Emotion perception abnormalities across sensory modalities in bipolar disorder with psychotic features and schizophrenia

Emotion perception deficits are a well-established feature of schizophrenia (SZ). Individuals with SZ have difficulty labeling emotional stimuli across auditory, visual, and audio-visual modalities and also misattribute threat towards neutral stimuli. The relationship between a history of psychosis and similar abnormalities in bipolar disorder (BD) is less clear. The current study set out to examine emotion perception across sensory modalities in a sample of 24 stabilized individuals meeting criteria for SZ, 24 remitted individuals meeting criteria for BD with psychotic features, 24 remitted individuals meeting criteria for BD without psychotic features, and 24 healthy controls. Results indicated that the bipolar with psychotic features group had intermediary performance between the SZ group and the other two groups for auditory, visual, and audio-visual items, with particularly poor performance in identifying angry stimuli. The SZ group misattributed neutral stimuli as negative when they were in visual format, but as positive when they were in auditory or audio-visual formats. The bipolar with psychotic features group had a trend towards misattributing more neutral visual stimuli as negative. These findings indicate that emotion perception deficits are present in BD with psychotic features and comparatively spared in BD without psychotic features, and that a similar bias of misattributing negative emotions to neutral visual stimuli may be present across diagnostic boundaries.