Emotion perception and psychosis risk in 22q11.2 deletion syndrome: Rethinking psychotic early markers in children

Although social cognition impairments are common in 22q11.2 deletion syndrome and are linked to psychosis risk, research on this association has yielded contradictory results. The present study aims to investigate emotion perception processes in 22q11.2 deletion syndrome as a function of the presence of psychotic symptoms in children under the age of 13. Forty-six children with 22q11.2 deletion syndrome and fifty-four healthy controls completed one task of facial expression recognition, one task of attribution of facial expressions to faceless characters involved in visually presented social interactions, and one task of attribution of facial expressions to characters involved in orally presented dialogues. Children with 22q11.2 deletion syndrome were subdivided in groups with or without psychotic symptoms based on a structured clinical interview. 22q11.2 deletion patients didn’t perform as well as controls on all three tasks, performing particularly poorly on the second and third tasks. This pattern of performance was independent of the presence of psychotic symptoms. The debate over the complex relationships between social cognition and psychosis remains open, but our data indicate that deficits in social cognition may not be a marker of early psychosis.