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Abstract
BackgroundPeople with chronic psychosis often display theory of mind impairments that are not fully accounted for by other, more general neurocognitive deficits. In these patients, both theory of mind and neurocognitive deficits contribute to poor functioning, independently of psychotic symptoms. In young people with recent-onset psychosis, however, it is unclear the extent to which theory of mind impairment is independent of neurocognitive deficits. The primary aim of this study was to examine the evidence for specific theory of mind impairments in early psychosis. A secondary aim was to explore the relations between theory of mind, neurocognition, symptom severity, and functional outcomes.MethodsTwenty-three patients who were within two years of their first psychotic episode and 19 healthy controls completed theory of mind and neurocognitive batteries. Social functioning, quality of life, and symptom severity were also assessed in patients.ResultsPatients demonstrated deficits in tasks assessing theory of mind and neurocognition relative to controls. Patients’ deficits in theory of mind were evident even after adjusting for their deficits in neurocognition. Neither theory of mind nor neurocognition predicted social functioning or quality of life in this early psychosis sample. Severity of negative symptoms, however, was a significant predictor of both outcomes.ConclusionsWhile a specific theory of mind impairment was evident in this early psychosis sample, severity of negative symptoms emerged as the best predictor of poor functional outcome. Further early psychosis research is needed to examine the longitudinal progression of theory of mind impairments – independent of neurocognitive deficits – and their impact on psychosocial function.
Highlights
People with chronic psychosis often display theory of mind impairments that are not fully accounted for by other, more general neurocognitive deficits
The poor functioning that is associated with psychosis, may be due, in part, to the psychotic symptoms themselves or to other neurocognitive deficits
Sullivan et al found that social functioning in their sample was associated with theory of mind” (ToM) and verbal IQ, but not with other general cognitive measures or a measure of negative symptoms that excluded symptoms that overlapped with poor social functioning. These findings suggest that both theory of mind and aspects of neurocognition contribute to poor social functioning in early psychosis
Summary
People with chronic psychosis often display theory of mind impairments that are not fully accounted for by other, more general neurocognitive deficits. In these patients, both theory of mind and neurocognitive deficits contribute to poor functioning, independently of psychotic symptoms. ToM is essential to negotiating social interactions and there is strong evidence that patients across all stages of psychosis, including those with at-risk mental states, have impairment in this ability [6,7]. Patients with psychosis typically display deficits in attention, working memory, and many other aspects of neurocognition, which predict poor functioning, independent of severity of negative symptoms [9,10,11]
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