Bechi Margherita, Agostoni Giulia, Buonocore Mariachiara, Gritti Davide, Mascia Mattia, Spangaro Marco, Bianchi Laura, Cocchi Federica, Guglielmino Carmelo, Bosia Marta, Cavallaro Roberto
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.
School of Psychology, Vita-Salute San Raffaele University, Milan, Italy.
Schizophr Res Cogn. 2019 Oct 31;19:100164. doi: 10.1016/j.scog.2019.100164. eCollection 2020 Mar.
Literature has recently identified a discrete subgroup of patients affected by schizophrenia that also present autistic traits (ATs), showing a peculiar cognitive, clinical and functional profile. Theory of Mind (ToM) represents a core, impaired feature in both schizophrenia and Autism Spectrum Disorder (ASD), ToM in patients with schizophrenia and ATs has yet to be investigated. Thus, this study aims, on the one hand, to assess differences among patients with and without ATs on clinical, cognitive and ToM abilities as well as in daily functioning; on the other hand, to compare the efficacy on mentalizing abilities of a specific ToM training in these two groups. Ninety-six patients with schizophrenia were enrolled and underwent a broad cognitive, social-cognitive and functional assessment before and after the ToM training. ANOVAs revealed that patients with schizophrenia and ATs are more impaired in cognition, ToM, in premorbid and daily functioning as well as in clinical features, as compared to patients without ATs. This latter group also showed a general improvement in mentalizing abilities after ToM training, while patients with schizophrenia and ATs did not, with a significant time × group interaction on ToM abilities. These data shed new light on the relation among schizophrenia and ATs, highlighting that patients with these traits are highly impaired in ToM abilities. Thus, ATs seem to limit the effectiveness of ToM training, having implications in clinical and rehabilitative practice.
最近的文献发现了一个受精神分裂症影响且伴有自闭症特征（ATs）的离散患者亚组，这些患者呈现出独特的认知、临床和功能特征。心理理论（ToM）是精神分裂症和自闭症谱系障碍（ASD）的核心受损特征，然而，精神分裂症合并ATs患者的ToM尚未得到研究。因此，本研究一方面旨在评估有无ATs的精神分裂症患者在临床、认知、ToM能力以及日常功能方面的差异；另一方面，比较这两组中特定ToM训练对心理化能力的疗效。96名精神分裂症患者入组，并在ToM训练前后接受了广泛的认知、社会认知和功能评估。方差分析显示，与无ATs的患者相比，伴有ATs的精神分裂症患者在认知、ToM、病前和日常功能以及临床特征方面受损更严重。后一组在ToM训练后心理化能力也有普遍改善，而伴有ATs的精神分裂症患者则没有，在ToM能力上存在显著的时间×组间交互作用。这些数据为精神分裂症与ATs之间的关系提供了新的线索，突出了具有这些特征的患者在ToM能力上严重受损。因此，ATs似乎限制了ToM训练的有效性，这对临床和康复实践具有启示意义。
