Facial emotion recognition and its relationship to symptomatic, subjective, and functional outcomes in outpatients with chronic schizophrenia

Abstract

Outcome in schizophrenia is multidimensional and consists of clinical and psychosocial domains. Difficulties in affect recognition are a hallmark of schizophrenia, but there is little research investigating the consequences of this deficit on patients' psychosocial status. This cross-sectional study examined the relationship of facial affect recognition and treatment outcomes in terms of psychopathology, quality of life (QOL), and psychosocial functioning. We investigated 40 regular attendees of a specialized schizophrenia outpatient clinic who had been stable both from a symptomatic and a medication perspective for a minimum of 6 months and 40 healthy volunteers who were chosen to match patients in age, sex, and education. Affect recognition was positively associated with patients' level of education and negatively with increasing age. Deficits in this area corresponded to the severity of negative and affective symptoms as well as to poor work and global functioning. These findings suggest that affect recognition is an important aspect of psychosocial functioning in stable outpatients with schizophrenia.

Effects of the 5-HTTLPR Polymorphism of the Serotonin Transporter Gene on the Recognition of Mimicked Emotional Expressions in Schizophrenia

“…In particular, patients with the S allele showed decreased verbal learning and executive functions relative to LL homozygotes [3,9], which distinguishes patients from the general population, in which the S allele is linked with better measures of executive functions [8,62]. In the present study, the defi cit in the recognition of emotions correlated with enhancement of negative symptoms, degradation of neurocognition, and low trait anxiety, which is consistent with published data [26,32]. However, we did not see any infl uence from the 5-HTTLPR polymorphism on these features, or any signifi cant modulatory effect of these features on the association between the 5-HTTLPR polymorphism and the defect in the recognition of emotions.…”

“…Numbers of subjects studied in the corresponding groups are shown for each genotype (in parentheses); HWE -Hardy-Weinberg equilibrium. Effects of the 5-HTTLPR Polymorphism of the Serotonin Transporter Gene overall defi cit of perception of emotional faces in schizophrenia [26,41]. It can therefore be suggested that the effect of the 5-HTTLPR S allele on identifi cation of emotions by patients seen here is also mainly associated with the recognition of fear.…”

Positive and negative symptom scores are correlated with activation in different brain regions during facial emotion perception in schizophrenia patients: A voxel-based sLORETA source activity study

“…Studies on facial emotion processing, which is an aspect of social cognition, have demonstrated that schizophrenia patients have defects in interpreting the emotions and intentions of others (Marwick and Hall, 2008;Green et al, 2012). Although some studies have shown that negative symptoms are more closely associated with dysfunction in facial emotion discrimination (Mandal et al, 1999;Kohler et al, 2003;Hofer et al, 2009), the different neural correlates of facial emotional processing with respect to negative and positive symptoms have not yet been studied.…”

Potential therapeutic avenues to tackle social cognition problems in schizophrenia

“…Emotion processing deficits in schizophrenia encompass multiple impairments, including emotion recognition from facial expression and prosody [15], emotion discrimination, emotion interpretation [16][17][18][19] and emotional awareness [20]. In real-world social functioning, recognizing and correctly interpreting facial emotional expressions is a crucial component for social interaction [17]. One study has shown a direct relationship between deficits in emotion recognition and the severity of negative and affective symptoms, as well as poor vocational and global functioning [18].…”

“…These domains have been listed as: emotion processing, theory of mind, attributional bias, social perception and social knowledge. Emotion processing deficits in schizophrenia encompass multiple impairments, including emotion recognition from facial expression and prosody [15], emotion discrimination, emotion interpretation [16][17][18][19] and emotional awareness [20]. In real-world social functioning, recognizing and correctly interpreting facial emotional expressions is a crucial component for social interaction [17].…”