A meta-analysis of emotion perception and functional outcomes in schizophrenia

Abstract

Introduction Emotion perception (EP) is impaired in schizophrenia, is stable across clinical state, resistant to antipsychotic treatment and linked to symptom severity. Given its pervasive nature, there is a need to quantitatively examine whether this dysfunction impacts functional outcomes. We used a meta-analytic strategy to combine results from several studies and examine synthesized effect sizes. Methods A Meta-analysis Of Observational Studies in Epidemiology standard was used to extract data following a PubMed and PsychInfo search. Studies reporting correlations between measures of EP and functional outcomes in schizophrenia spectrum disorders were selected. The impact of potential methodological (task type), demographic (sex, age, race, education, marital status) and clinical (age of onset, duration of illness, setting, symptoms, anti-psychotic medication) moderators on effect sizes were examined. Results Twenty-five studies met inclusion criteria and included 1306 patients who were 37 years old, with 12 years of education, 64% male and 63% Caucasian. There was a significant relationship between EP and functional outcomes in individuals with schizophrenia or schizoaffective disorder, with effect sizes in the medium range. Medium to large range positive correlations were observed between emotion identification and functional outcome domains involving social problem solving, social skills and community functioning. Significant moderators included task type (emotion identification tasks), sex (% male in sample), race (% Caucasian in sample) and clinical symptoms (negative and positive). Conclusions Emotion identification deficits are associated with functional impairments in schizophrenia and moderated by sex, race and symptoms. This has implications for treatment efforts to improve outcomes.

Facial emotion perception in schizophrenia: Does sex matter?

“…It also remains unclear why men with schizophrenia would benefit more from cognitive remediation treatments that target FEP compared to women [10] when they both show equivalent deficits in FEP. Again, women may have other social or emotional skills that may help them function in the world despite their deficits in FEP, thus improving this one skill may not benefit them as much as it benefits men.…”

“…People with schizophrenia are less accurate at FEP compared to people without schizophrenia [5][6][7][8][9] , and poorer accuracy on FEP tasks is positively correlated with poorer functioning, poorer social skills, and more severe symptoms, particularly negative symptoms, in schizophrenia [3,8,10] . To illustrate, imagine a person with schizophrenia who consistently perceives the smiling face of his landlord as anger (inaccurate FEP).…”

“…These interventions have been found to improve functioning (e.g., social skills, community functioning) in people with schizophrenia [11] . Interestingly, a recent metaanalysis found that this relationship was moderated by sex: There was a stronger positive correlation between functional outcome and FEP in men compared to women with schizophrenia [10] . In other words, men with schizophrenia appeared to benefit more (show improved functioning) from interventions targeting FEP compared to women.…”

Función reflexiva y neurocognición en psicosis: un estudio comparativo

“…En las últimas decádas se ha desarrollado una amplia línea de investigaciones acerca de las dificultades en cognición social de las personas con esquizofrenia (Irani, Seligman, Kamath, Kohler, y Gur, 2012;Penn, Sanna, y Roberts, 2008;Savla, Vella, Armstrong, Penn, y Twamle, 2013). Dentro del marco de la cognición social, se define la función reflexiva (FR), así como sus conceptos relacionados (mentalización o Teoría de la Mente -TdM-), como la capacidad que permite interpretar las intenciones, los deseos, sentimientos y creencias, propios y ajenas y por ende, predecir y explicar la propia conducta y de los otros (Fonagy, Gergely, Jurist, y Target, 2002;Fonagy, Steele, Moran, Steele, y Higgit, 1991).…”

The neuroimaging and genetics of emotion perception in schizophrenia

“…A key aspect of social cognition is emotion perception, which is the ability to recognise how another person is feeling. Impaired emotion perception is a wellestablished deficit in SCZ Kohler et al, 2010) and has a significant impact on overall daily functioning (Irani et al, 2012). Deficits in processing emotion are stable throughout the course of illness Horan et al, 2012;McCleery et al, 2016) and resistant to current pharmacological treatment (Mueser et al, 1996;Penn et al, 2009).…”