Thibaudeau Élisabeth, Cellard Caroline, Reeder Clare, Wykes Til, Ivers Hans, Maziade Michel, Lavoie Marie-Audrey, Pothier William, Achim Amélie M
École de Psychologie, Université Laval, Québec, QC, Canada G1V 0A6; Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Québec, QC, Canada G1J 2G3.
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
Schizophr Res Treatment. 2017;2017:7203871. doi: 10.1155/2017/7203871. Epub 2017 Jan 26.
Schizophrenia is associated with deficits in theory of mind (ToM) (i.e., the ability to infer the mental states of others) and cognition. Associations have often been reported between cognition and ToM, and ToM mediates the relationship between impaired cognition and impaired functioning in schizophrenia. Given that cognitive deficits could act as a limiting factor for ToM, this study investigated whether a cognitive remediation therapy (CRT) that targets nonsocial cognition and metacognition could improve ToM in schizophrenia. Four men with schizophrenia received CRT. Assessments of ToM, cognition, and metacognition were conducted at baseline and posttreatment as well as three months and 1 year later. Two patients reached a significant improvement in ToM immediately after treatment whereas at three months after treatment all four cases reached a significant improvement, which was maintained through 1 year after treatment for all three cases that remained in the study. Improvements in ToM were accompanied by significant improvements in the most severely impaired cognitive functions at baseline or by improvements in metacognition. This study establishes that a CRT program that does not explicitly target social abilities can improve ToM.
精神分裂症与心理理论（ToM）缺陷（即推断他人心理状态的能力）及认知障碍有关。认知与ToM之间的关联屡有报道，且ToM介导了精神分裂症中认知受损与功能障碍之间的关系。鉴于认知缺陷可能成为ToM的限制因素，本研究调查了一种针对非社会性认知和元认知的认知康复疗法（CRT）是否能改善精神分裂症患者的ToM。四名精神分裂症男性患者接受了CRT治疗。在基线、治疗后以及治疗后三个月和一年时对ToM、认知和元认知进行了评估。两名患者在治疗后立即在ToM方面有显著改善，而在治疗后三个月时，所有四例患者均有显著改善，并且在研究中持续到治疗后一年的三例患者中这种改善一直保持。ToM的改善伴随着基线时受损最严重的认知功能的显著改善或元认知的改善。本研究证实，一种未明确针对社交能力的CRT方案可以改善ToM。
