%0 Journal Article
%@ 1573-2517
%A Bone, JK
%A Lewis, G
%A Button, KS
%A Duffy, L
%A Harmer, CJ
%A Munafò, MR
%A Penton-Voak, IS
%A Wiles, NJ
%A Lewis, G
%D 2019
%F discovery:10078515
%J Journal of Affective Disorders
%K Depression, Facial expressions, Emotion recognition, Cognition, Cohort study
%P 461-469
%T Variation in recognition of happy and sad facial expressions and self-reported depressive symptom severity: A prospective cohort study
%U https://discovery.ucl.ac.uk/id/eprint/10078515/
%V 257
%X Objective: Cognitive theories suggest people with depression interpret self-referential social information negatively. However, it is unclear whether these biases precede or follow depression. We investigated whether facial  expression recognition was associated with depressive symptoms cross-sectionally and longitudinally.  Methods: Prospective cohort study of people who had visited UK primary care in the past year reporting depressive symptoms (n = 509). Depressive symptoms were measured using the Patient Health Questionnaire  (PHQ-9) at four time-points, 2 weeks apart. A computerised task assessed happy and sad facial expression recognition at three time-points (n = 505 at time 1). The unbiased hit rate measured ability to recognise emotions  accounting for any general tendency to identify the emotion when it was not present.  Results: The sample included the full range of depressive symptom severity, with 45% meeting diagnostic criteria for depression. There was no evidence that happy or sad unbiased hit rates were associated with concurrent  or subsequent depressive symptoms. There was weak evidence that, for every additional face incorrectly classified as happy, concurrent PHQ-9 scores reduced by 0.05 of a point (95% CI = -0.10 to 0.002, p = 0.06 after  adjustment for confounders). This association was strongest for more ambiguous facial expressions (interaction  term p<0.001).  Limitations: This was an observational study with relatively short follow-up (6 weeks) and small changes in  depressive symptoms and emotion recognition. Only 7% of invited patients consented to participate.  Conclusions: Reduced misclassifications of ambiguous faces as happy could be a state marker of depression, but  was not associated with subsequent depressive symptoms. Future research should focus on the interpretation of  ambiguous social information
%Z This is an open access article under the CC BY-NC-ND license  (http://creativecommons.org/licenses/by-nc-nd/4.0/).