Voice atypicalities have been a characteristic feature of schizophrenia (SCZ) since its first definitions. They are often associated with core negative symptoms such as flat affect and alogia, and with the social impairments seen in the disorder. This suggests that voice atypicalities may represent a marker of clinical features and social functioning in SCZ. We systematically reviewed and meta-analyzed the evidence for distinctive acoustic patterns in SCZ, as well as their relation to clinical features. We identified 46 articles, including 55 studies with a total of 1254 patients with SCZ and 699 healthy controls. Summary effect size (Hedges'g) estimates were calculated using multilevel Bayesian modeling. We identified weak atypicalities in pitch variability (g = -0.55) related to flat affect, and stronger atypicalities in proportion of spoken time, speech rate, and pauses (g's between -0.75 and -1.89) related to alogia and flat affect. However, the effects were modest compared to perceptual and clinical judgments, and characterized by large heterogeneity between studies.Moderator analyses revealed that tasks with a more demanding cognitive and social component had significantly larger effects both in contrasting patients and controls and in assessing symptomatology. In conclusion, studies of acoustic patterns are a promising but, yet unsystematic avenue for establishing markers of SCZ. We outline recommendations towards more cumulative, open, and theory-driven research.

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The present study compared life story chapters and self-defining memories in 25 patients with schizophrenia and 25 matched controls. All participants were tested on neurocognition and rated on symptoms. Participants identified and rated life story chapters and self-defining memories on emotional valence, causal coherence, and self-continuity. Temporal coherence and temporal macrostructure were also assessed. Patients rated their life story chapters as more negative compared to controls, but there were few significant differences regarding temporal coherence, temporal macrostructure, and ratings of causal coherence and self-continuity. In patients, poorer neurocognitive function and higher degree of negative symptoms were related to less causal coherence and lower self-continuity in relation to chapters. In general, few differences were found between the patients and the controls. This may be due to the highly structured method used to assess life stories or to the fact that our patient group was cognitively well-functioning.