Reduced medial prefrontal responses to social interaction images in remitted depression.

CONTEXT Major depressive disorder is associated with impairments in processing emotional stimuli, and residual impairments are observed during remission, possibly indicating trait vulnerability. Stimuli with social context represent a distinct class of emotional stimuli, which in healthy volunteers are associated with specific neural substrates but have not previously been studied relative to vulnerability to depression. OBJECTIVE To explore whether individuals with remitted major depressive disorder had altered neuronal processing of social emotional stimuli. DESIGN Cross-sectional design using functional magnetic resonance imaging, combined with a cognitive activation task. SETTING General community of greater Manchester, England. PARTICIPANTS Twenty-five unmedicated participants fully remitted from major depressive disorder and 29 age-matched control subjects. MAIN OUTCOME MEASURES Neuronal responses to positive and negative social interaction images vs valence-matched images with less overt social context. RESULTS Participants with remitted depression showed attenuated frontopolar response relative to controls for positive and negative images depicting social interactions. For negative social images, participants with remitted depression also showed reduced latero-orbitofrontal response relative to controls. CONCLUSIONS In the absence of current symptoms, individuals with remitted major depressive disorder showed reduced frontopolar processing of stimuli showing social interactions, a reduction not seen for stimuli showing individual successes and failures and, therefore, not simply an effect of emotional valence. These results suggest a specific trait abnormality in social emotional processing associated with vulnerability to depression, which may have implications for understanding social cognition mechanisms and for developing effective psychological therapies.