Fine Analysis of Abnormal Facial Expressions in Chronic Schizophrenic Patients - A Pilot Study

Objective: Facial expressions seem to be closely related to limbic processes. Abnormal facial expressions were described often in schizophrenic patients, but the specific nature of this disturbance is still unclear. Since facial activity in total seems to be not specifically disturbed in schizophrenics, analysis of movement details during facial expressions could be a more promising tool. Methods: Seven chronic schizophrenic patients (DSM III-R: 295.6, all males and medicated, 32.3±7.3 years) were investigated while watching a humorous movie. Movements of the corner of the mouth were assessed during laughing by a light-signal device with high spatial and temporal resolution. Results: Starting to laugh at an emotional stimulus, schizophrenic patients exhibited a faster speed of left and right corner of the mouth than matched healthy controls (2.02±0.42 cm/s versus 0.82±0.41 cm/s, t-test: p=0.0002). There was no overlap between the two groups. Conclusions: This faster beginning of the facial movement "laughing" could be an objective and specific measure of abnormal facial expression in schizophrenic patients which is correlated to the clinical picture of manneristic and parathymic behaviour. Possibly, the changed movement of starting a facial expression reflects a disturbed transformation of emotions into facial movements in the so-called limbic-motor interface -the nucleus accumbensin schizophrenic patients (German J Psychiatry 1998; 1: 6-9).