Familiarity and face emotion recognition in patients with schizophrenia

Objective: To assess the emotion recognition in familiar and unknown faces in a sample of schizophrenic patients and healthy controls.

Methods: Face emotion recognition of 18 outpatients diagnosed with schizophrenia (DSM-IVTR) and 18 healthy volunteers was assessed with two Emotion Recognition Tasks using familiar faces and unknown faces. Each subject was accompanied by 4 familiar people (parents, siblings or friends), which were photographed by expressing the 6 Ekman's basic emotions. Face emotion recognition in familiar faces was assessed with this ad hoc instrument. In each case, the patient scored (from 1 to 10) the subjective familiarity and affective valence corresponding to each person.

Results: Patients with schizophrenia not only showed a deficit in the recognition of emotions on unknown faces (p=.01), but they also showed an even more pronounced deficit on familiar faces (p=.001). Controls had a similar success rate in the unknown faces task (mean: 18 +/- 2.2) and the familiar face task (mean: 17.4 +/- 3). However, patients had a significantly lower score in the familiar faces task (mean: 13.2 +/- 3.8) than in the unknown faces task (mean: 16 +/- 2.4; p<.05). In both tests, the highest number of errors was with emotions of anger and fear. Subjectively, the patient group showed a lower level of familiarity and emotional valence to their respective relatives (p<.01).

Conclusions: The sense of familiarity may be a factor involved in the face emotion recognition and it may be disturbed in schizophrenia.