van Neerven Thomas, Bos Dienke J, van Haren Neeltje Em
University Medical Centre Utrecht - Brain Centre, Department of psychiatry, Utrecht, the Netherlands.
Erasmus Medical Center, Department of child and adolescent psychiatry/psychology, Rotterdam, the Netherlands.
Neurosci Biobehav Rev. 2021 Jan;120:249-261. doi: 10.1016/j.neubiorev.2020.11.011. Epub 2020 Nov 24.
Deficiencies in Theory of Mind (ToM) are consistently found in individuals with schizophrenia (SZ), major depressive disorder (MDD), and bipolar disorder (BD). However, the character of these deficits and their role in the pathogenesis of mental illness remains poorly understood. This systematic review synthesizes the available secondary literature pertaining to ToM functioning in individuals with MDD, BD, or SZ, and their respective spectrum disorders in order to delineate disorder or symptom specific patterns of ToM impairment. Literature suggests that ToM deficits increase in severity along the affective-psychotic spectrum, with mild deficits in patients with MDD, and severe deficits in patients with mania or psychosis. Furthermore, ToM deficits appear to be part of a broader developmental phenotype associated with SZ and BD, as suggested by findings of attenuated impairments in ToM in remitted patients with SZ or BD, unaffected first-degree relatives of patients, and clinical high-risk groups. Future psychiatric research on ToM should aim to disentangle relationships between ToM deficits and specific symptom dimensions transdiagnostically, and employ standardized, construct-specific ToM tasks.
在精神分裂症（SZ）、重度抑郁症（MDD）和双相情感障碍（BD）患者中，始终发现存在心理理论（ToM）缺陷。然而，这些缺陷的特征及其在精神疾病发病机制中的作用仍知之甚少。本系统综述综合了与MDD、BD或SZ患者及其各自谱系障碍的ToM功能相关的现有二手文献，以描绘出特定于障碍或症状的ToM损害模式。文献表明，ToM缺陷在情感 - 精神病谱系中严重程度增加，MDD患者存在轻度缺陷，而躁狂或精神病患者存在严重缺陷。此外，正如在缓解期的SZ或BD患者、患者未受影响的一级亲属以及临床高风险组中ToM损害减弱的研究结果所表明的那样，ToM缺陷似乎是与SZ和BD相关的更广泛发育表型的一部分。未来关于ToM的精神病学研究应旨在跨诊断地厘清ToM缺陷与特定症状维度之间的关系，并采用标准化的、针对特定结构的ToM任务。
