Short-term impact of alcohol detoxification on facial emotions recognition

Background and aims: Alcohol use disorder (AUD) is associated with impaired social cognition, including the disturbance of facial emotion recognition (FER). Previous studies have focused on the assessment of basic emotions decoding among patients with AUD, but the evolution of these performances in the early phase of alcohol withdrawal remains unknown.

Methods: This study was based on evolution of social cognition over a period of 21 days in two groups of individuals: a group of 20 AUD patients and a control group of 25 healthy individuals. AUD patients were tested on admission in a detoxification ward and after a 3-week stay. We evaluated FER with the Reading the Mind in the Eyes Test (RMET). We assessed empathy with a multidimensional questionnaire, the Interpersonal Reactivity Index (IRI). We measured anxiety and depression through the self-rating scale Hospital Anxiety and Depression (HAD). We hypothesized that FER would be impaired in AUD patients on admission and improve after detoxification, while being stable in the control group.

Results: RMET scores on admission and at discharge were inferior in AUD patients to those observed in HC (P=2×10^-6 and P=0.033, respectively). In the patient group, the RMET score improved over the stay (P=0.034). A time-by-group interaction for RMET score was observed (P=0.003). IRI scores on admission were superior in AUD patients (P=0.023) whichwas no longer observed at discharge (P=0.54). This suggests that RMET might be more accurate in measuring theory of mind evolution in AUD patients after withdrawal. HAD scores on admission and at discharge were inferior in AUD patients compared to controls (P=3×10^-5 and P=0.007, respectively). After controlling for HAD initial score, a time-by-group interaction was still observed for RMET scores (P=0.026).

Conclusion: FER is impaired in patients with Alcohol Use Disorder compared to controls. This alteration improves after alcohol detoxification. We suggest the RMET could be used to follow the improvement of FER during the first month of abstinence, especially as RMET performance has been associated with maintenance of alcohol withdrawal.