Eye Movement Patterns Can Distinguish Schizophrenia From the Major Affective Disorders and Healthy Control Subjects

David St Clair* (Corresponding Author), Graeme MacLennan, Sara A Beedie, Eva Nouzová, Helen Lemmon, Dan Rujescu, Philip J Benson, Andrew McIntosh, Mintu Nath

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


No objective tests are currently available to help diagnosis of major psychiatric disorders. This study evaluates the potential of eye movement behavior patterns to predict schizophrenia subjects compared to those with major affective disorders and control groups.Eye movements were recorded from a training set of UK subjects with schizophrenia (SCZ; n = 120), bipolar affective disorder (BPAD; n = 141), major depressive disorder (MDD; n = 136), and healthy controls (CON; n = 142), and from a hold-out set of 133 individuals with proportional group sizes. A German cohort of SCZ (n = 60) and a Scottish cohort of CON subjects (n = 184) acted as a second semi-independent test set. All patients met DSMIV and ICD10 criteria for SCZ, BPAD, and MDD. Data from 98 eye movement features were extracted. We employed a gradient boosted (GB) decision tree multiclass classifier to develop a predictive model. We calculated the area under the curve (AUC) as the primary performance metric.Estimates of AUC in one-versus-all comparisons were: SCZ (0.85), BPAD (0.78), MDD (0.76), and CON (0.85). Estimates on part-external validation were SCZ (0.89) and CON (0.65). In all cases, there was good specificity but only moderate sensitivity. The best individual discriminators included free viewing, fixation duration, and smooth pursuit tasks. The findings appear robust to potential confounders such as age, sex, medication, or mental state at the time of testing.Eye movement patterns can discriminate schizophrenia from major mood disorders and control subjects with around 80\% predictive accuracy.
Original languageEnglish
Article numbersgac032
Number of pages10
JournalSchizophrenia Bulletin Open
Issue number1
Early online date20 May 2022
Publication statusPublished - 2022


  • eye movement
  • schizophrenia
  • affective disorder
  • biomarker
  • predictive modelling


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