Social Cognitive Processes in Mild-Moderate Depression

Prathima Alevoor Raghavendra^1,2Shantala Hegde^1,2,3*Mariamma Philip^2,4Kesavan Muralidharan^2,5

• ¹Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, India
• ²National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
• ³Music Cognition Laboratory, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
• ⁴Department of Biostatistics, National Institute of Mental Health and NeuroSciences, Bengaluru, Karnataka, India
• ⁵Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India

Background: Social cognition (SC), the ability to interpret and respond to social situations appropriately, is essential for effective interpersonal functioning. Challenges in these areas are a core feature of depression. Evidence shows mixed findings regarding the extent and presence of these deficits in depression, especially in its milder forms. Social cognition comprises key processes such as the theory of mind, attribution style, emotion, and social perception. In addition to exploring emotion perception (EP) ability through faces and vocal stimuli, music has recently emerged as a valuable tool in studying EP, given the effectiveness of music intervention in improving mood and overall emotional functioning in patients with depression. Aim: To explore social cognition abilities in patients with mild-moderate MDD and the relationship between social cognition (SC) and neuro-cognition in depression. Methods: Patients diagnosed with mild-moderate MDD (n=19) and age, sex and educationmatched healthy controls (HC) (n=18) were assessed on SOCRATIS (Social Cognition Rating tools in Indian Setting), NIMHANS emotion perception test (NEPT) (across domains of faces and prosody) and Music emotion perception test (MEPT)Results: Patients with MDD showed first-order theory of mind (ToM) deficits compared to HC (p=0.01). On the Music emotion recognition test, the MDD group rated the intensity of positive emotions (happiness) significantly lesser than the HC group (p=0.007). However, the groups did not differ in the accuracy of emotion identification of faces, prosody, or music stimuli. Correlational analyses revealed trends towards a significant positive relationship between attention and second-order ToM (r=0.58, p<0.01), executive function index with emotion perception (r=0.60, p<0.01), second-order ToM (r=0.56, p=0.01) and social perception (r=0.60, p<0.01).Individuals with mild-moderate depression show reduced first-order ToM ability and emotion scaling of positive emotions on music excerpts. A potential association exists between neurocognitive (attention and executive functions) and SC measures.