Deficits in Early Stages of Face Processing in Schizophrenia: A Systematic Review of the P100 Component

Schizophrenia is associated with deficits in face and affect recognition, which contribute to broader social functioning deficits. The present aim was to conduct a meta-analysis of early face processing in schizophrenia, as indexed by the P100 event-related potential component.Twelve studies (n = 328 patients with schizophrenia, n = 330 healthy controls) of the P100 component during face processing were evaluated by calculating Cohen's d for each study and overall weighted mean effect size (ES). In additional exploratory analyses, moderating influences of method and design were investigated, and the P100 component during face processing was evaluated based on valence: 5 studies (n = 225 patients, n = 225 controls) included neutral stimuli, 5 studies (n = 225 patients, n = 225 controls) included happy stimuli, and 4 studies (n = 209 patients, n = 209 controls) included fearful stimuli.The amplitude of the P100 to face stimuli was smaller in patients relative to controls (ES = .41, P < .01). Methodological or design differences did not account for heterogeneity in ES. When split by valence, results indicate smaller P100 in patients relative to control subjects in response to neutral (ES = .32, P < .001) and happy (ES = .21, P < .05) stimuli, whereas there was no difference in response to fearful faces (ES = .09, P > .05).The results indicate that P100 amplitude in response to faces is smaller in patients with schizophrenia, showing that socially relevant visual processing deficits begin earlier in processing than previously suggested. Additionally, the exploratory analyses suggest emotional specificity in these deficits. Ramifications for our understanding of face processing deficits and treatment development are discussed.