Impaired eye expression recognition in schizophrenia

Schizophrenia has been associated with abnormalities in recognising social emotions, inferring others' mental states and in gaze and visual scanning b ehaviours. Eye expression is known to convey considerable information in no rmal circumstances. Our study assessed the ability of individuals with schi zophrenia to recognise simple and complex mental states from eye expression s alone. Sixteen individuals with a DSM-IV diagnosis of schizophrenia follo wing SCAN [Schedules for Clinical Assessment in Neuropsychiatry (Wing JK, B abor T, Brugha T, Burke J, Cooper JE, Giel R et al. SCAN: schedules for cli nical assessment in neuropsychiatry. Archives of General Psychiatry 1990;47 :589-593).] interview and 16 healthy controls acted as participants. Expres sions of 10 emotions (e.g. happy, afraid) and 10 complex mental states (e.g . thoughtful, bored), in the form of pictures of whole faces or eyes alone, were presented for recognition using a forced-choice response design. We o bserved impaired recognition of complex mental states in individuals with s chizophrenia, from eye expressions alone (P = 0.012). No differences in the recognition of basic emotions were detected. We also observed a negative c orrelation between illness chronicity and expression recognition performanc e (r = -0.65, P = 0.006). The reduced ability of schizophrenia patients to recognise eye expressions of complex mental states could be interpreted as supporting a lack of "theory of mind". However, more parsimonious explanati ons based on impairments in basic recognition processes could also apply. A n awareness of these processing abnormalities may have implications for fut ure therapeutic strategies and our understanding of the pathophysiology of the disorder. (C) 2000 Elsevier Science Ltd. All rights reserved.