Visual scanning of emotional faces in schizophrenia

This study investigated eye movement differences during facial emotion recognition between 101 patients with chronic schizophrenia and 101 controls. Independent of facial emotion, patients with schizophrenia processed facial information inefficiently; they showed significantly more direct fixations that lasted longer to interest areas (IAs), such as the eyes, nose, mouth, and nasion. The total fixation number, mean fixation duration, and total fixation duration were significantly increased in schizophrenia. Additionally, the number of fixations per second to IAs (IA fixation number/s) was significantly lower in schizophrenia. However, no differences were found between the two groups in the proportion of number of fixations to IAs or total fixation number (IA fixation number %). Interestingly, the negative symptoms of patients with schizophrenia negatively correlated with IA fixation number %. Both groups showed significantly greater attention to positive faces. Compared to controls, patients with schizophrenia exhibited significantly more fixations directed to IAs, a higher total fixation number, and lower IA fixation number/s for negative faces. These results indicate that facial processing efficiency is significantly decreased in schizophrenia, but no difference was observed in processing strategy. Patients with schizophrenia may have special deficits in processing negative faces, and negative symptoms may affect visual scanning parameters.