TY - JOUR

T1 - Emotional cognition subgroups in mood disorders

T2 - Associations with familial risk

AU - Varo, Cristina

AU - Kjærstad, Hanne Lie

AU - Poulsen, Emilie

AU - Meluken, Iselin

AU - Vieta, Eduard

AU - Kessing, Lars Vedel

AU - Vinberg, Maj

AU - Miskowiak, Kamilla Woznica

N1 - Funding Information: The BIO study is funded by grants from the Mental Health Services, Capital Region of Denmark, The Danish Council for Independent Research, Medical Sciences (DFF-4183–00,570), Markedsmodningsfonden (the Market Development Fund 2015–310), Gangstedfonden (A29594), Helsefonden (16-B-0063), Innovation Fund Denmark (the Innovation Fund, Denmark, 5164–00001B), Copenhagen Center for Health Technology (CACHET), EU H2020 ITN (EU project 722,561), Augustinusfonden (16–0083). The NEAD study was funded by The Lundbeck Foundation (grant number R108-A10015) and the Hørslev Foundation. Funding Information: KWM has received consultancy fees from Lundbeck and Janssen-Cilag in the past three years. EV has received grants and served as consultant, advisor or CME speaker for the following entities: AB-Biotics, Abbott, Allergan, Angelini, AstraZeneca, Bristol-Myers Squibb, Dainippon Sumitomo Pharma, Farmindustria, Ferrer, Forest Research Institute, Galenica, Gedeon Richter, Glaxo-Smith-Kline, Janssen, Lundbeck, Otsuka, Pfizer, Roche, Sage, Sanofi-Aventis, Servier, Shire, Sunovion, and Takeda, unrelated to the present work. LVK has within recent three years been a consultant for Lundbeck. MV has within the last three years received a consultancy fee from Lundbeck, Janssen-Cilag and Sunovion. The NEAD study was supported by The Capital Region of Denmark, the Augustinus Foundation, the Axel Thomsen's Foundation, the Lundbeck Foundation (R108-A10015), the Hoerslev Foundation, and Fonden til Lægevidensskabens Fremme. The sponsors had no role in the planning or conduct of the study or in the interpretation of the results. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Funding Information: KWM holds a five-year Lundbeck Foundation Fellowship (grant no. R215–2015–4121). EV thanks the support of the Spanish Ministry of Science and Innovation (PI15/00,283, PI18/00,805) integrated into the Plan Nacional de I + D + I and co-financed by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM); the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement (2017 SGR 1365), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00,357. We thank the Danish Twin Registry for cooperation in the study, especially thanks for support, data work and technical help from Inge Petersen and Axel Skytthe from the Danish Twin Registry. Publisher Copyright: © 2021 The Author(s)

PY - 2021

Y1 - 2021

N2 - Patients with mood disorders show heterogeneity in non-emotional cognition. However, it is unclear whether emotional cognition (EC) is characterised by similar heterogeneity. We aimed to investigate the heterogeneity in EC among remitted patients with mood disorders and explore its association with familial risk. Data from 269 partially or fully remitted patients with mood disorders, 87 of their unaffected relatives (UR) and 203 healthy controls (HC) were pooled from two cohort studies. Hierarchical cluster analysis was conducted using the EC data from patients. UR were categorised into groups consistent with their affected relatives’ cluster assignment. Clusters were compared to HC on EC, non-emotional cognition, clinical characteristics and functioning. We identified three clusters: an ‘emotionally preserved’ (57%), an ‘emotionally blunted’ (26%) and an ‘emotionally volatile’ cluster (17%). ‘Emotionally blunted’ and ‘emotionally volatile’ patients also presented more deficits in non-emotional cognition (global cognition read z=-0.3 and -0.5 respectively). Relatives of ‘emotionally preserved’ patients were more successful at dampening negative emotions (p=.01, d=0.39, 95% CI [-0.76,-0.09]), whereas UR of ‘emotionally impaired’ patients underperformed in verbal fluency (p=.03, d=0.46, 95% CI [.03, 0.68]) compared to HC. The existence of impaired EC groups in remitted mood disorder highlights a need to screen for and treat EC in mood disorders. Improved ability to dampen emotions in UR of ‘emotionally preserved’ patients may reflect a resilience marker while impaired verbal fluency in UR of ‘emotionally impaired’ patients may reflect distinct genetic risk profiles in these EC subgroups.

AB - Patients with mood disorders show heterogeneity in non-emotional cognition. However, it is unclear whether emotional cognition (EC) is characterised by similar heterogeneity. We aimed to investigate the heterogeneity in EC among remitted patients with mood disorders and explore its association with familial risk. Data from 269 partially or fully remitted patients with mood disorders, 87 of their unaffected relatives (UR) and 203 healthy controls (HC) were pooled from two cohort studies. Hierarchical cluster analysis was conducted using the EC data from patients. UR were categorised into groups consistent with their affected relatives’ cluster assignment. Clusters were compared to HC on EC, non-emotional cognition, clinical characteristics and functioning. We identified three clusters: an ‘emotionally preserved’ (57%), an ‘emotionally blunted’ (26%) and an ‘emotionally volatile’ cluster (17%). ‘Emotionally blunted’ and ‘emotionally volatile’ patients also presented more deficits in non-emotional cognition (global cognition read z=-0.3 and -0.5 respectively). Relatives of ‘emotionally preserved’ patients were more successful at dampening negative emotions (p=.01, d=0.39, 95% CI [-0.76,-0.09]), whereas UR of ‘emotionally impaired’ patients underperformed in verbal fluency (p=.03, d=0.46, 95% CI [.03, 0.68]) compared to HC. The existence of impaired EC groups in remitted mood disorder highlights a need to screen for and treat EC in mood disorders. Improved ability to dampen emotions in UR of ‘emotionally preserved’ patients may reflect a resilience marker while impaired verbal fluency in UR of ‘emotionally impaired’ patients may reflect distinct genetic risk profiles in these EC subgroups.

KW - Cluster-analysis

KW - Emotional cognition

KW - Emotional processing

KW - Emotional regulation

KW - Mood disorders

U2 - 10.1016/j.euroneuro.2021.05.003

DO - 10.1016/j.euroneuro.2021.05.003

M3 - Journal article

C2 - 34098515

AN - SCOPUS:85108110629

VL - 51

SP - 71

EP - 83

JO - European Neuropsychopharmacology

JF - European Neuropsychopharmacology

SN - 0924-977X

ER -