 279–282. https://doi.org/10.1007/BF00431831
Espinós, U., Fernández-Abascal, E. G., & Ovejero, M. (2019). Theory of mind in remitted bipolar disorder: Interpersonal accuracy in recognition of dynamic nonverbal signals. PLoS One, 14(9), e0222112. https://doi.org/10.1371/journal.pone.0222112
Espinoza, I., Osorio, P., Torrejón, M. J., Lucas-Carrasco, R., & Bunout, D. (2011). Validation of the WHOQOL-BREF quality of life questionnaire among Chilean older people. Revista Medica de Chile, 139(5), 579–586. https://doi.org/10.4067/S0034-98872011000500003
Faith, R. N., Miller, S. A., & Kosson, D. S. (2022). Facial affect recognition and psychopathy: A signal detection theory perspective. Journal of Psychopathology and Behavioral Assessment, 44(3), 738–749. https://doi.org/10.1007/s10862-022-09969-5
Fernández-Sotos, P., García, A. S., Vicente-Querol, M. A., Lahera, G., Rodriguez-Jimenez, R., & Fernández-Caballero, A. (2021). Validation of dynamic virtual faces for facial affect recognition. PLoS One, 16(1 1). https://doi.org/10.1371/journal.pone.0246001
Fernández-Sotos, P., Fernández-Caballero, A., & Rodriguez-Jimenez, R. (2020). Virtual reality for psychosocial remediation in schizophrenia: A systematic review. The European Journal of Psychiatry, 34(1), 1–10. https://doi.org/10.1016/j.ejpsy.2019.12.003
Fernández-Sotos, P., Torio, I., Fernández-Caballero, A., Navarro, E., González, P., Dompablo, M., & Rodriguez-Jimenez, R. (2019). Social cognition remediation interventions: A systematic mapping review. PLoS One, 14(6), e0218720. https://doi.org/10.1371/journal.pone.0218720
Fredriksen, K. J., Gjestad, R., Walby, F. A., Anda, L. G., Oedegaard, K. J., & Schoeyen, H. K. (2022). High scores on the Montgomery-Åsberg depression rating scale and psychotic symptoms predict suicide. The Journal of Clinical Psychiatry, 83(5). https://doi.org/10.4088/JCP.21m14018
Gago, B., Perea, M., Livianos, L., Sierra, P., & García-Blanco, A. (2022). Attentional processing of threat in bipolar disorder: Going beyond mood-congruency. Journal of Psychopathology and Behavioral Assessment, 44(2), 396–404. https://doi.org/10.1007/s10862-021-09905-z
García, A. S., Fernández-Sotos, P., Vicente-Querol, M. A., Lahera, G., Rodriguez-Jimenez, R., & Fernández-Caballero, A. (2020). Design of reliable virtual human facial expressions and validation by healthy people. Integrated Computer-Aided Engineering, 27(3), 287–299. https://doi.org/10.3233/ICA-200623
Geraets, C. N. W., Klein Tuente, S., Lestestuiver, B. P., van Beilen, M., Nijman, S. A., Marsman, J. B. C., & Veling, W. (2021). Virtual reality facial emotion recognition in social environments: An eye-tracking study. Internet Interventions, 25, 100432. https://doi.org/10.1016/j.invent.2021.100432
Getz, Gl. E., Shear, P. K., & Strakowski, S. M. (2003). Facial affect recognition deficits in bipolar disorder. Journal of the International Neuropsychological Society, 9(4), 623–632. https://doi.org/10.1017/S1355617703940021
Gillissie, E. S., Lui, L. M. W., Ceban, F., Miskowiak, K., Gok, S., Cao, B., Teopiz, K. M., Ho, R., Lee, Y., Rosenblat, J. D., & McIntyre, R. S. (2022). Deficits of social cognition in bipolar disorder: Systematic review and meta-analysis. Bipolar Disorders, 24(2), 137–148. https://doi.org/10.1111/bdi.13163
Goghari, V. M., & Sponheim, S. R. (2013). More pronounced deficits in facial emotion recognition for schizophrenia than bipolar disorder. Comprehensive Psychiatry, 54(4), 388–397. https://doi.org/10.1016/j.comppsych.2012.10.012
Gomes, B. C., Rocca, C. C., Belizario, G. O., Fernandes, F., Valois, I., Olmo, G. C., Fachin, R. V. P., Farhat, L. C., & Lafer, B. (2019). Cognitive behavioral rehabilitation for bipolar disorder patients: A randomized controlled trial. Bipolar Disorders, 21(7), 621–633. https://doi.org/10.1111/bdi.12784
Grabowski, K., Rynkiewicz, A., Lassalle, A., Baron-Cohen, S., Schuller, B., Cummins, N., Baird, A., Podgórska-Bednarz, J., Pieniążek, A., & Łucka, I. (2019). Emotional expression in psychiatric conditions: New technology for clinicians. Psychiatry and Clinical Neurosciences, 73(2), 50–62. https://doi.org/10.1111/pcn.12799
Green, M. F., Horan, W. P., & Lee, J. (2015). Social cognition in schizophrenia. Nature Reviews Neuroscience, 16(10), 620–631. https://doi.org/10.1038/nrn4005
Green, M. F., Penn, D. L., Bentall, R., Carpenter, W. T., Gaebel, W., Gur, R. C., Kring, A. M., Park, S., Silverstein, S. M., & Heinssen, R. (2008). Social cognition in schizophrenia: An NIMH workshop on definitions, assessment, and research opportunities. Schizophrenia Bulletin, 34(6), 1211–1220. https://doi.org/10.1093/schbul/sbm145
Gruber, J. (2011). Can feeling too good be bad? Positive emotion persistence (PEP) in bipolar disorder. Current Directions in Psychological Science, 20(4), 217–221. https://doi.org/10.1177/0963721411414632
Gur, R. E., Moore, T. M., Calkins, M. E., Ruparel, K., & Gur, R. C. (2017). Face processing measures of social cognition: A dimensional approach to developmental psychopathology. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 2(6), 502–509. https://doi.org/10.1016/j.bpsc.2017.03.010
Haffner, P., Quinlivan, E., Fiebig, J., Sondergeld, L.-M., Strasser, E. S., Adli, M., Moritz, S., & Stamm, T. J. (2018). Improving functional outcome in bipolar disorder: A pilot study on metacognitive training. Clinical Psychology & Psychotherapy, 25(1), 50–58. https://doi.org/10.1002/cpp.2124
Hoertnagl, C. M., Muehlbacher, M., Biedermann, F., Yalcin, N., Baumgartner, S., Schwitzer, G., Deisenhammer, E. A., Hausmann, A., Kemmler, G., Benecke, C., & Hofer, A. (2011). Facial emotion recognition and its relationship to subjective and functional outcomes in remitted patients with bipolar I disorder. Bipolar Disorders, 13(5–6), 537–544. https://doi.org/10.1111/j.1399-5618.2011.00947.x
Hørlyck, L. D., Obenhausen, K., Jansari, A., Ullum, H., & Miskowiak, K. W. (2021). Virtual reality assessment of daily life executive functions in mood disorders: Associations with neuropsychological and functional measures. Journal of Affective Disorders, 280, 478–487. https://doi.org/10.1016/j.jad.2020.11.084
Hwang, H. C., Kim, S. M., & Han, D. H. (2021). Different facial recognition patterns in schizophrenia and bipolar disorder assessed using a computerized emotional perception test and fMRI. Journal of Affective Disorders, 279, 83–88. https://doi.org/10.1016/j.jad.2020.09.125
Ioannou, A., Papastavrou, E., Avraamides, M. N., & Charalambous, A. (2020). Virtual reality and symptoms management of anxiety, ddepression, fatigue, and pain: A systematic review. SAGE Open Nursing, 6, 237796082093616. https://doi.org/10.1177/2377960820936163
Işık Ulusoy, S., Gülseren, ŞA., Özkan, N., & Bilen, C. (2020). Facial emotion recognition deficits in patients with bipolar disorder and their healthy parents. General Hospital Psychiatry, 65, 9–14. https://doi.org/10.1016/j.genhosppsych.2020.04.008
Kasley, G. B., Salzman, L. F., Ciccone, J. R., & Klorman, R. (1980). Effects of lithium on evoked potentials and performance during sustained attention. Psychiatry Research, 3(3), 281–289. https://doi.org/10.1016/0165-1781(80)90058-X
Kim, E., Jung, Y.-C., Ku, J., Kim, J.-J., Lee, H., Kim, S. Y., Kim, S. I., & Cho, H.-S. (2009a). Reduced activation in the mirror neuron system during a virtual social cognition task in euthymic bipolar disorder. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 33(8), 1409–1416. https://doi.org/10.1016/j.pnpbp.2009.07.019
Kim, K., Kim, C.-H., Kim, S.-Y., Roh, D., & Kim, S. I. (2009b). Virtual reality for obsessive-compulsive disorder: Past and the future. Psychiatry Investigation, 6(3), 115–121. https://doi.org/10.4306/pi.2009.6.3.115
Korgaonkar, M. S., Erlinger, M., Breukelaar, I. A., Boyce, P., Hazell, P., Antees, C., Foster, S., Grieve, S. M., Gomes, L., Williams, L. M., Harris, A. W. F., & Malhi, G. S. (2019). Amygdala activation and connectivity to emotional processing distinguishes asymptomatic patients with bipolar disorders and unipolar depression. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 4(4), 361–370. https://doi.org/10.1016/j.bpsc.2018.08.012
Lembke, A., & Ketter, T. A. (2002). Impaired recognition of facial emotion in mania. American Journal of Psychiatry, 159(2), 302–304. https://doi.org/10.1176/appi.ajp.159.2.302
Lobo, A., Chamorro, L., Luque, A., Dal-Ré, R., Badia, X., & Baró, E. (2002). Validación de las versiones en español de la Montgomery-Asberg Depression Rating Scale y la Hamilton Anxiety Rating Scale para la evaluación de la depresión y de la ansiedad. Medicina Clínica, 118(13), 493–499. https://doi.org/10.1016/S0025-7753(02)72429-9
Maples-Keller, J. L., Bunnell, B. E., Kim, S.-J., & Rothbaum, B. O. (2017). The use of virtual reality technology in the treatment of anxiety and other psychiatric disorders. Harvard Review of Psychiatry, 25(3), 103–113. https://doi.org/10.1097/HRP.0000000000000138
Martino, D. J., Samamé, C., & Strejilevich, S. A. (2016). Stability of facial emotion recognition performance in bipolar disorder. Psychiatry Research, 243, 182–184. https://doi.org/10.1016/j.psychres.2016.06.026
Martino, D. J., Strejilevich, S. A., Fassi, G., Marengo, E., & Igoa, A. (2011). Theory of mind and facial emotion recognition in euthymic bipolar I and bipolar II disorders. Psychiatry Research, 189(3), 379–384. https://doi.org/10.1016/j.psychres.2011.04.033
Mayer, J. D., Salovey, P., Caruso, D. R., & Sitarenios, G. (2001). Emotional intelligence as a standard intelligence. Emotion (Washington, D.C.), 1(3), 232–242. https://doi.org/10.1037/1528-3542.1.3.232
Monferrer, M., Ricarte, J. J., Montes, M. J., Fernández-Caballero, A., & Fernández-Sotos, P. (2021). Psychosocial remediation in depressive disorders: A systematic review. Journal of Affective Disorders, 290, 40–51. https://doi.org/10.1016/j.jad.2021.04.052
Montgomery, S. A., & Åsberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134(4), 382–389. https://doi.org/10.1192/bjp.134.4.382
Muros, N. I., García, A. S., Forner, C., López-Arcas, P., Lahera, G., Rodriguez-Jimenez, R., Nieto, K. N., Latorre, J. M., Fernández-Caballero, A., & Fernández-Sotos, P. (2021). Facial affect recognition by patients with schizophrenia using human avatars. Journal of Clinical Medicine, 10(9), 1904. https://doi.org/10.3390/jcm10091904
Nigam, S. G., Shenoy, S., Sharma, P. S. V., & Behere, R. V. (2021). Facial emotion recognition and its association with quality of life and socio-occupational functioning in patients with bipolar disorder and their first-degree relatives. Asian Journal of Psychiatry, 65, 102843. https://doi.org/10.1016/j.ajp.2021.102843
Ochsner, K. N. (2008). The social-emotional processing stream: Five core constructs and their translational potential for schizophrenia and beyond. Biological Psychiatry, 64(1), 48–61. https://doi.org/10.1016/j.biopsych.2008.04.024
Park, M. J., Kim, D. J., Lee, U., Na, E. J., & Jeon, H. J. (2019). A literature overview of virtual reality (VR) in treatment of psychiatric disorders: Recent advances and limitations. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00505
Peckham, A. D., McHugh, R. K., & Otto, M. W. (2010). A meta-analysis of the magnitude of biased attention in depression. Depression and Anxiety, 27(12), 1135–1142. https://doi.org/10.1002/da.20755
Pinkham, A. E. (2014). Social cognition in schizophrenia. The Journal of Clinical Psychiatry, 75(suppl 2), 14–19. https://doi.org/10.4088/JCP.13065su1.04
Riva, G., & Serino, S. (2020). Virtual reality in the assessment, understanding and treatment of mental health disorders. Journal of Clinical Medicine, 9(11), 3434. https://doi.org/10.3390/jcm9113434
Rosa, A. R., Sánchez-Moreno, J., Martínez-Aran, A., Salamero, M., Torrent, C., Reinares, M., Comes, M., Colom, F., Van Riel, W., Ayuso-Mateos, J., Kapczinski, F., & Vieta, E. (2007). Validity and reliability of the Functioning Assessment Short Test (FAST) in bipolar disorder. Clinical Practice and Epidemiology in Mental Health, 3(1), 5. https://doi.org/10.1186/1745-0179-3-5
Roux, P., Etain, B., Cannavo, A.-S., Aubin, V., Aouizerate, B., Azorin, J.-M., Bellivier, F., Belzeaux, R., Bougerol, T., Cussac, I., Courtet, P., Kahn, J.-P., Leboyer, M., M’Bailara, K., Payet, M. P., Olié, E., Henry, C., & Passerieux, C. (2019). Prevalence and determinants of cognitive impairment in the euthymic phase of bipolar disorders: Results from the FACE-BD cohort. Psychological Medicine, 49(3), 519–527. https://doi.org/10.1017/S0033291718001186
Ruiz-Murugarren, S., García-Ramos, P., & Lahera, G. (2011). Déficit de cognición social en el trastorno bipolar: Relevancia y estrategias de rehabilitación. Revista Colombiana de Psiquiatría, 40(1), 99–114. https://doi.org/10.1016/S0034-7450(14)60107-4
Samamé, C. (2013). Social cognition throughout the three phases of bipolar disorder: A state-of-the-art overview. Psychiatry Research, 210(3), 1275–1286. https://doi.org/10.1016/j.psychres.2013.08.012
Samamé, C., Martino, D. J., & Strejilevich, S. A. (2013). A quantitative review of neurocognition in euthymic late-life bipolar disorder. Bipolar Disorders, 15(6), 633–644. https://doi.org/10.1111/bdi.12077
Samamé, C., Martino, D. J., & Strejilevich, S. A. (2015). An individual task meta-analysis of social cognition in euthymic bipolar disorders. Journal of Affective Disorders, 173, 146–153. https://doi.org/10.1016/j.jad.2014.10.055
Samara, M. T., Levine, S. Z., & Leucht, S. (2023). Linkage of young mania rating scale to clinical global impression scale to enhance utility in clinical practice and research trials. Pharmacopsychiatry, 56(01), 18–24. https://doi.org/10.1055/a-1841-6672
Sammer, G., & Ruprecht, C. (2023). No faces, just body movements—Effects of perceived emotional valence of body kinetics and psychological factors on interpersonal distance behavior within an immersive virtual environment. Current Psychology, 42(23), 19486–19502. https://doi.org/10.1007/s12144-022-03082-2
Sandín, B., Chorot, P., Lostao, L., Joiner, T. E., Santed, M. A., & Valiente, R. M. (1999). Escalas PANAS de afecto positivo y negativo: Validación factorial y convergencia transcultural. Psicothema, 11(1), 37–51.
Schaefer, K. L., Baumann, J., Rich, B. A., Luckenbaugh, D. A., & Zarate, C. A. (2010). Perception of facial emotion in adults with bipolar or unipolar depression and controls. Journal of Psychiatric Research, 44(16), 1229–1235. https://doi.org/10.1016/j.jpsychires.2010.04.024
Schön, U.-K., Denhov, A., & Topor, A. (2009). Social relationships as a decisive factor in recovering from severe mental illness. International Journal of Social Psychiatry, 55(4), 336–347. https://doi.org/10.1177/0020764008093686
Sharma, A. N., Barron, E., Le Couteur, J., Close, A., Rushton, S., Grunze, H., Kelly, T., Nicol Ferrier, I., & Le Couteur, A. S. (2017). Facial emotion labeling in unaffected offspring of adults with bipolar I disorder. Journal of Affective Disorders, 208, 198–204. https://doi.org/10.1016/j.jad.2016.10.006
Souto, T., Conde, A. R., Ferreira, M. J., Queirós, C., & Figueiredo, V. (2023). How to assess emotional recognition in individuals with a diagnosis of schizophrenia and other psychotic disorders: A pilot study. Current Psychology, 42(2), 1327–1336. https://doi.org/10.1007/s12144-021-01533-w
Tesli, M., Kauppi, K., Bettella, F., Brandt, C. L., Kaufmann, T., Espeseth, T., Mattingsdal, M., Agartz, I., Melle, I., Djurovic, S., Westlye, L. T., & Andreassen, O. A. (2015). Altered brain activation during emotional face processing in relation to both diagnosis and polygenic risk of bipolar disorder. PLoS One, 10(7), e0134202. https://doi.org/10.1371/journal.pone.0134202
The WHOQOL Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28(3), 551–558. https://doi.org/10.1017/S0033291798006667
Thonse, U., Behere, R. V., Praharaj, S. K., & Sharma, P. S. V. N. (2018). Facial emotion recognition, socio-occupational functioning and expressed emotions in schizophrenia versus bipolar disorder. Psychiatry Research, 264, 354–360. https://doi.org/10.1016/j.psychres.2018.03.027
van Neerven, T., Bos, D. J., & van Haren, N. E. (2021). Deficiencies in theory of mind in patients with schizophrenia, bipolar disorder, and major depressive disorder: A systematic review of secondary literature. Neuroscience & Biobehavioral Reviews, 120, 249–261. https://doi.org/10.1016/j.neubiorev.2020.11.011
Van Rheenen, T. E., Lewandowski, K. E., Bauer, I. E., Kapczinski, F., Miskowiak, K., Burdick, K. E., & Balanzá-Martínez, V. (2020). Current understandings of the trajectory and emerging correlates of cognitive impairment in bipolar disorder: An overview of evidence. Bipolar Disorders, 22(1), 13–27. https://doi.org/10.1111/bdi.12821
Van Rheenen, T. E., & Rossell, S. L. (2014). Let’s face it: Facial emotion processing is impaired in bipolar disorder. Journal of the International Neuropsychological Society, 20(2), 200–208. https://doi.org/10.1017/S1355617713001367
Varo, C., Jiménez, E., Solé, B., Bonnín, C. M., Torrent, C., Lahera, G., Benabarre, A., Saiz, P. A., Fuente, L., Martínez-Arán, A., Vieta, E., & Reinares, M. (2019). Social cognition in bipolar disorder: The role of sociodemographic, clinical, and neurocognitive variables in emotional intelligence. Acta Psychiatrica Scandinavica, 139(4), 369–380. https://doi.org/10.1111/acps.13014
Vlad, M., Raucher-Chéné, D., Henry, A., & Kaladjian, A. (2018). Functional outcome and social cognition in bipolar disorder: Is there a connection? European Psychiatry, 52, 116–125. https://doi.org/10.1016/j.eurpsy.2018.05.002
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070. https://doi.org/10.1037/0022-3514.54.6.1063
Yalcin-Siedentopf, N., Hoertnagl, C. M., Biedermann, F., Baumgartner, S., Deisenhammer, E. A., Hausmann, A., Kaufmann, A., Kemmler, G., Mühlbacher, M., Rauch, A.-S., Fleischhacker, W. W., & Hofer, A. (2014). Facial affect recognition in symptomatically remitted patients with schizophrenia and bipolar disorder. Schizophrenia Research, 152(2–3), 440–445. https://doi.org/10.1016/j.schres.2013.11.024
Young, R. C., Biggs, J. T., Ziegler, V. E., & Meyer, D. A. (1978). A rating scale for mania: Reliability, validity and sensitivity. British Journal of Psychiatry, 133(5), 429–435. https://doi.org/10.1192/bjp.133.5.429
Zimmermann, D., Wehler, A., & Kaspar, K. (2023). Self-representation through avatars in digital environments. Current Psychology, 42(25), 21775–21789. https://doi.org/10.1007/s12144-022-03232-6
Funding
Grants PID2020-115220RB-C21 and EQC2019-006063-P funded by MCIN/AEI/10.13039/501100011033 and by ``ERDF A way to make Europe''. This work was also partially funded by CIBERSAM-ISCIII and co-funded by “ERDF A way to make Europe”.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethics approval
Clinical Research Ethics Committee of the Complejo Hospitalario Universitario de Albacete approved the study on 24 September 2019, with code number 2019/07/073. The authors confirm that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.
Consent
All participants signed an informed consent after receiving a careful explanation of the study, and before conducting the experiment.
Competing interests
None.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Monferrer, M., García, A.S., Ricarte, J.J. et al. Dynamic virtual faces demonstrate deterioration in the recognition of facial emotion in bipolar disorder patients. Curr Psychol 43, 15113–15124 (2024). https://doi.org/10.1007/s12144-023-05426-y
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12144-023-05426-y