Emotion perception impaired in patients at risk for psychosis

By Mark Cowen

Patients at ultra-high risk for psychosis, as well as those with first-episode schizophrenia, show significant impairments in facial and vocal emotion recognition, researchers report.

The findings, published in Early Intervention in Psychiatry, show that emotion recognition impairments are present before the development of full-blown psychosis.

Paul Amminger (Medical University of Vienna, Austria) and team studied 79 patients at ultra-high risk for psychosis due to attenuated positive psychotic symptoms, transient psychosis, and/or genetic risk plus a decrease in functioning, 30 first-episode schizophrenia patients, and 30 mentally healthy controls.

All of the participants performed emotion labeling tasks in which they were asked to identify facial and vocal expressions of sadness, anger, happiness, disgust, surprise, and fear, as well as neutrality.

The team found that both the ultra-high risk and first-episode schizophrenia patients had a significantly lower mean proportion of correct answers on the facial emotion recognition task compared with controls, at 74.8% and 73.0% versus 80.6%, respectively.

Ultra-high risk and first-episode schizophrenia patients also had a significantly lower mean proportion of correct answers on the vocal emotion recognition task compared with controls, at 72.2% and 70.9% versus 77.4%, respectively.

The difference in emotion recognition performance between both groups of patients and controls persisted after accounting for age, gender, and education level, the researchers note.

Amminger and team conclude: "The findings suggest that emotion recognition impairments may be independent of the stage of illness in schizophrenia."

They add: "Inaccurate decoding of emotional expression is a barrier to social interactions and communication, and thus impaired emotion recognition could be one mechanism among the factors contributing to the functional decline that occurs during the onset of psychoses."

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