Facial emotion perception in schizophrenia: Does sex matter?

Abstract

AIM:To review the literature on sex differences in facial emotion perception (FEP) across the schizophrenia spectrum. METHODS:We conducted a systematic review of empirical articles that were included in five separate meta-analyses of FEP across the schizophrenia spectrum, including meta-analyses that predominantly examined adults with chronic schizophrenia, people with early (onset prior to age 18) or recent-onset (experiencing their first or second psychotic episode or illness duration less than 2 years) schizophrenia, and unaffected first-degree relatives of people with schizophrenia. We also examined articles written in English (from November 2011 through June 2015) that were not included in the aforementioned metaanalyses through a literature search in the PubMed database. All relevant articles were accessed in full text. We examined all studies to determine the sample sizes, diagnostic characteristics, demographic information, methodologies, results, and whether each individual study reported on sex differences. The results from the meta-analyses themselves as well as the individual studies are reported in tables and text. RESULTS:We retrieved 134 articles included in five separate meta-analyses and the PubMed database that examined FEP across the schizophrenia spectrum. Of these articles, 38 examined sex differences in FEP. Thirty of these studies did not find sex differences in FEP in either chronically ill adults with schizophrenia, early-onset or recently diagnosed people with schizophrenia, or first-degree relatives of people with schizophrenia. Of the eight studies that found sex differences in FEP, three found that chronically ill women outperformed men, one study found that girls with early-onset schizophrenia outperformed boys, and two studies found that women (including first-degree relatives, adults with schizophrenia, and the healthy control group) outperformed men on FEP tasks. In total, six of the eight studies that examined sex differences in FEP found that women outperformed men across the SYSTEMATIC REVIEWS Core tip: People with schizophrenia exhibit deficits in facial emotion perception (FEP) compared to healthy controls. These deficits are associated with poorer functioning and more severe symptoms. Although the literature to date suggests that there are few sex differences in FEP in schizophrenia, continued assessment of sex differences in FEP can help researchers and clinicians better understand other sex differences in the disorder and assist in treatment development aimed at improving functioning in people with schizophrenia. This review summarizes and critically evaluates the literature on FEP across the schizophrenia spectrum, focusing on the evidence related to sex differences in FEP.Mote J, Kring AM. Facial emotion perception in schizophrenia: Does sex matter? World J Psychiatr 2016; 6(2): 257-268

The Effect of Age, Race, and Sex on Social Cognitive Performance in Individuals With Schizophrenia

“…The effect size in our larger patient sample; however, was almost zero. This is consistent with several previous reports indicating that individuals with schizophrenia fail to show the normative female advantage in emotion recognition (Kohler et al, 2009; Mote et al, 2016) and may suggest important interactions between sex and diagnosis that should be considered in future attempts to understand the mechanisms underlying emotion recognition impairment. Data from the BLERT failed to show a meaningful sex difference in either patients or controls, but it is important to note that sex differences in recognizing emotion from dynamic stimuli have not been supported among healthy individuals (reviewed in (Kret et al, 2012)).…”

“…For example, within emotion recognition, females with schizophrenia do not appear to have an advantage in overall accuracy relative to males (Kohler et al, 2009; Mote et al, 2016), but increased age has been found to be associated with greater impairment (Kohler et al, 2009). The one study that has examined demographic factors and mental state attribution suggests a different pattern in that females did show an advantage, but only minimal relations between mental state attribution abilities and age were evident among patients (Abu-Akel et al, 2013).…”

A Short Empathy Paradigm to Assess Empathic Deficits in Schizophrenia

“…The influence of gender on empathy in schizophrenia, however, remains imprecise due to inconsistent findings so far. Mote and Kring [65] included in their meta-analysis 38 studies on gender differences in facial emotion processing in schizophrenia. Significant results occurred only in eight of those studies and in six of those, women outperformed men across the schizophrenia spectrum.…”

Éléments de validation du Protocole d’Évaluation de la Cognition Sociale de Bordeaux (PECS-B) en population générale et dans la schizophrénie

“…Enfin, les résultats montrent un effet de l'âge (plus les personnes sont âgées et moins bonnes sont leurs performances), du niveau d'études (plus les personnes ont un niveau d'études élevé et meilleures sont leurs performances) et du sexe (les femmes ont de meilleures performances que les hommes) pour de nombreuses tâches du PECS-B. Ces différents effets ont déjà été rapportés dans la littérature [1,39] mais restent contestés [11,26]. Du fait des liens entre cognition sociale et neurocognition, les effets de l'âge et du niveau d'études pourraient être partiellement médiatisés par la neurocognition, connue pour être liée négativement avec l'âge et positivement avec le niveau d'études.…”