Abstract

BackgroundNonverbal social perception is the ability to interpret the intentions and dispositions of others by evaluating cues such as facial expressions, body movements, and emotional prosody. Nonverbal social perception plays a key role in social cognition and is fundamental for successful social interactions. Patients with schizophrenia have severe impairments in nonverbal social perception leading to social isolation and withdrawal. Collectively, these aforementioned deficits affect patients’ quality of life. Here, we compare nonverbal social perception in patients with schizophrenia and controls and examine how nonverbal social perception relates to daily functioning.MethodsWe compared nonverbal social perception in 41 stable outpatients with schizophrenia and 30 healthy controls using the Mini Profile of Nonverbal Sensitivity (Mini-PONS). The participants evaluated 64 video clips showing a female actor demonstrating various nonverbal social cues. Participants were asked to choose one of two options that best described the observed scenario. We correlated clinical ratings (Positive and Negative Syndrome Scale, Brief Negative Syndrome Scale), Self-report of Negative Symptoms, and functional assessments (functional capacity and functional outcome) with Mini-PONS scores.ResultsPatients performed significantly poorer in the Mini-PONS compared to controls, suggesting deficits in nonverbal social perception. These deficits were not associated with either positive symptoms or negative symptoms (including self-report). However, impaired nonverbal social perception correlated with distinctive domains of BNSS (mainly avolition and blunted affect), as well as functional capacity and functional outcome in patients.ConclusionWe demonstrate that nonverbal social perception is impaired in stable outpatients with schizophrenia. Nonverbal social perception is directly related to specific negative symptom domains, functional capacity and functional outcome. These findings underline the importance of nonverbal social perception for patients’ everyday life and call for novel therapeutic approaches to alleviate nonverbal social perception deficits.

Highlights

  • Schizophrenia is a severe and debilitating psychiatric disorder that affects nearly 1% of the world’s population (McGrath et al, 2008)

  • While earlier studies reported poor nonverbal social perception to be correlated with low functional outcomes in schizophrenia patients (Green and Horan, 2010; Walther et al, 2016; Pinkham et al, 2017), the present study extends these findings by exploring the correlations in distinct functional domains and functional capacity

  • Schizophrenia outpatients exhibit nonverbal social perception deficits, which are linked to their ability to function in everyday life

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Summary

Introduction

Schizophrenia is a severe and debilitating psychiatric disorder that affects nearly 1% of the world’s population (McGrath et al, 2008). Impaired social cognition is prevalent in chronic schizophrenia patients, and in early-onset psychosis and early psychosis patients (FornellsAmbrojo and Garety, 2009; Barkl et al, 2014; Giannitelli et al, 2015; Healey et al, 2016) These deficits occur across different stages of the disorder. Social cognition acts as a mediator between neurocognition and functional outcome (Vauth et al, 2004; Brekke et al, 2005; Couture et al, 2006; Sparks et al, 2010; Mancuso et al, 2011; Galderisi et al, 2020) These impairments play a key role in the development of the disorder, and in the functional outcome of patients. Patients with schizophrenia have severe impairments in nonverbal social perception leading to social isolation and withdrawal These aforementioned deficits affect patients’ quality of life. We compare nonverbal social perception in patients with schizophrenia and controls and examine how nonverbal social perception relates to daily functioning

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