Theory of mind impairment and its clinical correlates in patients with schizophrenia, major depressive disorder and bipolar disorder

Abstract

Background: Although Theory of Mind (ToM) impairment has been observed in patients with a wide range of mental disorders, the similarity and uniqueness of these deficits across diagnostic groups has not been thoroughly investigated. Methods: We recruited 35 participants with schizophrenia (SCZ), 35 with bipolar disorder (BD), 35 with major depressive disorder (MDD), and 35 healthy controls in this study. All participants were matched in age, gender proportion and IQ estimates. The Yoni task, capturing both the cognitive and affective components of ToM at the first-and second-order level was administered. Repeated-measure ANOVA and MANOVA were conducted to compare the group differences in ToM performance. A network was then constructed with ToM performances, psychotic and depressive symptoms, and executive function as nodes exploring the clinical correlates of ToM. Results: Overall, ToM impairments were observed in all patient groups compared with healthy controls, with patients with SCZ performing worse than those with BD. In second-order conditions, patients with SCZ and MDD showed deficits in both cognitive and affective conditions, while patients with BD performed significantly poorer in cognitive conditions. Network analysis showed that second-order affective ToM performance was associated with psychotic and depressive symptoms as well as executive dysfunction, while second-order affective ToM performance and negative symptoms showed relatively high centrality in the network. Conclusions: Patients with SCZ, MDD and BD show different variety and severity of impairments in ToM sub-components. Impairment in higher-order affective ToM appears to be closely related to clinical symptoms in both psychotic and affective disorders.

Theory of mind abilities and its relationship with clinical features in euthymic bipolar patients

“…We demonstrated that age of onset was negatively correlated with total DEToMS score and metaphor, also first order belief test was negatively correlated with number of hospitalisations and number of manic/mixed episodes. This is contrary with the results of the Inoue et al's study which showed no correlation between age of onset, duration of illness and first and second order false beliefs 3 28 . Also, we found some clinical variables may be predictor for ToM, therefore for social cognition.…”

“…There are different results for the correlation of psychotic episodes and ToM and we could not demonstrate any relationship 7,21 . Wang et al research results revealed that second order beliefs test was associated wih psychotic and depressive symptoms 28 . Also, we found some clinical variables may be predictor for ToM, therefore for social cognition.…”

Impaired social cognition in bipolar disorder: A meta-analysis of Theory of Mind in euthymic patients

“…A total of 30 studies were included (27 full paper and 3 theses) in this meta-analysis. The sample was heterogeneous regarding BD type, 12 studies included only BD I patients, 2 studies included only BD II patients (Ibanez et al, 2012, 2014), 12 studies included both types (BD I and II) and 4 studies did not mention type of BD in their sample (Dalkner et al, 2019; Goitia et al, 2017; Kerr et al, 2003; Wang et al, 2017). For more information, see Table 1.…”

“…Some studies have used novel tasks aimed at assessing more specific ToM deficits (Feyerabend et al, 2018; Montag et al, 2010). It is necessary to adapt assessments making them more applicable and specific for BD patients, given that the impairments in BD tend to be more subtle when compared to other populations, such as schizophrenia (Lee et al, 2013; Wang et al, 2017). Finally, further studies should include, in parallel to ToM tasks, a comprehensive neuropsychological battery, making it possible to investigate the relation between cognitive function and ToM performance.…”

Social Inferences as Mediators of Wellbeing in Depression

“…The evaluation of individual ToM abilities continues to be of interest in current mental health research, since its deficits impact people suffering with schizophrenia, 32 bipolar affective disorder, 33 addictive pathologies, 34 and depressive disorders, 35 alongside other general medical conditions, such as Parkinson’s disease. 36 Recent studies have shown that in people suffering with a chronic depressive illness, both, the cognitive and the affective components, are deficient, 37 and that a flawed individual ToM might be the culprit for the psychosocial and functional deficits associated with a poor mental health. 17 , 38 …”