Abstract
Background
Schizophrenia and Bipolar I disorder patients lack the ability to identify emotional expressions, which is characterized by poor social and professional functions. Facial affect recognition is a complex function that includes cortical and limbic connections, providing an essential source of information during face-to-face communication. In this study, the Facial Labeling Task, which can evaluate Koreans’ ability to recognize emotions using facial expressions, is used to compare defects in face emotional recognition in patients with remitted schizophrenia patients, euthymic bipolar I disorder patients, and normal controls.
Methods
Three groups were included in this study: remitted patients with schizophrenia (n=75), patients in euthymic states of bipolar I disorder (n=70), and healthy controls (n=59) who were matched on age, sex, years of education. Facial Labeling Task was used to examine face emotional recognition defects the standardized happy, fearful, disgust, anger, sad, contempt, surprise and neutral faces from actors (4 males, 4 females) were used (emotional intensity 100%). Accuracy (commission error rates), correct response times of each trial were calculated. All subjects had to satisfy the inclusion criteria(absence of substance abuse, head trauma, mental retardation) and subjects with above mild level of psychiatric symptoms [BPRS(Brief Psychiatric Rating Scale) >31, K-MADRS(Korean version Montgomery-Asberg Depression Scale) Score >9, YMRS(Young Mania Rating Scale Korean version) Score >7] were excluded. All of patients group had to be in remitted state at least 3 months. All of subjects in normal control group were interviewed before the test using Structured Clinical Interview for DSM-IV Axis-1 Disorder to rule out psychiatric history. We used Korean version-Wechsler Adult Intelligence Scale. Psychomotor performance was examined using Finger Tapping Test.
Results
There were no differences on demographic data between three groups. Although psychopathologies in all groups were within the criteria, there were group differences. The scoring of BPRS, YMRS, MADRS were higher in schizophrenia patients. Intelligence was low in schizophrenia and Bipolar I disorder patients. There was no difference among the group in the psychomotor speed. Two patients groups were significantly higher error rates for sadness (p < 0.01), anger (p < 0.001),, and neutral (p < 0.01). Schizophrenia group showed significantly higher error rates for contempt to normal controls (p < 0.05). Happy and neutral face had significantly more delayed correct response times in two patient groups than in the healthy controls (p < 0.05).
Discussion
These finds suggest that the patients with schizophrenia and bipolar I disorder have a defects in the perception and response of specific emotions in the remitted states, and schizophrenia is more emotionally impaired than bipolar disease. Therefore, it is thought that a defects in facial recognition should be considered in the process of assessing and treating patients with bipolar I disorder as well as those with schizophrenia.
S58. COMPARISON OF FACE EMOTIONAL RECOGNITION DEFICITS IN REMITTED SCHIZOPHRENIA AND BIPOLAR I DISORDER