Facial affect recognition in early and late-stage schizophrenia patients.

Prior studies have shown deficits in social cognition and emotion perception in first-episode psychosis (FEP) and multi-episode schizophrenia (MES) patients. These studies compared patients at different stages of the illness with only a single control group which differed in age from at least one clinical group. The present study provides new evidence of a differential pattern of deficit in facial affect recognition in FEP and MES patients using a double age-matched control design. Compared to their controls, FEP patients only showed impaired recognition of fearful faces (p=.007). In contrast to this, the MES patients showed a more generalized deficit compared to their age-matched controls, with impaired recognition of angry, sad and fearful faces (ps<.01) and an increased misattribution of emotional meaning to neutral faces. PANSS scores of FEP patients on Depressed factor correlated positively with the accuracy to recognize fearful expressions (r=.473). For the MES group fear recognition correlated positively with negative PANSS factor (r=.498) and recognition of sad and neutral expressions was inversely correlated with disorganized PANSS factor (r=-.461 and r=-.541, respectively). These results provide evidence that a generalized impairment of affect recognition is observed in advanced-stage patients and is not characteristic of the early stages of schizophrenia. Moreover, the finding that anomalous attribution of emotional meaning to neutral faces is observed only in MES patients suggests that an increased attribution of salience to social stimuli is a characteristic of social cognition in advanced stages of the disorder.

Patterns of Emotion Attribution are Affected in Patients with Schizophrenia.

Deficits in facial affect recognition have been repeatedly reported in schizophrenia patients. The hypothesis that this deficit is caused by poorly differentiated cognitive representation of facial expressions was tested in this study. To this end, performance of patients with schizophrenia and controls was compared in a new emotion-rating task. This novel approach allowed the participants to rate each facial expression at different times in terms of different emotion labels. Results revealed that patients tended to give higher ratings to emotion labels that did not correspond to the portrayed emotion, especially in the case of negative facial expressions (p < .001, η 2 = .131). Although patients and controls gave similar ratings when the emotion label matched with the facial expression, patients gave higher ratings on trials with "incorrect" emotion labels (p s < .05). Comparison of patients and controls in a summary index of expressive ambiguity showed that patients perceived angry, fearful and happy faces as more emotionally ambiguous than did the controls (p < .001, η 2 = .135). These results are consistent with the idea that the cognitive representation of emotional expressions in schizophrenia is characterized by less clear boundaries and a less close correspondence between facial configurations and emotional states.

Patterns of emotion attribution are affected in patients with schizophrenia

Deficits in facial affect recognition have been repeatedly reported in schizophrenia patients. The hypothesis that this deficit is caused by poorly differentiated cognitive representation of facial expressions was tested in this study. To this end, performance of patients with schizophrenia and controls was compared in a new emotion-rating task. This novel approach allowed the participants to rate each facial expression at different times in terms of different emotion labels. Results revealed that patients tended to give higher ratings to emotion labels that did not correspond to the portrayed emotion, especially in the case of negative facial expressions (p < .001, η2 = .131). Although patients and controls gave similar ratings when the emotion label matched with the facial expression, patients gave higher ratings on trials with "incorrect" emotion labels (ps < .05). Comparison of patients and controls in a summary index of expressive ambiguity showed that patients perceived angry, fearful and happy faces as more emotionally ambiguous than did the controls (p < .001, η2 = .135). These results are consistent with the idea that the cognitive representation of emotional expressions in schizophrenia is characterized by less clear boundaries and a less close correspondence between facial configurations and emotional states (AU)

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Reduced visual surround suppression in schizophrenia shown by measuring contrast detection thresholds.

Visual perception in schizophrenia is attracting a broad interest given the deep knowledge that we have about the visual system in healthy populations. One example is the class of effects known collectively as visual surround suppression. For example, the visibility of a grating located in the visual periphery is impaired by the presence of a surrounding grating of the same spatial frequency and orientation. Previous studies have suggested abnormal visual surround suppression in patients with schizophrenia. Given that schizophrenia patients have cortical alterations including hypofunction of NMDA receptors and reduced concentration of GABA neurotransmitter, which affect lateral inhibitory connections, then they should be relatively better than controls at detecting visual stimuli that are usually suppressed. We tested this hypothesis by measuring contrast detection thresholds using a new stimulus configuration. We tested two groups: 21 schizophrenia patients and 24 healthy subjects. Thresholds were obtained using Bayesian staircases in a four-alternative forced-choice detection task where the target was a grating within a 3∘ Butterworth window that appeared in one of four possible positions at 5∘ eccentricity. We compared three conditions, (a) target with no-surround, (b) target embedded within a surrounding grating of 20∘ diameter and 25% contrast with same spatial frequency and orthogonal orientation, and (c) target embedded within a surrounding grating with parallel (same) orientation. Previous results with healthy populations have shown that contrast thresholds are lower for orthogonal and no-surround (NS) conditions than for parallel surround (PS). The log-ratios between parallel and NS thresholds are used as an index quantifying visual surround suppression. Patients performed poorly compared to controls in the NS and orthogonal-surround conditions. However, they performed as well as controls when the surround was parallel, resulting in significantly lower suppression indices in patients. To examine whether the difference in suppression was driven by the lower NS thresholds for controls, we examined a matched subgroup of controls and patients, selected to have similar thresholds in the NS condition. Patients performed significantly better in the PS condition than controls. This analysis therefore indicates that a PS raised contrast thresholds less in patients than in controls. Our results support the hypothesis that inhibitory connections in early visual cortex are impaired in schizophrenia patients.

Cognición y calidad de vida en pacientes con esquizofrenia: utilidad de la MATRICS Consensus Cognitive Battery / Cognition and quality of life in patients with schizophrenia: usefullness of the MATRICS Consensus Cognitive Battery

El déficit cognitivo es un síntoma nuclear de la esquizofrenia. La iniciativa Measurement And Treatment Research to Improve Cognition in Schizophrenia (MATRICS) del National Institute of Mental Health (NIMH) de Estados Unidos se planteó como objetivo desarrollar una batería cognitiva de consenso para evaluar en un contexto clínico los diferentes dominios cognitivos afectados en estos pacientes. El resultado de ese trabajo fue el desarrollo de la MATRICS Consensus Cognitive Battery (MCCB). La estandarización y obtención de datos normativos en nuestro medio ha sido realizada recientemente. Los objetivos del presente trabajo fueron: a) estudiar el funcionamiento cognitivo medido con la MCCB en una muestra de pacientes con esquizofrenia y comparar los resultados con un grupo control, y b) estudiar la relación entre los diferentes dominios cognitivos y la calidad de vida en el grupo de pacientes con esquizofrenia. Se realizó el estudio con un grupo de 40 pacientes con diagnóstico de esquizofrenia según los criterios de la cuarta edición del Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), y un grupo control de 40 sujetos pareados por sexo y edad. Los resultados mostraron un déficit cognitivo de los pacientes con esquizofrenia en todos los dominios cognitivos evaluados por la MCCB, así como la utilidad de la MCCB en el estudio de la función cognitiva en nuestro medio. Además, se encontraron correlaciones significativas entre la calidad de vida y algunos dominios cognitivos: velocidad de proceso (0,398; p = 0,011), aprendizaje y memoria verbal (0,456; p = 0,003), y razonamiento y solución de problemas (0,496; p = 0,001) (AU)

Cognitive dysfunction is a nuclear symptom of schizophrenia. The Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative of the U.S. National Institute of Mental Health (NIMH) set as one of its objectives the development of a consensus cognitive battery for the clinical assessment of the different cognitive domains that are impaired in these patients. The result of this was the MATRICS Consensus Cognitive Battery (MCCB). The standardization and obtention of normative data of the battery in our milieu was recently carried out. The objectives of the present investigation were a) to study the cognitive performance of a sample of schizophrenic patients as assessed by the MCCB and to compare the results with a control group; b) to study the relationship between the different cognitive domains and quality of life in the sample of schizophrenic patients. The study was carried out with a group of 40 patients diagnosed with schizophrenia according to DSM-IV criteria, and a control group of 40 subjects who were matched by age and gender. Results show cognitive deficits in the patient group across all the cognitive domains assessed by the MCCB, as well as the usefulness of the MCCB in the study of cognitive function in our milieu. In addition, significant correlations were found between quality of life and some of the cognitive domains: speed of processing (0.398; p = 0.011), verbal learning and memory (0.456; p = 0.003), and reasoning and problem solving (0.496; p = 0.001) (AU)

Neurocognition, social cognition and functional outcome in schizophrenia

Background and Objectives: A relationship has been found between cognition and functioning in patients with schizophrenia. Our objective was to study the relationship between the cognitive domains assessed by the MATRICS Consensus Cognitive Battery (MCCB), and functioning as evaluated using the functioning subscale of the Global Assessment of Functioning scale (GAF-f). Methods: A sample of 83 clinically stable outpatients diagnosed with schizophrenia according to DSM-IV criteria were assessed using the MCCB and the GAF-f. Pearson correlations and stepwise linear regression analyses were performed. Results: Correlation analysis between the GAF-f and the cognitive domains of the MCCB showed a significant relationship between functioning and all of the cognitive domains. Regression yielded a statistically significant model (F2,74 = 20.4, p < 0.001) in which functioning was related to Speed of processing (standardized â = 0.369, p = 0.001) and to Social cognition (standardized â = 0.325, p = 0.003). Together, these two variables explained33.8% of the variance of functioning. Conclusions: Both speed of processing and social cognition have an important association with functioning in patients with schizophrenia (AU)