Patients with schizophrenia show impairments in social cognitive abilities, such as recognizing facial emotions. However, the relationships between specific deficits of emotion recognition and with clusters of psychotic remain unclear.

To explore whether facial emotion recognition was associated with severity of symptoms and to which presentation of psychotic symptoms.

Facial emotion recognition (FER) were evaluated in 58 patients with stable schizophrenia with a newly validated FER task constructed from photographs of the face of a famous Tunisian actress representing the Ekman's six basic emotions (happiness, anger, disgust, sadness, fear, and surprise). Symptomatology evaluation comprised the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Clinical Global Impressions Scale Improvement and severity (CGI).

Patients who failed to identify anger had significantly higher scores in hyperactivity item (P < 0.0001). The patients who had a difficulty to identify sadness had more grandiosity (P ≤ 0.002). The impairment in happiness recognition was correlated with hallucination (P = 0.007) and delusion (P = 0.024) items. Incapacity to identify fear was associated to lack of judgment and insight (P = 0.004).

Deficits in recognition of specific facial emotions may reflect severity of psychiatric symptoms. They may be related to specific clusters of psychotic symptoms, which need to be confirmed in further studies.

The authors have not supplied their declaration of competing interest.