SoundPics: visual and auditory psychophysics reveals distinct sensory profiles that differentiate schizophrenia from bipolar disorder in early psychosis across three independent Brazilian public health clinical samples.

Authors

Maria Lucia de Bustamante Simas, Aline Mendes Lacerda, Joselma Tavares Frutuoso, Isabela de Fatima Pina de Almeida, Mateus Monteiro de Gois Barros, Katherine Karla Souza da Silva, Thays Macambira da Silva, Giuliano Baltar Melo de Souza Ramos, Tamires Lima da Silva, Naianna Mocelin Ribeiro Dos Santos, Amanda Almeida Rodrigues E Silva, Kayke Kauã de Siqueira

Published in

Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). Oct 20, 2026. Epub Oct 20, 2026.

Abstract

Psychosis assessment relies mostly on top-down cognitive and behavioral evaluations. We investigated whether low-cost visual and auditory psychophysical tests can detect early sensory alterations. Participants (schizophrenia [SCHZ] n = 45, bipolar disorder [BIP] n = 36, first-episode psychosis [FEP] n = 39) recruited from three independent Brazilian public mental health facilities (SUS) were independently compared to age-matched healthy controls (pooled N = 94). The Pictorial Size Test (PST) measured perceived image size in degrees of visual angle (dva). The Sound Appreciation Test (SAT) measured sound discomfort levels (SDL) across pure-frequency sweeps. SCHZ and FEP patients exhibited significantly larger perceived pictorial sizes relative to controls (d = 0.76, p = 0.0057; and d = 0.58, p = 0.013, respectively), whereas BIP patients did not differ from controls. Elevated hearing discomfort was present across all groups but was most pronounced in BIP (d = 1.16; p < 0.0001), followed by FEP (d = 0.70; p = 0.0057) and SCHZ (d = 0.51; p = 0.028). Empirical cutoffs derived from chronic cohorts created the hierarchical rule-based algorithm SoundPics-(V3). SoundPics differentiated schizophrenia from bipolar disorder yielding 70.8% accuracy among clinically determined cases (72 of 81) and demonstrated convergent classification in an independent FEP group. Early psychophysical screening is viable in clinical triage in public mental health settings.

PMID:
42900862
Bibliographic data and abstract were imported from PubMed on 21 Oct 2026.

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