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Schizophrenia Patients Often Mistake Angry Expression for Fear

Schizophrenia Patients Often Mistake Angry Expression for FearPatients with schizophrenia have a hard time recognizing angry facial expressions, often mistaking them for fear, according to a new study.

The problem appears to be specific to emotion recognition, say the researchers, because schizophrenia patients performed as well as bipolar disorder patients and mentally healthy controls when asked to figure out the age of people with angry facial expressions.

The study included 27 patients with schizophrenia, 16 with bipolar I disorder, and 30 mentally healthy controls.

“A better understanding of facial emotional recognition deficits in the two severe mental disorders might assist with diagnostic clarification, as well as inform treatment development and selection,” according to the researchers, psychologists Drs. Vina Goghari of the University of Calgary and Scott Sponheim of the University of Minnesota.

During the study, schizophrenia patients correctly identified angry facial expressions just 60 percent of the time, most often mistaking these faces as frightened, followed by happy, sad, and then neutral.

Similarly, the patients with bipolar disorder tended to mistake anger as fear, significantly more so than the controls.

However, they were more accurate overall than schizophrenia patients, correctly labeling 75 percent of the angry faces, which was not very different from the controls, who got 78 percent correct.

“Greater facial emotion recognition deficits in schizophrenia patients compared to bipolar patients found in this study may be a reflection of greater degree of brain abnormalities in regions associated with facial emotion recognition, such as in the amygdala and hippocampus, in schizophrenia patients,” said the researchers.

While trying to identify the other facial expressions — fear, sad, happy, and neutral — both the schizophrenia and bipolar groups were as accurate as the controls. The three groups also had similar ability in identifying the age of the faces.

The only other difference found was that bipolar disorder patients took much longer to figure out emotional expressions than they did to determine age.  Schizophrenia patients and controls took a similar length of time to complete both tasks.

“This finding may have clinical implications for treatment development in schizophrenia as it suggests that schizophrenia patients may have a different strategy when viewing faces compared to bipolar patients, which may result in lower accuracy,” said the researchers.

Source:  Comprehensive Psychiatry

Man with angry expression photo by shutterstock.

Schizophrenia Patients Often Mistake Angry Expression for Fear

Traci Pedersen

Traci Pedersen is a professional writer with over a decade of experience. Her work consists of writing for both print and online publishers in a variety of genres including science chapter books, college and career articles, and elementary school curriculum.

APA Reference
Pedersen, T. (2018). Schizophrenia Patients Often Mistake Angry Expression for Fear. Psych Central. Retrieved on September 26, 2020, from
Scientifically Reviewed
Last updated: 8 Aug 2018 (Originally: 27 Apr 2013)
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
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