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Facial emotion recognition ability in patients with schizophrenia and other psychotic disorders.

Conference paper
Authors Elin Kjellenberg
Stefan Winblad
Published in Schizophrenia Bulletin
ISSN 0586-7614
Publisher Oxford academic
Place of publication London
Publication year 2020
Published at Department of Psychology
Language en
Keywords Schizofreni, psykos, ansiktsemotioner
Subject categories Psychiatry, Psychology


Background: Psychotic disorders are associated with impaired facial emotion recognition (FER) and poor functional outcome. Most studies regarding facial emotion recognition have focused on schizophrenia. The aim of this study was to explore FER in patients with different psychotic disorders at psychiatric outpatient facilities. The intention was also to examine if patients diagnosed with schizophrenia differed from patients diagnosed with other psychotic disorders in the ability to recognize facial emotions. Methods: FER was examined in forty outpatients, evenly divided between schizophrenia and other psychotic disorders and 33 healthy control per-sons. The ability to recognize facial emotions was assessed with The Facially Expressed Emotion Labelling (FEEL). To assess the severity of psychotic symptoms in the patient group The Structured Clinical Interview for Symptoms of Remission (SCI-SR) was used. Results: Patients performed significantly worse than healthy controls (p<.001, r =-.28) in recognizing facial emotions in general, including expressions of fear, disgust and sadness. Subjects with a schizophrenia diagnosis performed poorer than healthy controls when depicting fear (p<.01, r=.45) or anger (p=.026, r=.36). Compared to other psychotic disorders they were less accurate in recognizing anger (p=.036, r=-.040). We did not find any significant differences between patients with other psychotic disorders and healthy controls in FER. Furthermore, patients performed significantly slower on the FEEL test (p<.001, r=0.44), including both patients with a schizophrenia diagnosis and other psychotic disorders as compared to healthy controls. Patients diagnosed with schizophrenia showed significantly more psychotic symptoms (p= .001, r= -.53). However, there were no significant differences between patients in remission (40 %) and patients with more severe psychotic symptoms regarding the FEEL measures. Discussion: In this study, patients with psychotic disorders performed less accurately and slower on the FEEL task as compared to healthy control persons. Patients diagnosed with schizophrenia tended to exhibit more difficulties. The results from this between-group comparison should however be interpreted with caution due to limited statistical power. Since no significant difference in FEEL score was demonstrated between patients in remission and patients suffering from more severe psychotic symptoms, it could be suggested that deficits in FER are independent of current psychotic symptoms. Impaired facial emotion recognition ability may negatively influence social interaction and functional outcome and the results from this study indicate that FER should be further explored in larger cohorts of outpatients with different psychotic disorders.

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