This article is more than 5 years old. Information may no longer be current.

Emotion regulation differs among patients with major depressive disorder, bipolar disorder

Cross-sectional study findings indicate patients with major depressive disorder process emotions differently than patients with bipolar disorder, both while depressed and in remission.

“Major depressive disorder and bipolar disorder are difficult to distinguish clinically during the depressed or remitted states. Both mood disorders are characterized by emotion regulation disturbances; however, little is known about emotion regulation differences between MDD and BD,” study researcher Maria M. Rive, MD, of the University of Amsterdam, and colleagues wrote in JAMA Psychiatry.

To determine differences between positive and negative emotion regulation among patients with major depressive disorder (MDD) or bipolar disorder (BD), researchers compared behavioral and function MRI emotion regulation data for 42 patients with MDD, 35 with BD and 36 healthy controls. Study participants were free of psychotropic medication.

Patients in the remitted state who had BD showed impaired emotion regulation (P < .001), regardless of emotion type. This was associated with increased activity in the dorsolateral prefrontal cortex in comparison to patients with MDD and controls.

Happy vs. sad emotion regulation differed among patients with BD and MDD in the depressed state (P < .001) and was linked with differing activity in the rostral anterior cingulate (P < .001).

Compared with patients with BD and controls, patients with MDD regulated happy and sad emotions poorly. Activity in the rostral anterior cingulate did not differ when processing happy or sad emotions among patients with MDD.

Patients with BD had poorer regulation of negative emotions vs. patients with MDD, but exhibited normal regulation of happy emotions. Patients with BD had significantly lower activity in the rostral anterior cingulate while regulating happy vs. sad emotions.

“This study demonstrated that medication-free patients with MDD and BD differ regarding overall emotion regulation associated with differences in [dorsolateral prefrontal cortical] activity, whereas medication-free depressed patients with MDD and BP differ regarding happy vs. sad emotion regulation associated with differences in emotional appraisal and [rostral anterior cingulate cortex] activity,” Rive and colleagues wrote. “These results corroborate previous findings indicating that during depression, MDD and BD may differ particularly regarding happy vs. sad emotion processing/regulation.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.