title: Facial expression in patients with bipolar disorder and schizophrenia in response to emotional stimuli: a partially shared cognitive and social deficit of the two disorders.
abstract: BACKGROUND
  It has recently been highlighted that patients affected by schizophrenia (SCZ) and those affected by bipolar disorder (BD) undergo gradual chronic worsening of cognitive and social functioning. The objective of the current study was to evaluate and compare (using the Facial Action Coding System [FACS]) the way by which patients with the two disorders experience and display emotions in relation to specific emotional stimuli.
  
  
  METHODS
  Forty-five individuals participated in the study: 15 SCZ patients, 15 BD patients, and 15 healthy controls. All participants watched emotion-eliciting video clips while their facial activity was videotaped. The congruent/incongruent feeling of emotions and the facial expression in reaction to emotions were evaluated.
  
  
  RESULTS
  SCZ and BD patients presented similar incongruent emotive feelings and facial expressions (significantly worse than healthy participants); SCZ patients expressed the emotion of disgust significantly less appropriately than BD patients.
  
  
  CONCLUSIONS
  BD and SCZ patients seem to present a similar relevant impairment in both experiencing and displaying emotions; this impairment may be seen as a behavioral indicator of the deficit of social cognition present in both the disorders. As the disgust emotion is mainly elaborated in the insular cortex, the incongruent expression of disgust of SCZ patients can be interpreted as a further evidence of a functional deficit of the insular cortex in this disease. Specific remediation training could be used to improve emotion and social cognition in SCZ and BD patients.
authors: Department of Medico-Surgical sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
authors: Giuseppe
authors: G
authors: Bersani
authors: Elisa
authors: E
authors: Polli
authors: Giuseppe
authors: G
authors: Valeriani
authors: Daiana
authors: D
authors: Zullo
authors: Claudia
authors: C
authors: Melcore
authors: Enrico
authors: E
authors: Capra
authors: Adele
authors: A
authors: Quartini
authors: Pietropaolo
authors: P
authors: Marino
authors: Amedeo
authors: A
authors: Minichino
authors: Laura
authors: L
authors: Bernabei
authors: Maddalena
authors: M
authors: Robiony
authors: Francesco Saverio
authors: FS
authors: Bersani
authors: Damien
authors: D
authors: Liberati
keywords: FACS; bipolar disorder; facial expression; schizophrenia; social cognition
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