Self-face recognition in schizophrenia.

Objective: Altered self-awareness might be a core feature of schizophrenia. Facial self-recognition in children and non-human primates has been linked to the emergence of self-awareness. In this study, the ability to recognize the own face as an indicator of certain aspects of self-awareness was investigated in patients with schizophrenia.

Methods: Standardized facial pictures of the participants (20 patients with DSM-IV schizophrenia and 20 healthy controls), of close same-sex relatives of the participants and of unknown persons were taken. These stimuli were presented on a computer screen serially in three forced choice identity recognition experiments: facial identities were presented (I) for 5 s centrally on the screen; (II) in the participants' left and right visual hemifields for 100 ms; (III) as morphed blendings between the identities, centrally for 5 s.

Results: There was no interaction between group and facial identity in experiments I and III. However, in experiment II an interaction between hemifield and identity emerged in the patients (p=.002). They exhibited higher error rates for their own face presented to the right hemifield (p=.003), whereas there was no effect for the control subjects. Additionally, self-face recognition (reaction time in experiment I; p=.0009 and error rates in II; p=.0006) was related to hallucinations in the patients.

Conclusions: These results support the notion of a specific self-face processing dysfunction in schizophrenia. This might be related to altered self-awareness in schizophrenia.