Facial affect perception in psychosis: recent evidence

Background: Facial affect processing (FAP) deficits in schizophrenia (SZ) and bipolar disorder (BD) have been widely reported; although effect sizes vary across studies, and there are limited direct comparisons of the two groups. Conversely, no study has examined how schizoaffective disorder (SZA) patients perform on FAP tasks as an independent group (they are usually included within schizophrenia groups). Further, there is debate as to the influence of both psychotic and mood symptoms on FAP. Methods: This study aimed to address these limitations by recruiting groups of psychosis patients with either a diagnosis of SZ, BD or SZA and comparing them to healthy controls (HC) on a well validated battery of four FAP subtests: affect discrimination, name affect, select affect and match affect. Results: Overall, SZ patients performed poorly on all four subtests, with SZA patients performing similarly to the SZ group, although group comparisons between SZA and HC were not significant on all subtests due to limited sample size of the SZA group. The BD patients showed impaired performance specifically on the match affect subtest, a task that had a high cognitive load. Their performance on the other three subtests was similar to the HC group. FAP performance in the psychosis patients was correlated with severity of positive symptoms and mania. Discussion: This study confirmed that FAP deficits are a potential social cognitive endophenotype for SZ and SZA, independent of the specific methodology of the task; whilst deficits in BD are more subtle. It appears that deficits in BD are more apparent during conditions of high cognitive load, although further work with this group is recommended. In this large sample of psychosis patients FAP deficits were associated with positive psychotic symptom severity, in contrast to previous work that has suggested negative symptoms are associated