Facial emotion perception in schizophrenia: a meta-analytic review

Abstract

Objectives: A considerable body of literature has reported on emotion perception deficits and the relevance to clinical symptoms and social functioning in schizophrenia. Studies published between 1970-2007 were examined regarding emotion perception abilities between patient and control groups and potential methodological, demographic, and clinical moderators. DATA SOURCES AND REVIEW: Eighty-six studies were identified through a computerized literature search of the MEDLINE, PsychINFO, and PubMed databases. A quality of reporting of meta-analysis standard was followed in the extraction of relevant studies and data. Data on emotion perception, methodology, demographic and clinical characteristics, and antipsychotic medication status were compiled and analyzed using Comprehensive Meta-analysis Version 2.0 (Borenstein M, Hedges L, Higgins J and Rothstein H. Comprehensive Meta-analysis. 2. Englewood, NJ: Biostat; 2005).

Results: The meta-analysis revealed a large deficit in emotion perception in schizophrenia, irrespective of task type, and several factors that moderated the observed impairment. Illness-related factors included current hospitalization and--in part--clinical symptoms and antipsychotic treatment. Demographic factors included patient age and gender in controls but not race.

Conclusion: Emotion perception impairment in schizophrenia represents a robust finding in schizophrenia that appears to be moderated by certain clinical and demographic factors. Future directions for research on emotion perception are discussed.

Fig. 1.

Individual Effect Sizes (Cohen d and 95% CIs) for Emotion Perception Studies.

Fig. 2.

Effect Sizes (Cohen d and 95% CI) for Facial Emotion Identification and Differentiation Deficits.

Fig. 3.

Effect Sizes (Cohen d and 95% CI) for Facial Emotion Perception Deficits in Schizophrenia Patients by Study Setting (ie, Inpatients, Outpatients, and Mixed).

Fig. 4.

Effect Sizes (Cohen d and 95% CI) for Facial Emotion Perception Deficits in Schizophrenia Patients by Medication Status (ie, Medicated, Unmedicated, and Mixed).

Fig. 5.

Effect Sizes (Cohen d and 95% CI) for Facial Emotion Perception Deficits in Schizophrenia Patients by Type of Antipsychotic Medication (ie, First Generation, Second Generation, and Mixed).