Emotion recognition deficits in schizophrenia-spectrum disorders and psychotic bipolar disorder: Findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study

Abstract

Background Difficulty recognizing facial emotions is an important social-cognitive deficit associated with psychotic disorders. It also may reflect a familial risk for psychosis in schizophrenia-spectrum disorders and bipolar disorder. Objective The objectives of this study from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium were to: 1) compare emotion recognition deficits in schizophrenia, schizoaffective disorder and bipolar disorder with psychosis, 2) determine the familiality of emotion recognition deficits across these disorders, and 3) evaluate emotion recognition deficits in nonpsychotic relatives with and without elevated Cluster A and Cluster B personality disorder traits. Method Participants included probands with schizophrenia (n=297), schizoaffective disorder (depressed type, n=61; bipolar type, n=69), bipolar disorder with psychosis (n=248), their first-degree relatives (n=332, n=69, n=154, and n=286, respectively) and healthy controls (n=380). All participants completed the Penn Emotion Recognition Test, a standardized measure of facial emotion recognition assessing four basic emotions (happiness, sadness, anger and fear) and neutral expressions (no emotion). Results Compared to controls, emotion recognition deficits among probands increased progressively from bipolar disorder to schizoaffective disorder to schizophrenia. Proband and relative groups showed similar deficits perceiving angry and neutral faces, whereas deficits on fearful, happy and sad faces were primarily isolated to schizophrenia probands. Even non-psychotic relatives without elevated Cluster A or Cluster B personality disorder traits showed deficits on neutral and angry faces. Emotion recognition ability was moderately familial only in schizophrenia families. Conclusions Emotion recognition deficits are prominent but somewhat different across psychotic disorders. These deficits are reflected to a lesser extent in relatives, particularly on angry and neutral faces. Deficits were evident in non-psychotic relatives even without elevated personality disorder traits. Deficits in facial emotion recognition may reflect an important social-cognitive deficit in patients with psychotic disorders.

Familial covariation of facial emotion recognition and IQ in schizophrenia

“…Possible explanation for that finding is aberrant assignment of salience to neutral stimuli that was earlier described in psychotic patients (Kapur, 2003). Moreover, studies by Ruocco et al (2014) and by Eack et al (2010) have demonstrated that individuals at genetic risk of schizophrenia (i.e. siblings) also tend to have negative attribution bias (i.e.…”

“…On the other side, contrary to the majority of previous findings, our patient group exhibited impaired recognition of neutral facial expression in comparison to both siblings and controls. However, Ruocco et al (2014) and Kohler et al (2003) have also reported deficits perceiving neutral faces in patients with schizophrenia-spectrum disorders. Possible explanation for that finding is aberrant assignment of salience to neutral stimuli that was earlier described in psychotic patients (Kapur, 2003).…”

Facial Emotion Recognition in Bipolar Disorder and Healthy Aging

“…Recent literature has shown that mood disorders such as BD also have a strong impact on how individuals perceive facial expression (Samamé et al, 2012;Ruocco et al, 2014;van Rheenen and Rossell, 2013). Several studies with bipolar patients have shown how they are less accurate and slower at identifying facial expressions compared with control subjects, and contrary to the positive effect shown for older adults, these patients show a negative bias in face perception (Bozikas et al, 2006;Getz et al, 2003;Rocca et al, 2009).…”

Sex and Diagnosis-Specific Associations Between DNA Methylation of the Oxytocin Receptor Gene With Emotion Processing and Temporal-Limbic and Prefrontal Brain Volumes in Psychotic Disorders

“…Individuals with psychotic disorders often have persistent impairments in social cognition (1, 2), especially in schizophrenia (2, 3). Multiple lines of clinical and preclinical evidence indicate that social cognition abilities are influenced by the neuropeptide oxytocin (OT)(4-6).…”