Email updates

Keep up to date with the latest news and content from BMC Psychiatry and BioMed Central.

Open Access Research article

Impaired social decision making in patients with major depressive disorder

Yun Wang12, Yuan Zhou1*, Shu Li1, Peng Wang3, Guo-Wei Wu3 and Zhe-Ning Liu3

Author Affiliations

1 Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China

2 University of Chinese Academy of Sciences, Beijing 100049, China

3 Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha 410011, China

For all author emails, please log on.

BMC Psychiatry 2014, 14:18  doi:10.1186/1471-244X-14-18

Published: 23 January 2014



Abnormal decision-making processes have been observed in patients with major depressive disorder (MDD). However, it is unresolved whether MDD patients show abnormalities in decision making in a social interaction context, in which decisions have actual influences on both the self-interests of the decision makers per se and those of their partners.


Using a well-studied ultimatum game (UG), which is frequently used to investigate social interaction behavior, we examined whether MDD can be associated with abnormalities in social decision-making behavior by comparing the acceptance rates of MDD patients (Nā€‰=ā€‰14) with those of normal controls (Nā€‰=ā€‰19).


The acceptance rates of the patients were lower than those of the normal controls. Additionally, unfair proposals were accepted at similar rates from computer partners and human partners in the MDD patients, unlike the acceptance rates in the normal controls, who were able to discriminatively treat unfair proposals from computer partners and human partners.


Depressed patients show abnormal decision-making behavior in a social interaction context. Several possible explanations, such as increased sensitivity to fairness, negative emotional state and disturbed affective cognition, have been proposed to account for the abnormal social decision-making behavior in patients with MDD. This aberrant social decision-making behavior may provide a new perspective in the search to find biomarkers for the diagnosis and prognosis of MDD.

Ultimatum game; Major depressive disorder; Decision making; Fairness