Through the lens of schizophrenia: Recognizing negative facial expressions and family patterns

Schizophrenia is a complex disorder with symptoms such as hallucinations, delusions, and impaired social interactions, and deficits in facial emotion recognition are a key area of impairment. Studies indicate that recognizing facial emotions is essential for social interaction, and individuals with schizophrenia show significant difficulties, especially in recognizing negative emotions. Previous research has primarily focused on patients, with less attention on their first-degree relatives. This study investigates the ability to recognize negative facial expressions in paranoid and non-paranoid schizophrenia patients, their siblings, and matched healthy controls. This cross-sectional study included 60 paranoid schizophrenia patients, 60 non-paranoid schizophrenia patients, 59 siblings of paranoid patients, 60 siblings of non-paranoid patients, and 30 healthy controls, recruited from outpatients at Razi Hospital in Tabriz, Iran. The mean age was 35.7 years, and 54 % of participants were female. The Ekman 60 Faces Test assessed the recognition of basic facial emotions, focusing on negative emotions. The results revealed that paranoid schizophrenia patients showed significantly lower performance in recognizing negative facial emotions (mean score: 15.7) compared to non-paranoid patients (16.4) and siblings (28.1 for paranoid siblings, 27.4 for non-paranoid siblings). In contrast, healthy controls scored highest (29.0). This study highlights the deficits in emotion recognition in schizophrenia and their potential genetic underpinnings within family lines, contributing to understanding social cognition deficits related to the disorder.