Theory of Mind Abilities and Insight Dimension in Patients with Obsessive-Compulsive Disorder and Schizophrenia

Abstract

Objective: The present study aims to compare ToM traits among healthy controls, patients with OCD, and patients with schizophrenia. Methods: Participants were 38 patients with OCD, 37 patients with a schizophrenia diagnosis, and 38 healthy controls. The study protocol was approved by the Ethics Committee of Marmara University. Sociodemographic information of the participants was collected, and the Fear of Covid-19 Scale, Reading Mind in the Eyes Test (RMET), First Order False Belief (FOFB ) and Second-Order False Belief (SOFB), Hinting Task (HT) and Strange Stories (SS), Brown Assessment of Beliefs Scale (BABS) and the Hamilton Depression Scale (HAM-D) were administered. All statistical analyzes were performed using IBM SPSS Statistics (Statistical Package for the Social Sciences) 24.0 for Windows (SPSS Inc., Chicago, IL, USA). All variables were screened for accuracy of data entry, missing values, and homoscedasticity. Results: A significant impairment in both cognitive and affective ToM tests in OCD patients compared to the healthy controls was found. Furthermore, the present study results revealed that ToM impairment in OCD patients is less severe than ToM impairment in schizophrenia patients. Although a significant deterioration was observed in all ToM evaluations in OCD patients than healthy controls, it was determined that ToM performance in schizophrenia patients was significantly worse than both OCD and healthy controls. Conclusions: This cross-sectional study suggested that OCD and schizophrenia patients have different ToM profiles, mainly evident with lower ToM abilities in OCD patients. Understanding of ToM abilities–psychopathology relationship will have important implications for assessing and developing treatment strategies in patients with OCD and schizophrenia for clinical psychiatrists.