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Facial expressivity in the course of schizophrenia and depression

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Abstract.

This study investigates the nosological specificity and time stability of reduced facial expressivity in schizophrenia by means of objective measurement. Facial expression in an emotional interview was evaluated using the „Facial Action Coding System“ in 33 acute schizophrenia patients and 23 acute depressive patients in comparison with 21 nonpatient controls, each assessed twice within 4 weeks, and in 36 partly remitted schizophrenia patients assessed twice within 3 months.

Acute schizophrenia patients showed reduced facial activity especially in the upper face and in facial activity often used as communicative signs or as signs of positive emotions. As depressive patients showed a comparable pattern of facial activity, nosological specificity is questionable. This pattern remained stable in the acute illness course and was almost identical in remitted schizophrenia patients, indicating a marked time stability of attenuated facial expressivity in schizophrenia and—for the acute phase assessed—in depression.

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References

  1. Alpert M, Rush M (1983) Comparison of affects in parkinson’s disease and schizophrenia. Psychopharmacol Bull 19:118–120

    Google Scholar 

  2. American Psychiatric Association (1994) Schizophrenia and other psychotic disorders. In: American Psychiatric Association (ed) Diagnostic and Statistical Manual of Mental Disorders (Fourth edition), DSM-IV. Washington DC, pp 273–315

  3. Andreasen NC (1982) Negative symptoms in schizophrenia. Definition and reliability. Arch Gen Psychiatry 39:784–788

    CAS  PubMed  Google Scholar 

  4. Andreasen NC (1989) The scale for the assessment of negative symptoms (SANS): Conceptual and theoretical foundations. Br J Psychiatry 155 (Suppl):S49–S52

    Google Scholar 

  5. Bartlett MS, Hager JC, Ekman P, Sejnowski TJ (1999) Measuring facial expressions by computer image analysis. Psychophysiology 36:253–263

    Article  CAS  PubMed  Google Scholar 

  6. Berenbaum H (1992) Posed facial expressions of emotion in schizophrenia and depression. Psychol Med 22:929–937

    CAS  PubMed  Google Scholar 

  7. Berenbaum H, Oltmanns TF (1992) Emotional Experience and Expression in Schizophrenia and Depression. J Abnorm Psychol 101:37–44

    Article  CAS  PubMed  Google Scholar 

  8. Borod JC (1989) A preliminary comparison of flat affect schizophrenics and brain- damaged patients on measures of affective processing. J Commun Disord 22:93–104

    Article  CAS  PubMed  Google Scholar 

  9. Cohn JF, Zlochower AJ, Lien J, Kanade T (1999) Automated face analysis by feature point tracking has high concurrent validity with manual FACS coding. Psychophysiology 36:35–43

    Article  CAS  PubMed  Google Scholar 

  10. Crow TJ (1985) The two-syndrome concept: origins and current status. Schizophr Bull 11:471–486

    CAS  PubMed  Google Scholar 

  11. Dworkin RH, Clark SC, Amador XF, Gorman JM (1996) Does affective blunting in schizophrenia reflect affective deficit or neuromotor dysfunction? Schizophr Res 20:301–306

    Article  CAS  PubMed  Google Scholar 

  12. Earnst KS, Kring AM (1999) Emotional responding in deficit and non-deficit schizophrenia. Psychiatry Res 88(3):192–207

    Article  Google Scholar 

  13. Earnst KS, Kring AM, Kadar MA, Salem JE, Shepard DA, Loosen PT (1996) Facial expression in schizophrenia. Biol Psychiatry 40(6):556–558

    Article  CAS  PubMed  Google Scholar 

  14. Ekman P (1979) About brows: Emotional and conversational signals. In: Cranach von M (ed) Human Ethology: Claims and limits of a new discipline. Cambridge University Press

  15. Ekman P, Friesen WV (1978) Facial action coding system. Consulting Psychologist Press, Palo Alto, C. A.

  16. Ellgring H (1989) Facial Expression as a Behavioral Indicator of Emotional States. Pharmacopsychiatry 22(Suppl):S23–S28

    Google Scholar 

  17. Ellgring H, Gaebel W (1994) Facial expression in schizophrenic patients. In: Beigel A, Lopez Ibor JJ, Costa e Silva JA (eds) Past present and future of psychiatry, Singapore: Worlds Scientific, pp 435–439

  18. Friesen WV, Ekman P (1984) EMFACS. Human Interactions Laboratory, San Francisco

  19. Gaebel W, Ellgring H, Wölwer W (1994) Behavioral assessment in psychiatry: concepts, measurement, and meaning. In: Beigel A, Lopez Ibor JJ, Costa e Silva JA (eds) Past, present and future of psychiatry, Singapore: Worlds Scientific, pp 201–203

  20. Gaebel W, Wölwer W (1992) Facial expression and emotional face recognition in schizophrenia and depression. Eur Arch Psychiatry Clin Neurosci 242:46–52

    CAS  PubMed  Google Scholar 

  21. Grimes K, Walker EF (1994) Childhood emotional expressions, educational attainment, and age at onset of illness in schizophrenia. J Abnorm Psychol 103(4):784–790

    Article  CAS  PubMed  Google Scholar 

  22. Hamilton M (1967) A rating scale for primary depressive illness. Br J Soc Clin Psychol 6:278–296

    CAS  PubMed  Google Scholar 

  23. Iwase M, Yamashita K, Takahashi K, Kajimoto O, Shimizu A, Nishikawa T, Shinosaki K, Sugita Y, Takeda M (1999) Diminished facial expression despite the existence of pleasant emotional experience in schizophrenia. Methods Find Exp Clin Pharmacol 21:189–194

    CAS  PubMed  Google Scholar 

  24. Jones IH, Pansa M (1979) Some nonverbal aspects of depression and schizophrenia occuring during the interview. J Nerv Ment Dis 167:402–409

    CAS  PubMed  Google Scholar 

  25. Krause R, Steimer E, Sänger-Alt C,Wagner G (1989) Facial expression of schizophrenic patients and their interaction partners. Psychiatry 52:1–11

    CAS  PubMed  Google Scholar 

  26. Kring AM, Kerr SL, Earnst KS (1999) Schizophrenic patients show facial reactions to emotional facial expressions. Psychophysiology 36:186–192

    Article  CAS  PubMed  Google Scholar 

  27. Kring AM, Kerr SL, Smith DA, Neale JM (1993) Flat affect in schizophrenia does not reflect diminished subjective experience of emotion. J Abnorm Psychol 102(4):507–517

    Article  CAS  PubMed  Google Scholar 

  28. Kring AM, Neale JM (1996) Do schizophrenic patients show a disjunctive relationship among expressive, experiential, and psychophysiological components of emotion? J Abnorm Psychol 105:249–257

    Article  CAS  PubMed  Google Scholar 

  29. Mattes RM, Schneider F, Heimann H, Birbaumer N (1995) Reduced emotional response of schizophrenic patients in remission during social interaction. Schizophr Res 17:249–255

    Article  CAS  PubMed  Google Scholar 

  30. Overall JE, Gorham DR (1962) The brief psychiatric rating scale. Psychol Rep 10:799–812

    Google Scholar 

  31. Peralta V, Cuesta MJ (1998) Subjective experiences in psychotic disorders: diagnostic value and clinical correlates. Compr Psychiatry 39:11–15

    Article  CAS  PubMed  Google Scholar 

  32. Rinn WE (1984) The neuropsychology of facial expression: a review of the neurological and psychological mechanisms for producing facial expressions. Psychol Bull 95:52–77

    Article  CAS  PubMed  Google Scholar 

  33. Schneider F, Ellgring H, Friedrich J, Fus I, Beyer T, Heimann H, Himer W (1992) The effects of neuroleptics on facial action in schizophrenic patients. Pharmacopsychiatry 25:233–239

    CAS  PubMed  Google Scholar 

  34. Schneider F, Heimann H, Himer W, Huss D, Mattes R, Adam B (1990) Computer-based analysis of facial action in schizophrenic and depressed patients. Eur Arch Psychiatry Clin Neurosci 240:67–76

    CAS  PubMed  Google Scholar 

  35. Simpson GM, Angus CHB, Angus JWS (1970) A rating scale for extrapyramidale side effects. Acta psychiatr Scand 212:11–19

    CAS  Google Scholar 

  36. Spitzer RL, Endicott J, Robins E (1978) Research diagnostic criteria. Rationale and reliability. Arch Gen Psychiatry 35:773–782

    CAS  PubMed  Google Scholar 

  37. Steimer-Krause E, Krause R, Wagner G (1990) Prozesse der Interaktionsregulierung bei schizophrenen und psychosomatisch erkrankten Patienten—Studien zum mimischen Verhalten in dyadischen Interaktionen. Z Klin Psychol 19:32–49

    Google Scholar 

  38. Steimer E, Krause R, Sänger-Alt C, Wagner G (1988) Mimisches Verhalten schizophrener Patienten und ihrer Gesprächspartner. Z Klin Psychol 17:132–147

    Google Scholar 

  39. Walker EF, Grimes KE, Davis DM, Smith AJ (1993) Childhood precursors of schizophrenia: facial expressions of emotion. A J Psychiatry 150:1654–1660

    CAS  Google Scholar 

  40. Whittaker JF, Connell J, Deakin JF (1994) Receptive and expressive social communication in schizophrenia. Psychopathology 27:262–267

    CAS  PubMed  Google Scholar 

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Correspondence to Wolfgang Gaebel.

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Gaebel, W., Wölwer, W. Facial expressivity in the course of schizophrenia and depression. European Archives of Psychiatry and Clinical Neurosciences 254, 335–342 (2004). https://doi.org/10.1007/s00406-004-0510-5

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  • DOI: https://doi.org/10.1007/s00406-004-0510-5

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