Theory of mind subgroups in schizophrenia

Abstract

This paper gives an overview of state-of-the-art theory of mind (ToM) deficits in schizophrenia and patient subgroups.

Only a few studies have directly compared ToM in people with autism spectrum disorders to patients with schizophrenia. Several meta-analyses have had no luck differentiating between ToM deficits in the two disorders. Results indicate that current research has compared high functioning people with autism to patients with a chronic course of schizophrenia.

Within the group of patients with schizophrenia, considerable differences in ToM have been found. State-of-the-art  theory of mind suggests that specific aspects of negative symptoms are related to more severe ToM deficits. No clear correlation has been established between the level of psychotic symptoms and ToM. Patients in remission have fewer ToM deficits. However, patients with apparently no ToM deficits have been shown to have abnormal brain activity in the mentalising network. These results indicate that the patients mentally have to work harder when interacting socially with other people.

Current evidence indicates that patients with schizophrenia should routinely be social cognitive tested in order to offer the most optimal treatment.