Spatial processing of facial emotion in patients with unipolar depression: a longitudinal study

Background: In this study, a face-in-the-crowd task was applied to examine the spatial detection of facial emotion as a function of depression and comorbid anxiety in the course of a psychotherapeutic inpatient treatment. Methods: Patients with unipolar depression (n=22) and normal controls (n=22) were tested twice, about 7 weeks apart, on a face-in-the-crowd task using displays of schematic faces. Half the patients were suffering from a comorbid anxiety disorder. Results: From test 1 to test 2, depressivity, frequency of negative thoughts, and worrying of patients improved significantly. At both sessions, depressed patients, irrespective of the presence of comorbid anxiety disorders, showed no performance differences in the detection of negative faces compared to controls. However, depressed patients with but not those without comorbid anxiety disorders were slower in responding to positive faces than controls. Both patient groups were slower in responding to the neutral facesʹ condition than controls. Conclusions: Our data indicate a spatial processing deficit for positive facial expression in depressives with a comorbid anxiety disorder. This impairment, which appears to persist during remission, might be due to deficits in effortful visual search processes.