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This study is the first to date examining the impact of AUDs/SUDs and COMT variants on FER in an epidemiologically representative sample of subjects with schizophrenia. Our findings do not suggest an additional impairment from comorbid AUDs/SUDs on FER among subjects with schizophrenia, whilst COMT Val158Met, though based on a limited sample, might have a role just among those without AUDs/SUDs. Based on our results, additional research is needed also exploring differential roles of various substances.

This study is the first to date examining the impact of COMT on cognition in a highly representative sample of people with schizophrenia and comorbid AUD/SUD. Differential moderating effects of COMT Val/Met genotype variations may similarly influence executive functions in people with schizophrenia and comorbid AUD/SUD.

IntroductionSchizophrenia (SKZ) is a disease characterized by positive and negative symptoms, thoughts and behaviour disorganization with a progressive socio-cognitive impairment1; deficits in facial emotion recognition (FER) represent one of the most serious problems linked to interpersonal problems2. In addition, these patients have often comorbid condition of alcohol and substances abuse3.Objectivesto compare the ability of FER in patients with SKZ using alcohol and/or substances (SKZ+SUD) compared to schizophrenics without SUD (SUD-SKZ).Methodswe enrolled 53 subjects (M=40, F=13) with a DSM-IV diagnosis of SKZ (SCID I). The sample was divided according to alcohol and/or substance abuse (AUS and DUS) into two groups, compared for socio-demographic and clinic characteristics (PANSS and Bell model4). We analyzed the association between abuse condition and Ekman test performance.ResultsSKZ+SUD (n=20; M=16, F=4) and SKZ-SUD (n=33; M=24, F=9) show a statistically significant age difference with a mean (SD) of 38.4 years (10.5) and 46.0 years (8.7) respectively (p=0.006). SKZ+SUD Ekman test score (mean=43.1, SD=6.9) was statistically higher (p=0.006) than SKZ-SUD (mean=34.6, SD=12.0). The different performance was more evident in comparison with poly-abusers (44.94±7.05 vs 12.04±34.6; p=0.002). We further noticed the role of disorganization as a mediator of the relationship between abuse and FER score (p=0.017): the proportion of the effect of abuse on Ekman test score was 48%.ConclusionsIn subjects with SKZ, FER seems to be less impaired in abusers than non-abusers. We also showed an important role of thoughts and behavioral disorganization as a mediator between SKZ+SUD and FER.