Symptom severity of panic disorder associated with impairment in emotion processing of threat-related facial expressions


Correspondence: Kyoung-Uk Lee, MD, PhD, Department of Psychiatry, Uijeongbu St Mary's Hospital, Catholic University of Korea College of Medicine, 65-1 Geumo-dong, Uijeongbu 480-130, Korea. Email:



To compare emotion recognition patterns between patients with panic disorder (PD) and healthy volunteers and to analyze the correlation between the degree of emotion recognition impairment and symptom severity in patients with PD.


Twenty-four patients with PD and 20 healthy controls were tested with a facial emotional expression recognition task involving four basic emotions (i.e. happiness, sadness, anger, and fear). Emotion recognition measures included the recognition threshold, response time, response time of correctly classified emotions (response time_crt), and recognition error. An average of all four emotions for each emotion recognition measure was compared between the two groups and then a comparison of recognition measures for each specific emotion was conducted. The correlations between severity of the State–Trait Anxiety Inventory, Beck Depression Inventory (BDI), and Panic Disorder Severity Scale with emotion recognition indices were also analyzed.


Average recognition threshold was significantly higher in the PD group compared to the control group. In the PD group, there was a non-significant trend of increase in the emotion recognition threshold for fear and the response time for anger compared with the control group. In the correlation analysis, higher trait anxiety was associated with slower response time_crt for anger and a higher BDI score was associated with slower response times and response time_crt for happiness and anger.


This study suggests that symptom severity of PD might be associated with impairment in emotion processing of threat-related facial expressions.