JMIR Publications

ABSTRACT

Background:

It is well established that individuals with schizophrenia experience deficits in emotional perception that can impact long-term social and occupational functioning. Understanding the factors that impact these impairments is important for targeting interventions to improve recovery. In the general population, compared to males, females tend to show greater perception of emotions, but whether this sex difference persists in schizophrenia is less clear. In contrast to males, females diagnosed with schizophrenia tend to have a higher age of disease onset and better premorbid functioning. Still, despite this, they don’t necessarily have better outcomes. Effective treatments for social cognitive impairments are highly relevant to long-term functional rehabilitation. Therefore, a greater understanding of the cognitive deficits in emotional perception within females and males living with schizophrenia may assist interventions to be better tailored to individuals.

Objective:

This systematic review aims to collate, synthesise, and critically appraise evidence considering the influence of biological sex (female and male) on the emotional perception of individuals with schizophrenia.

Methods:

This is a systematic review protocol based on the PRISMA-P guidelines. The electronic databases Medline, EMBASE, CENTRAL, CINAHL, and PsycINFO will be systematically searched, and the reference lists of included studies will be manually screened. To be included in this review, studies must compare the emotional perceptions of male and, or female participants aged over 18 years who have a primary diagnosis of a schizophrenia spectrum disorder (SSD). Qualitative studies, case reports, case series, unpublished manuscripts, and studies not reported in English will be excluded. Key search strategies will include combinations of the following terms: “men”, “male”, “man”, “female”, “women”, “woman”, “emotional perception”, “emotional processing”, “schizophrenia”, “schizophren” “psychotic disorders” “psychosis” “psychoses” “psychotic” “schizoaffective” “schizotypal personality disorder” “schizotyp”. Identified studies will be uploaded to the online Covidence systematic review management software, and titles and abstracts will be screened by at least two independent reviewers against the study inclusion and exclusion criteria. At least three independent researchers will review full-text versions of studies that meet the selection criteria, and data will be extracted from eligible studies. The risk of bias for individual studies will be assessed using the relevant Joanna Briggs Institute (JBI) checklist tools. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system will also be used to evaluate the strength of the evidence base. Findings will be synthesised to provide a systematic summary of the existing literature. If sufficiently comparable data to permit meta-analysis emerges, a random-effects meta-analysis will be performed.

Results:

This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) in October 2023. The search and screening of study titles and abstracts is currently underway. Data is expected to be extracted and analysed in July 2024.

Conclusions:

Results will contribute to an improved understanding of the social cognitive profiles of males and females with schizophrenia. This knowledge is expected to inform the adaptation of interventions to improve functional outcomes. Clinical Trial: PROSPERO 2023 CRD42023463561. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023463561.