Female patients with schizophrenia are less impaired in social life than male patients. Because social impairment in schizophrenia has been found to be associated with deficits in emotion recognition, we examined whether the female advantage in processing emotional prosody and semantics is preserved in schizophrenia.

Forty-eight patients (25 males, 23 females) and 46 controls (23 males, 23 females) were assessed using an emotional language task (in which healthy women generally outperform healthy men), consisting of 96 sentences in four conditions: (1) neutral-content/emotional-tone (happy, sad, angry or anxious); (2) neutral-tone/emotional-content; (3) emotional-tone/incongruous emotional-content; and (4) emotional-content/incongruous emotional-tone. Participants had to ignore the emotional-content in the third condition and the emotional-tone in the fourth condition. In addition, participants were assessed with a visuospatial task (in which healthy men typically excel). Correlation coefficients were computed for associations between emotional language data, visuospatial data, IQ measures and patient variables.

Overall, on the emotional language task, patients made more errors than control subjects, and women outperformed men across diagnostic groups. Controlling for IQ revealed a significant effect on task performance in all groups, especially in the incongruent tasks. On the rotation task, healthy men outperformed healthy women, but male patients, female patients and female controls obtained similar scores.

The advantage in emotional prosodic and semantic processing in healthy women is preserved in schizophrenia, whereas the male advantage in visuospatial processing is lost. These findings may explain, in part, why social functioning is less compromised in women with schizophrenia than in men.