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Area of Science:

  • Psychiatry
  • Cognitive Neuroscience
  • Clinical Psychology

Background:

  • Facial emotion recognition (decoding) and expression (encoding) are crucial in schizophrenia diagnosis and therapeutic alliance.
  • Existing literature presents conflicting views: a generalized emotion deficit versus an emotion-specific deficit in schizophrenia.
  • Previous reviews suggest generalized deficits linked to perceptual impairments in schizophrenia.

Purpose of the Study:

  • To systematically review and synthesize findings on emotion processing in schizophrenia from 2010-2022.
  • To revisit the controversy regarding generalized versus emotion-specific deficits in schizophrenia.
  • To examine the influence of negative symptoms and illness state on emotion processing.

Main Methods:

  • Comprehensive literature search of studies published between 2010 and 2022.
  • Inclusion of 47 studies encompassing 2364 patients across 20 countries.
  • Analysis of both emotion decoding (37 studies) and encoding (10 studies) in schizophrenia.

Main Results:

  • Schizophrenia is consistently associated with reduced emotion processing ability.
  • Deficits are more pronounced in patients with negative symptoms and during acute phases of the illness.
  • The independence of these deficits from generalized face perception or subjective emotional experience remains unclear.

Conclusions:

  • Emotion processing deficits are a significant characteristic of schizophrenia, particularly evident in specific clinical presentations.
  • Further research is needed to disentangle the contributions of face perception and subjective experience to these observed deficits.
  • Understanding these impairments is vital for improving diagnostic accuracy and therapeutic interventions in schizophrenia.