Bilderbeck Amy C, Atkinson Lauren Z, Geddes John R, Goodwin Guy M, Harmer Catherine J
Department of Psychiatry, University of Oxford, Oxford, UK.
J Psychopharmacol. 2017 Mar;31(3):320-326. doi: 10.1177/0269881116668594. Epub 2016 Sep 28.
Emotional processing abnormalities have been implicated in bipolar disorder (BD) but studies are typically small and uncontrolled. Here, facial expression recognition was explored in a large and naturalistically recruited cohort of BD patients.
271 patients with BD completed the facial expression recognition task. The effects of current medication together with the influence of current mood state and diagnostic subtype were assessed whilst controlling for the effects of demographic variables.
Patients who were currently receiving treatment with lithium demonstrated significantly poorer accuracy in recognising angry faces, an effect that held in a monotherapy sub-analysis comparing those participants on lithium only and those who were medication-free. Accuracy in recognising angry faces was also lower amongst participants currently taking dopamine antagonists (antipsychotics). Higher levels of current depressive symptoms were linked to poorer accuracy at identifying happy faces.
Use of lithium and possibly dopamine antagonists may be associated with reduced processing of anger cues in BD. Findings support the existence of mood-congruent negative biases associated with depressive symptoms in BD. Observational cohort studies provide opportunities to explore the substantial effects of demographic, psychometric and clinical variables on cognitive performance and emotional processing.
情绪加工异常与双相情感障碍（BD）有关，但相关研究通常规模较小且缺乏对照。在此，我们在一个大规模的、通过自然招募的双相情感障碍患者队列中探究面部表情识别情况。
271名双相情感障碍患者完成了面部表情识别任务。在控制人口统计学变量影响的同时，评估了当前药物治疗的效果以及当前情绪状态和诊断亚型所产生的影响。
目前正在接受锂盐治疗的患者在识别愤怒面孔方面的准确率显著更低，在一项单药治疗亚分析中，将仅服用锂盐的参与者与未服药的参与者进行比较时，这一效应依然存在。目前正在服用多巴胺拮抗剂（抗精神病药物）的参与者识别愤怒面孔的准确率也较低。当前抑郁症状水平较高与识别快乐面孔的准确率较低有关。
使用锂盐以及可能使用多巴胺拮抗剂可能与双相情感障碍患者对愤怒线索的加工减少有关。研究结果支持双相情感障碍中存在与抑郁症状相关的情绪一致的负性偏差。观察性队列研究为探究人口统计学、心理测量学和临床变量对认知表现和情绪加工的实质影响提供了机会。
