Abstract
Psychotic disorders are characterized by theory of mind (ToM) impairment. Although ToM undergoes maturational changes throughout adolescence, there is a lack of studies examining ToM performance and its brain functional correlates in individuals with an early onset of psychosis (EOP; onset prior to age 18), and its relationship with age. Twenty-seven individuals with EOP were compared with 41 healthy volunteers using the “Reading-the-Mind-in-the-Eyes” Test, as a measure of ToM performance. A resting-state functional MRI scan was also acquired, in which the default mode network was used to identify areas relevant to ToM processing employing independent component analysis. Group effects revealed worse ToM performance and less intrinsic functional connectivity in the medial prefrontal cortex in EOP relative to healthy volunteers. Group by age interaction revealed age-positive associations in ToM task performance and in intrinsic connectivity in the medial prefrontal cortex in healthy volunteers, which were not present in EOP. Differences in ToM performance were partially mediated by intrinsic functional connectivity in the medial prefrontal cortex. Poorer ToM performance in EOP, coupled with less medial prefrontal cortex connectivity, could be associated with the impact of psychosis during a critical period of development of the social brain, limiting normative age-related maturation.
Highlights
Social cognition refers to the ability of human beings to interact with others by recognizing their emotions and thoughts
Deficits in theory of mind” (ToM) have been historically associated with autism spectrum disorders (Baron-Cohen et al, 1985; Yirmiya et al, 1998), in the last decades it has been suggested that impairments in ToM underlie social difficulties observed in other mental health conditions (Korkmaz, 2011)
(4) Patients with early onset schizophrenia (EOSz) performed significantly worse than in dividuals with early onset affective disorders (EOAff) and than healthy volunteers in the ToM task, while there were no differences between diagnostic groups in Default Mode Network (DMN) connectivity
Summary
Social cognition refers to the ability of human beings to interact with others by recognizing their emotions and thoughts. Various psycholog ical processes are considered to be involved in social cognition: facial emotion processing and “theory of mind” (ToM) are the most frequently studied, among others such us empathy, or humor (Uekermann et al, 2010). The processes involved in social cognition are considered to play a key role in successful social interactions (Wade et al, 2018; Yager and Ehmann, 2006). Several meta-analyses have confirmed impaired ToM in schizo phrenia (Bora et al, 2009) and affective disorders (Bora et al, 2016; Bora and Berk, 2016), with possibly more severe deficits in the former (Mitchell and Young, 2016). Recent reports have shown that ToM pre sents the highest correlation with everyday functioning in schizo phrenia; stronger than any other neurocognitive domain (Bora, 2017; Fett et al, 2011)
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