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Processing of Facial and Nonsocial Information Is Differentially Associated With Severity of Symptoms in Patients With Multiepisode Schizophrenia

Barkhof, Emile MD*; de Sonneville, Leo M.J. MSc, PhD; Meijer, Carin J. MSc, PhD*; de Haan, Lieuwe MD, PhD*

The Journal of Nervous and Mental Disease: February 2015 - Volume 203 - Issue 2 - p 112–119
doi: 10.1097/NMD.0000000000000246
Original Articles

Patients with schizophrenia show impairments in social cognitive abilities, such as recognizing facial emotions. However, the relation to symptoms remains unclear. The goal of this study was to explore whether facial emotion recognition and face identity recognition are associated with severity of symptoms and to which extent associations with symptoms differ for processing of social versus nonsocial information. Facial emotion recognition, face recognition, and abstract pattern recognition were evaluated in 98 patients with multiepisode schizophrenia. Severity of symptoms was measured using a five-factor model of the Positive and Negative Syndrome Scale. Results show that facial emotion recognition and, to a lesser extent, face recognition were predominantly associated with severity of disorganization symptoms. In contrast, recognition of nonsocial patterns was associated with negative symptoms, excitement, and emotional distress. Reaction time rather than accuracy of social cognition explained variance in symptomatology. These results lead to the conclusion that facial emotion processing in schizophrenia appears to be associated with severity of symptoms, especially disorganization.

*Department of Psychiatry, Academic Medical Centre, Amsterdam; and †Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, the Netherlands

Send reprint requests to Emile Barkhof, MD, Department of Psychiatry, Academic Medical Centre, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands. E-mail:

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