Impaired nonverbal communication is associated with symptom severity in Depression

Nonverbal communication is crucial for successful communication during social interactions. Patients with depression show difficulties in navigating social situations, potentially related to difficulties in nonverbal communication. We aimed to compare gesture performance and nonverbal perception between healthy controls and patients with depression and investigate how gesture deficits are related to symptom severity.

Gesture performance and nonverbal perception were assessed in 24 controls and 26 patients using the Test of Upper Limb Apraxia (TULIA) and the mini-Profile of Nonverbal Sensitivity (mini-PONS), respectively. Symptom severity was measured in both controls and patients using the Montgomery–Åsberg Depression Rating Scale (MADRS) and the Hamilton Anxiety Rating Scale (HAM-A) and with self-reports using the Becks Depression Inventory II (BDI-II) and the Depression-Anxiety-Stress-Scale-21 (DASS-21).

Total gesture performance did not differ between controls and patients (TULIA total score: p=0.303), however group differences at trend level in gesture performance were observed specifically for the imitation of tool-related gestures (p=0.081) and the pantomime of novel meaningless gestures (p=0.090). In contrast, patients showed inferior nonverbal social perception compared to controls (PONS total score: p=0.009), specifically for bimodal stimuli (face and voice, p=0.004). In all participants nonverbal social perception correlated with ratings on all four symptom scales , while gesture performance only correlated with the HAM-A at trend level (rho=-0.285, p =0.072). Gesture performance and nonverbal perception were associated in patients, while controlling for depressive symptoms (rho=0. 562, p=0. 004).

Compared to healthy controls patients with depression showed deficits in nonverbal communication, specifically related to perception. Since nonverbal perception and gesture performance in patients were correlated irrespective of symptom severity, underlying cognitive processes might overlap. Nevertheless, since nonverbal perception, unlike gesture performance, was associated with symptom severity, impairments in perception might already be present at lower symptom levels, while gesture performance is only affected in more severe cases.

Publication History

Article published online:
30 April 2025