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06-04-2010 | Mental health | Article

Affect recognition impacts on overall function in schizophrenia

Abstract

Free abstract

MedWire News: A subgroup of patients with schizophrenia and relatively preserved affect recognition (AR) show better functional outcomes than their peers with defective AR, study results show.

Contrary to some previous findings, however, AR performance in schizophrenia was directly related to generalized neurocognitive impairments rather than being a distinct domain.

Affect recognition describes the ability to correctly interpret emotional cues in others, explain study authors Joanna Fiszdon and Jason Johannesen from Yale University School of Medicine in New Haven, Connecticut, USA, in the journal Psychiatry Research.

Relative to healthy comparison groups, patients with schizophrenia show impairments in AR, which are detectable before the onset of psychotic symptoms.

“There are many reasons to suggest that AR deficits could have profound impact on real-world functional outcomes in schizophrenia,” the researchers remark.

In addition, it is unclear whether impaired AR performance reflects a specific deficit in the processing of motive cues or, instead, a manifestation of more generalized neurocognitive impairments in schizophrenia.

To investigate the researchers recruited 48 schizophrenia outpatients and 56 mentally healthy controls.

Initial assessment of AR using the Bell-Lysaker Emotion Recognition Task (BLERT) scale confirmed that overall performance in the patient sample was significantly lower than in the controls, at 13.44 versus 17.32 of a maximum possible score of 21.

However, 17 (35%) schizophrenia patients had a BLERT score of 16 or above – generally considered to be in the lower end of the normal range – with the rest showing unequivocal deficits.

The two schizophrenia subgroups were then compared on measures of functioning including the University of California San Diego Performance-Based Skill Assessment (UPSA), Social Skills Performance Assessment (SSPA), Medication Management Ability Assessment (MMAA), and Quality of Life Scale (QLS), as well as a battery of neurocognitive tests.

The researchers found the near-normal schizophrenia group performed significantly better on the MMAA and QLS than the AR-deficient group.

Covariate analyses indicated that group differences in neurocognition fully mediated the observed associations between AR and MMAA, and attenuated the observed relationships between AR classification and QLS.

“Future studies can more closely examine the functional relevance of intact affect recognition in relation to other important outcomes, such as symptomatology, course, or response to rehabilitation,” the researchers conclude.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Andrew Czyzewski

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