title: Emotion recognition deficits in schizophrenia-spectrum disorders and psychotic bipolar disorder: Findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study.
abstract: BACKGROUND
  Difficulty recognizing facial emotions is an important social-cognitive deficit associated with psychotic disorders. It also may reflect a familial risk for psychosis in schizophrenia-spectrum disorders and bipolar disorder.
  
  
  OBJECTIVE
  The objectives of this study from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium were to: 1) compare emotion recognition deficits in schizophrenia, schizoaffective disorder and bipolar disorder with psychosis, 2) determine the familiality of emotion recognition deficits across these disorders, and 3) evaluate emotion recognition deficits in nonpsychotic relatives with and without elevated Cluster A and Cluster B personality disorder traits.
  
  
  METHODS
  Participants included probands with schizophrenia (n=297), schizoaffective disorder (depressed type, n=61; bipolar type, n=69), bipolar disorder with psychosis (n=248), their first-degree relatives (n=332, n=69, n=154, and n=286, respectively) and healthy controls (n=380). All participants completed the Penn Emotion Recognition Test, a standardized measure of facial emotion recognition assessing four basic emotions (happiness, sadness, anger and fear) and neutral expressions (no emotion).
  
  
  RESULTS
  Compared to controls, emotion recognition deficits among probands increased progressively from bipolar disorder to schizoaffective disorder to schizophrenia. Proband and relative groups showed similar deficits perceiving angry and neutral faces, whereas deficits on fearful, happy and sad faces were primarily isolated to schizophrenia probands. Even non-psychotic relatives without elevated Cluster A or Cluster B personality disorder traits showed deficits on neutral and angry faces. Emotion recognition ability was moderately familial only in schizophrenia families.
  
  
  CONCLUSIONS
  Emotion recognition deficits are prominent but somewhat different across psychotic disorders. These deficits are reflected to a lesser extent in relatives, particularly on angry and neutral faces. Deficits were evident in non-psychotic relatives even without elevated personality disorder traits. Deficits in facial emotion recognition may reflect an important social-cognitive deficit in patients with psychotic disorders.
authors: Department of Psychiatry, University of Illinois at Chicago, Chicago, USA. Electronic address: anthony.ruocco@gmail.com.
authors: Anthony C
authors: AC
authors: Ruocco
authors: Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, USA.
authors: James L
authors: JL
authors: Reilly
authors: Department of Psychiatry, University of Illinois at Chicago, Chicago, USA.
authors: Leah H
authors: LH
authors: Rubin
authors: Department of Psychology, University of Toronto Scarborough, Toronto, Canada.
authors: Alex R
authors: AR
authors: Daros
authors: Department of Psychiatry, University of Chicago, Chicago, USA.
authors: Elliot S
authors: ES
authors: Gershon
authors: Department of Psychiatry, University of TX Southwestern Medical Center, Dallas, USA.
authors: Carol A
authors: CA
authors: Tamminga
authors: Department of Psychiatry, Yale University, New Haven, CT, USA.
authors: Godfrey D
authors: GD
authors: Pearlson
authors: Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, USA.
authors: S Kristian
authors: SK
authors: Hill
authors: Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, USA.
authors: Matcheri S
authors: MS
authors: Keshavan
authors: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.
authors: Ruben C
authors: RC
authors: Gur
authors: Departments of Psychiatry and Pediatrics, University of Texas Southwestern Medical Center, Dallas, USA.
authors: John A
authors: JA
authors: Sweeney
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000523:psychology*; D004644:Emotions; D005149:Facial Expression; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010364:Pattern Recognition, Visual; D010641:Phenotype; D010775:Photic Stimulation; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D011618:Psychotic Disorders / Q000523:psychology*; D021641:Recognition, Psychology; D012565:Schizophrenic Psychology; D012938:Social Perception; D055815:Young Adult
keywords: Bipolar disorder; Emotion recognition; Family study; Psychosis; Schizoaffective disorder; Schizophrenia