Impaired facial emotion recognition, especially fear were widely described in adolescents with conduct disorder, and some literature data indicate similar changes in adolescents with ADHD. However, to our best knowledge the relationship between emotion recognition, conduct symptoms and hyperactivity measures in a mixed clinical population were not investigated.

A mixed clinical population of 56 adolescents (19 girls) between age 11-16 (13.4 on average) admitted to the acute department of Vadaskert Child Psychiatry Hospital was taken part in our study. The parental and self-report version of the Strength and Difficulties Questionnaire (SDQ), facial emotion recognition test including six basic emotions (FEEST) and Raven IQ measures were performed.

In the overall population, in 21 cases externalization symptoms, while in 35 cases internalizing symptoms dominated the condition. Fear recognition irrespective to age and IQ were significantly worse in externalizing teens compared to internalizing ones (p< 0.05), while the recognition of other investigated emotions (anger, disgust, happiness, sadness, surprise) did not show significant differences. In the overall population, only fear recognition was significantly related to self reported conduct (R=-0.35, p< 0.01) and hyperactivity problems (R=-0.27, p< 0.05), while overall emotion recognition was related to both self reported hyperactivity (R=-0.33, p< 0.02) and parent reported hyperactivity problems (R=-0.29, p< 0.03).

Our results indicate that hyperactivity symptoms measured by SDQ were specifically related to impairments in fear recognition, and this effect is irrespective from attention problems as no relationship between symptom severity and other emotions were observed.