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Annals of General Psychiatry

Open Access

Áffect perception in everyday scenarios in schizophrenia: impairment in negative valence

  • M Kosmidis1, 2,
  • V Bozikas2,
  • M Giannakou1,
  • D Anezoulaki1,
  • P Petrikis2,
  • B Fantie3 and
  • A Karavatos2
Annals of General Hospital Psychiatry20032(Suppl 1):S129

Received: 1 November 2003

Published: 23 December 2003


Public HealthSchizophreniaCognitive ImpairmentSocial ContextLower Score


Studies of schizophrenia, in parallel to the converging evidence for cognitive impairments, have also suggested that patients may have difficulties in perceiving others' emotions, which may contribute to poor social functioning. The purpose of this study was to investigate whether a group of patients with schizophrenia presented impairment in affect recognition within social context. Furthermore, we wanted to explore whether the schizophrenic patients deficits in emotion perception depends on the valence of the emotion – positive or negative – that needs to be recognized.

Material and Methods

Participants were 35 patients with schizophrenia (DSM-IV): 21 men and 14 women and 32 healthy controls: 23 men and 9 women. The two groups were matched on age, education, and gender. All patients were receiving antipsychotic drugs at the time of the testing. We administered Fantie's Cartoon Test (FCT), which is a computerized test that comprises 57 drawings; each one depicts an everyday scenario with one or more people, and in each item the face of one person is missing. On each item, there is a series of seven photographs depicting the basic emotions (happiness, sadness, surprise, fear, anger, disgust, as well as neutral) expression. The participants were asked to indicate the photograph depicting the emotional expression which best fit the missing face.


Patients with schizophrenia had significantly lower scores on the FCT than healthy controls [F(1.65) = 5.81, p = 0.019]. Patients performed worse in sadness [F(1.65) = 5.66, p = 0.02] and anger [F(1.65) = 7.16, p = 0.009] but they were equally accurate with the controls in surprise [F(1.65) = 1.064, p = 0.306], happiness [F(1.65) = 0.455, p = 0.502], fear [F(1.65) = 2.50, p = 0.119] and disgust [F(1.65) = 2.41, p = 0.125]. The rank order of the six emotions from highest to lowest mean scores was for the healthy participants: happiness, anger, disgust, fear, sadness and surprise, and for the patients: happiness, disgust, fear, anger, sadness and surprise.


Patients with schizophrenia presented deficits in emotion perception in the presence of static everyday cues, which were attributable to impairment in recognition of anger and sadness. These results are in agreement with the negative valence hypotheses in schizophrenia.

Authors’ Affiliations

Department of Psychology, Aristotle University of Thessaloniki, Greece
1stDepartment of Psychiatry, Aristotle University of Thessaloniki, Greece
Department of Psychology, American University, Washington, USA


© The Author(s) 2003