Comparison of cognitive function, face recognition skills, thought and language function in schizophrenia patients, their healthy siblings and healthy controls

Introduction and Aim: Schizophrenia is a chronic mental disorder characterized by destructive outcomes; positive symptoms such as delusions and hallucinations, negative symptoms such as avolution and disabiliy of social communication and cognitive symptoms like impairment of executive functioning. Facial and emotion recognition functions are shown to be related to phenomenological appearances of schizophrenia. However, it is not clear whether this deterioration is only in patients or also in healthy relatives whom the disorder haven't emerged. Many studies point that executive functions correlate with findings in schizophrenia. It is not clear how the discrimination of face's structural features and recognition of emotion would change in patients with schizophrenia, healthy siblings and healthy controls after controlling the executive functions. In this study, we tried to find the difference of facial and emotional recognition between schizophrenia patients, healthy siblings of schizophrenic patients and healthy controls and to determine whether the severity of the difference is a state or trait marker and to analyze if facial and emotion recognition are related with clinical factors, executive functions, magical ideation scale and thought and language index; and finally to find out the predictors of the impairment in emotion recognition. Material and Methods: 33 schizophrenia patients, 33 healthy siblings of schizophrenia patients and 30 healthy subjects matched in terms of age, gender and educational status were compared for facial and emotional recognition skills. Benton Face Recognition Test was used for facial recognition and Ekman emotional recognition battery was used for emotion recognition. Wisconsin Card Sorting Test (WCST) and Stroop Test were used for executive functions, the Global Assessment Scale was used for Functionality (GAS), Thought and Language İndex was used for evaluating structural thought disorder in all three groups; Positive and Negative Symptom Assessment Scale (PANSS) was used for clinical appearance in schizophrenia gruoup and Magical Thought Scale was used in healthy siblings and control groups to determine similar symptoms of psychosis that could be found in the society, which is not enough to make a clinical diagnosis. Findings and Results: Schizophrenia patients, healthy siblings of the schizophrenia patients and healthy control group differed from each other in terms of discrimination of identity and faces measured by Benton and the recognition of emotion measured by Ekman battery. Ekman battery turned out to be a trait marker whereas Benton facial recognition test turned out to be a state marker. Deficits in executive functions were found to be closely related to functionality and negative symptoms. It was found that TLI had better discriminatory characteristics than the Magical Thought Scale in defining the psycho-similar identities within the community. The prediction of the deficit in recognizing angry feelings (which is thought to be related to the formation of hallucinations and delusions) by TLI total score, TLI subscale scores, attention and positive psychotic symptoms suggest that dimensional approach has a central projection. According to the results of this study, use of Ekman battery for emotional recognition and TLI in screening studies of risky individuals like healthy siblings, who have not developed psychosis, may provide additional contribution in terms of early diagnosis of psychosis.