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This study investigates the discrimination accuracy of emotional stimuli in subjects with major depression compared with healthy controls using photographs of facial expressions of varying emotional intensities. The sample included 88 unmedicated male and female subjects, aged 18-56 years, with major depressive disorder (n = 44) or no psychiatric illness (n = 44), who judged the emotion of 200 facial pictures displaying an expression between 10% (90% neutral) and 80% (nuanced) emotion. Stimuli were presented in 10% increments to generate a range of intensities, each presented for a 500-ms duration. Compared with healthy volunteers, depressed subjects showed very good recognition accuracy for sad faces but impaired recognition accuracy for other emotions (e.g., harsh, surprise, and sad expressions) of subtle emotional intensity. Recognition accuracy improved for both groups as a function of increased intensity on all emotions. Finally, as depressive symptoms increased, recognition accuracy increased for sad faces, but decreased for surprised faces. Moreover, depressed subjects showed an impaired ability to accurately identify subtle facial expressions, indicating that depressive symptoms influence accuracy of emotional recognition.

How do depressed and healthy adults interpret nuanced facial expressions?