Self-face recognition in schizophrenia is related to insight

A core feature of schizophrenia is the breakdown of the sense of self. A widespread clinical consequence of impaired self-awareness is a lack of insight. Self-face recognition is regarded as one aspect of self-awareness; how this relates to other self-referential processes such as insight into the disorder is as yet unknown. Nineteen patients with schizophrenia performed a facial recognition task using video morphings during which an average face gradually transformed into one's own, a famous or an unfamiliar face (and vice versa). Reaction times to detect faces during the transitions were compared between patients and a matched control group. In the patient group, we also examined correlations between face recognition and insight, psychopathology, and self-evaluation. Both patients with schizophrenia and controls recognised their own faces faster than unfamiliar faces. Whereas healthy subjects recognised a famous face at an intermediate speed that did not differ significantly from the recognition of one's own and unfamiliar faces, schizophrenia patients recognised the famous face, similar to their own face, significantly faster than an unfamiliar face. Moreover, in the patient group, higher insight correlated with faster reaction times in distinguishing one's own from famous faces. Patients with schizophrenia seem to distinguish less than controls between their own and a famous face relative to an unfamiliar face. Patients with good insight into the disorder, however, were better able to differentiate between their own and a famous face. This study supports the view that self-face recognition is an indicator for higher-order self-awareness.