Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Jun 22, 2016; 6(2): 257-268
Published online Jun 22, 2016. doi: 10.5498/wjp.v6.i2.257
Facial emotion perception in schizophrenia: Does sex matter?
Jasmine Mote, Ann M Kring
Jasmine Mote, Ann M Kring, Department of Psychology, University of California, Berkeley, CA 94720, United States
Author contributions: All authors contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Data sharing statement: As this was a systematic review of published data there were no participants to be approached for informed consent for data sharing. No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jasmine Mote, MA, Department of Psychology, University of California, 3210 Tolman Hall #1650, Berkeley, CA 94720, United States. mote@berkeley.edu
Telephone: +1-510-6434098 Fax: +1-510-6425293
Received: August 12, 2015
Peer-review started: August 12, 2015
First decision: October 27, 2015
Revised: March 6, 2016
Accepted: April 7, 2016
Article in press: April 11, 2016
Published online: June 22, 2016
Abstract

AIM: To review the literature on sex differences in facial emotion perception (FEP) across the schizophrenia spectrum.

METHODS: We conducted a systematic review of empirical articles that were included in five separate meta-analyses of FEP across the schizophrenia spectrum, including meta-analyses that predominantly examined adults with chronic schizophrenia, people with early (onset prior to age 18) or recent-onset (experiencing their first or second psychotic episode or illness duration less than 2 years) schizophrenia, and unaffected first-degree relatives of people with schizophrenia. We also examined articles written in English (from November 2011 through June 2015) that were not included in the aforementioned meta-analyses through a literature search in the PubMed database. All relevant articles were accessed in full text. We examined all studies to determine the sample sizes, diagnostic characteristics, demographic information, methodologies, results, and whether each individual study reported on sex differences. The results from the meta-analyses themselves as well as the individual studies are reported in tables and text.

RESULTS: We retrieved 134 articles included in five separate meta-analyses and the PubMed database that examined FEP across the schizophrenia spectrum. Of these articles, 38 examined sex differences in FEP. Thirty of these studies did not find sex differences in FEP in either chronically ill adults with schizophrenia, early-onset or recently diagnosed people with schizophrenia, or first-degree relatives of people with schizophrenia. Of the eight studies that found sex differences in FEP, three found that chronically ill women outperformed men, one study found that girls with early-onset schizophrenia outperformed boys, and two studies found that women (including first-degree relatives, adults with schizophrenia, and the healthy control group) outperformed men on FEP tasks. In total, six of the eight studies that examined sex differences in FEP found that women outperformed men across the schizophrenia spectrum.

CONCLUSION: Evidence to date suggests few sex differences in FEP in schizophrenia; both men and women across the schizophrenia spectrum have deficits in FEP.

Keywords: Clinical high risk, Emotion, Facial emotion perception, Gender, Recent-onset schizophrenia, Schizophrenia, Sex differences

Core tip: People with schizophrenia exhibit deficits in facial emotion perception (FEP) compared to healthy controls. These deficits are associated with poorer functioning and more severe symptoms. Although the literature to date suggests that there are few sex differences in FEP in schizophrenia, continued assessment of sex differences in FEP can help researchers and clinicians better understand other sex differences in the disorder and assist in treatment development aimed at improving functioning in people with schizophrenia. This review summarizes and critically evaluates the literature on FEP across the schizophrenia spectrum, focusing on the evidence related to sex differences in FEP.