Abstract

Objective To explore the metacognitive ability of patients with schizophrenia and its relationship with theory of mind. Methods Seventy schizophrenic patients in post-acute phase of illness and 50 patients with anxiety disorder were assessed with the Abbreviated Metacognition Assessment Scale (MAS-A) in order to measured their ability of metacognition, then the two groups of patients and 55 normal people were assessed with Theory of Mind-Picture Sequencing Task (ToM-PST). The metacognitve function of patients with schizophrenia was compared with that of patients with anxiety disorder. Correlation between metacognition ability and theory of mind in patients with schizophrenia was analyed using Spearman correlation anlysis. Results The MAS-A total score, the subscores of self-reflectivity, understanding the others' mind, decentration and mastery(respectively 8.91±3.45, 3.46±1.11, 2.50±1.09, 0.46±0.57, 2.49±1.19)were significantly lower in the patients with schizophrenia than those in the patients with anxiety disorder (respectively 12.72±3.27, 4.79±1.16, 3.28±0.95, 1.09±0.70, 3.56±1.08; Z=–3.858––5.309, all P<0.01). Compared with the normal people, patients with schizophrenia and anxiety disorder had significantly lower total scores in ToM-PST (47.30±9.19 vs.58.29±1.06; 55.58±5.02 vs.58.29±1.06; Z=–8.344, –2.084; both P<0.05). Correlation analysis showed a positive correlation between the total score of MAS-A and that of ToM-PST (r=0.460, P<0.01) in the patients with schizophrenia, and the correlation was persisted when the PANSS total score and ill-ness duration were statistically controled (r=0.418, P<0.01). The total score of MAS-A of patients with schizophrenia was negatively correlated with the total score of PANSS(r=–0.547, P<0.01) and the subscores of negative symptoms (r=–0.518, P<0.01) and positive symptoms (r=–0.348, P<0.01). Conclusion Patients with schizophrenia may experience metacognitive deficits which be related to the impairements of theory of mind, this suggest that they share the same neurophysiological basis. Key words: Schizophrenia; Metacognition; Theory of mind; Psychotic symptom

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