the aim of the study was to explore the association between functional outcomes and mismatch negativity (MMN) activity in participants with mood disorders. The study participants were 27 subjects with major depressive disorder (MDD), 29 subjects with bipolar disorder (BD), and 33 healthy controls who performed a passive auditory oddball paradigm while electroencephalography (eeG) was recorded. peak amplitudes and source activity of the MMn were compared across groups. Mood and anxiety symptoms were evaluated. the functional levels were the lowest in the BD group, followed by the MDD and healthy control groups. The subjects with BD had significantly lower MMN amplitudes at the frontal and frontocentral electrodes than the healthy controls. the source activity of the MMn from the left anterior cingulate cortex, inferior frontal gyrus, and middle frontal gyrus was significantly increased in the BD group compared to the MDD group. Significant correlations were detected between the functional outcomes and MMn amplitudes at frontal and frontocentral sites. The functional outcome was significantly correlated with left frontal regions. In conclusion, MMN activity appears to be a promising candidate as an evaluation tool for functional outcomes in mood disorders. Bipolar disorder (BD) and major depressive disorder (MDD) are chronic, severe and recurrent mood disorders with substantial disease burden 1. As these two psychiatric conditions both involve severe depressive symptoms, misdiagnosis of BD as unipolar depression is a serious clinical problem 2. Previous studies suggested that C-reactive protein level 3 and heart rate variability 4 are candidate biomarkers for discriminating between bipolar depression and unipolar depression. In addition, electroencephalography (EEG) cordance and coherence values may potentially discriminate unipolar from bipolar depression 5. Although it is important to find biomarkers to enable the differential diagnosis between unipolar and bipolar depression, relatively few studies have addressed this. As such, promising biomarkers to differentiate between the two conditions are needed. Many patients with BD or MDD usually experience serious functional decline 6. Depressive symptoms have been shown to be associated with functional role impairments in multiple domains, such as duties at work or school, responsibilities at home, and relationships with family and friends 7. A previous study found that only 38% patients with major mood disorder achieved functional recovery within 2 years 8. The psychosocial disability resulting from depression is extensive, and encompasses multiple domains, including work and social interactions, independent living in the community, family adjustment, mortality, and quality of life 6. However, it remains unclear why functional decline is so pervasive in mood disorders. In addition, very few studies have assessed the specific biomarkers related to functional decline. Psychosocial functioning is defined as a person's capability to conduct daily life tasks and to engag...