Auditory-prosodic processing in bipolar disorder; from sensory perception to emotion

Objectives Accurate emotion processing is critical to understanding the social world. Despite growing evidence of facial emotion processing impairments in patients with bipolar disorder (BD), comprehensive investigations of emotional prosodic processing is limited. The existing (albeit sparse) literature is inconsistent at best, and confounded by failures to control for the effects of gender or low level sensory-perceptual impairments. The present study sought to address this paucity of research by utilizing a novel behavioural battery to comprehensively investigate the auditory-prosodic profile of BD. Methods Fifty BD patients and 52 healthy controls completed tasks assessing emotional and linguistic prosody, and sensitivity for discriminating tones that deviate in amplitude, duration and pitch. Results BD patients were less sensitive than their control counterparts in discriminating amplitude and durational cues but not pitch cues or linguistic prosody. They also demonstrated impaired ability to recognize happy intonations; although this was specific to male s with the disorder. The recognition of happy in the patient group was correlated with pitch and amplitude sensitivity in female patients only. Limitations The small sample size of patients after stratification by current mood state prevented us from conducting subgroup comparisons between symptomatic, euthymic and control participants to explicitly examine the effects of mood. Conclusions Our findings indicate the existence of a female advantage for the processing of emotional prosody in BD, specifically for the processing of happy. Although male BD patients were impaired in their ability to recognize happy prosody, this was unrelated to reduced tone discrimination sensitivity. This study indicates the importance of examining both gender and low order sensory perceptual capacity when examining emotional prosody. ? 2013 Elsevier B.V.