The relation between theory of mind, empathy and insight abilities and clinical correlates in schizoprenia

Aim: Schizophrenia is a disorder which causes impairment in psychosocial functions. Psychosocial dysfunction in schizophrenia is thought to be related to social cognition. Theory of Mind (ToM), the cognitive capacity to represent the mental states of one and others, constitutes an important aspect of social cognition. The aim of this study was to assess social cognition in schizophrenia determined by ToM deficits and to identify the relation between ToM and effects of clinical correlates, predictor factors, empathy and insight in schizophrenia.Method: Eighty nine schizophrenia patients and 89 healthy controls were included into the study. ToM and empathic abilities of all subjects, and patients? insight for their illness were assessed. Correlations between ToM, empathy and insight scores in schizophrenia, and predictors for ToM disabilities were evaluated.Results: Theory of Mind and empathic abilities of schizophrenia patients were found to be impaired compared to controls. Patients were found to have moderate levels of insight. Correlations between ToM, empathy and insight in patients with schizophrenia were positively correlated whereas correlation between ToM and empathy was very strong. It was found that Theory of Mind was strongly related to education level and clinical correlates such as hallucinations, flat affect, feelings of guilt and sum of positive symptoms. Patients who had higher scores on PANSS items of hallucinations and flat affect were two times more likely to show impairment in Theory of Mind function compared to patients with lower PANSS items.Discussion: Theory of mind, which is related to social cognition, is impaired in schizophrenia. This impairment is positively correlated to empathy and insight. Education level of schizophrenia patients, hallucination and flat affect symptoms are the predictors of ToM ability.Keywords: Schizophrenia, Social Cognition, Theory of Mind, Empathy, Insight, Positive symptoms, Negative symptoms, Flat affect, Hallucinations