Recognition of affective prosody in bipolar and depressive conditions: A systematic review and meta-analysis.

Inconsistent results have been reported about the affective prosody recognition (APR) ability in patients with bipolar (BD) and depressive (DD) disorders. We aimed to (i) evaluate the magnitude of APR dysfunction in BD and DD patients, (ii) identify moderators for heterogeneous results, and (iii) highlight research trends in this field. A computerized literature search was conducted in five electronic databases from the inception to May 9th, 2022 to identify behavioural experiments that studied APR in BD or DD patients. Effect sizes were calculated using a random-effect model and recalculated after removing outliers and adjusting publication bias. Twelve eligible articles totalling 16 studies were included in the meta-analysis, aggregating 612 patients and 809 healthy controls. Individual r 2 ranged from 0.008 to 0.355, six of which reached a medium-to-large association strength. A medium-to-large pooled effect size (Hedges g = −0.58, 95 % CI −0.75 to −0.40, p < 0.001) for overall APR impairment in BD and DD patients was obtained. The Beck Depression Inventory score and answer option number were significant moderators. Neuropsychological mechanisms, multi-modal interaction and comorbidity effects have become primary research concerns. Extant statistics were insufficient for disorder-specific analysis. Current findings demonstrate deficits of overall APR in BD and DD patients at a medium-to-large magnitude. APR can clinically serve for early screening and prognosis, but the depression severity, task complexity and confounding variables influence patients' APR performance. Future studies should incorporate neuroimaging approaches and investigate the effects of tonal language stimuli and clinical interventions. • The first systematic review and meta-analysis that demonstrated overall deficits of affective prosody recognition in bipolar and depressive conditions • Affective prosody recognition ability provides clinical implications for early screening and prognosis in bipolar and depressive disorders. • Beck Depression Inventory score and the number of answer options are associative with heterogeneous results. • Recent research concerned about neuropsychological mechanism, multi-modal interaction and comorbidity effects in this field [ABSTRACT FROM AUTHOR]