School of Humanities and Social Sciences, Shanxi Medical University, No. 56 South Xinjian Road, Taiyuan, 030001, China.
BMC Psychiatry. 2023 Oct 2;23(1):711. doi: 10.1186/s12888-023-05224-7.
Schizophrenia (SCZ) is a mental disorder that can cause severe disability, including impairment of social cognition, which is considered a core feature of SCZ, and the Theory of Mind (ToM) is a core component of social cognition. Although many studies have confirmed the presence of ToM impairment in patients with SCZ, its characteristics in terms of different orders (first-order and second-order) and components remain unclear, and no studies have investigated the independent correlations between such impairment and clinical symptoms. Therefore, this study aimed to identify the characteristics of ToM impairment in patients with SCZ.
This study included 30 patients with SCZ and 30 healthy controls who were matched for age, sex, and level of education. The clinical symptoms of the patients with SCZ were evaluated using the Positive and Negative Symptom Scale (PANSS), and the neurocognitive ability of the subjects was evaluated using the Trail Making Test, Symbol Coding Test, and Digit Span Test. The degree of ToM impairment of the subjects at different stages (first- and second-order) and for individual components was evaluated using the Yoni task. Latent profile analysis and network analysis were conducted to identify and analyze the potential ToM performance types, and independent correlations were assessed between ToM impairment and clinical symptoms.
The patients with SCZ exhibited significant first-order and second-order impairment (P < 0.05), and the second-order affective ToM component was mainly reflected by complex affective states (P = 0.003). The latent profile analysis revealed that ToM impairments in patients with SCZ could be classified into groups with complete, second-order, and comprehensive defects, whereas it was impossible to classify patients according to differences in the cognitive and affective ToM components. The Network analysis demonstrated that the cognitive component of ToM was associated with positive symptoms, whereas the affective ToM component was associated with negative symptoms.
Patients with SCZ exhibited differences in order levels and ToM impairments, as well as different defect types. In addition, cognitive and affective ToM components may be related to different psychotic symptoms; therefore, understanding these differences could promote the rehabilitation of patients with SCZ.
精神分裂症（SCZ）是一种会导致严重残疾的精神障碍，包括社会认知受损，社会认知被认为是 SCZ 的核心特征，而心理理论（ToM）是社会认知的核心组成部分。尽管许多研究已经证实 SCZ 患者存在 ToM 受损，但在不同顺序（一阶和二阶）和组成部分方面，其特征仍然不清楚，也没有研究调查这种损害与临床症状之间的独立相关性。因此，本研究旨在确定 SCZ 患者 ToM 受损的特征。
本研究纳入了 30 名 SCZ 患者和 30 名年龄、性别和教育程度相匹配的健康对照组。使用阳性和阴性症状量表（PANSS）评估 SCZ 患者的临床症状，使用连线测试、符号编码测试和数字跨度测试评估受试者的神经认知能力。使用 Yon 任务评估受试者在不同阶段（一阶和二阶）和个别组成部分的 ToM 受损程度。进行潜在剖面分析和网络分析，以识别和分析潜在的 ToM 表现类型，并评估 ToM 受损与临床症状之间的独立相关性。
SCZ 患者表现出明显的一阶和二阶损害（P<0.05），二阶情感 ToM 成分主要反映在复杂的情感状态中（P=0.003）。潜在剖面分析显示，SCZ 患者的 ToM 损害可分为完全、二阶和综合缺陷组，而无法根据认知和情感 ToM 成分的差异对患者进行分类。网络分析表明，ToM 的认知成分与阳性症状相关，而情感 ToM 成分与阴性症状相关。
SCZ 患者在顺序水平和 ToM 受损方面存在差异，以及不同的缺陷类型。此外，认知和情感 ToM 成分可能与不同的精神病症状有关；因此，了解这些差异可以促进 SCZ 患者的康复。
