Perception of happy and sad facial expressions in chronic schizophrenia: evidence for two evaluative systems.

BACKGROUND Persons suffering from schizophrenia have impaired perception of emotional expressions, but it is not clear whether this is part of a generalized deficit in cognitive function. AIM To test for existence of emotion-specific deficits by studying the effects of valence on recognition of facial emotional expressions. METHODS 24 male subjects suffering from chronic schizophrenia were examined with two tests of perception of emotion: the Penn Emotion Acuity Test (PEAT 40) and the Emotion Differentiation Task (EMODIFF). Clinical state was assessed with the Scale for the Assessment of Negative Symptoms (SANS) and Scale for the Assessment of Positive Symptoms (SAPS), visual memory with the Benton Visual Retention Test (BVRT) and motor function with the finger tapping test. RESULTS Identification of happy facial expressions showed significant negative correlation with age, cumulated time in hospital and length of current hospitalization; positive correlations were found with visual retention and finger tapping scores. Identification of sad facial expressions showed significant correlation only with cumulated time in hospital while identification of neutral facial expressions showed no significant correlations. Discrimination between degrees of happy but not sad facial expression showed a positive correlation with negative symptoms. CONCLUSION Perception of happy and sad emotion relates differently to significant illness parameters. This differentiability supports the existence of an emotion-specific deficit in perception of emotions in schizophrenia and of separate channels for processing positive and negative emotions.