The mediating effect of theory of mind between psychotic symptoms and social functioning in stable schizophrenia

doi:10.3969/j.issn.1006-7795.2023.04.014

Abstract

Abstract: Objective To investigate the mediating role of theory of mind between psychotic symptoms and social functioning in stable schizophrenia patients. Methods Positive and negative syndrome scale (PANSS) was applied to assess patients’ psychiatric symptoms. The number of completed categories on the Wisconsin Card Sorting Test (WCST), the mean response time on the Continuous Performance Test (CPT), and the breadth of numbers on the Wechsler Adult Intelligence Scale (WAIS) were used to assess the general cognitive function of the patients. Four theory of mind tasks were selected to assess patients’ social cognition: the first-order false belief, the second-order false belief, the faux-pas task, and the reading the mind in eyes test. The Personal and Social Functioning Scale (PSP) was selected to assess the social functioning of patients with schizophrenia. Results PSP scores were negatively correlated with patients’ negative symptoms (r＝－0.453, P<0.001), positively correlated with faux-pas task scores (r=0.544, P=0.010). The faux-pas task scores were negatively correlated with negative symptoms (r＝－0.331, P<0.001), and negative symptoms had a direct effect on social functioning (β＝－0.470, P<0.01). There was a mediating effect of the aphasia task (β=0.407, P<0.01). Conclusions Impairment of social functioning in patients with stable schizophrenia is closely related to negative symptoms and social cognition. The faux-pas task partially mediates patients’ psychiatric symptoms and social functioning.

Key words: schizophrenia, cognitive function, social function, mediation

CLC Number:

R749.3

Zhong Jie, Zhu Hong, Hao Jun, Jia Hongxiao. The mediating effect of theory of mind between psychotic symptoms and social functioning in stable schizophrenia[J]. Journal of Capital Medical University, 2023, 44(4): 590-595.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2023.04.014

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2023/V44/I4/590

References

［1］ Sergi M, Green M, Widmark C, et al. Social cognition and neurocognition: effects of risperidone, olanzapine, and haloperidol［J］. Am J Psychiatry, 2007, 164(10): 1585-1592.
［2］ Lincoln T M, Mehl S, Kesting M L, et al. Negative symptoms and social cognition: identifying targets for psychological interventions［J］. Schizophr Bull, 2011, 37(Suppl 2): S23－S32.
［3］ Foussias G, Remington G. Negative symptoms in schizophrenia: avolition and Occam’s razor［J］. Schizophr Bull, 2010, 36(2): 359-369.
［4］ Fett A K J, Viechtbauer W, Dominguez M D G, et al. The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: a meta-analysis［J］. Neurosci Biobehav Rev, 2011, 35(3): 573-588.
［5］ Milev P, Ho B C, Arndt S, et al. Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: a longitudinal first-episode study with 7-year follow-up［J］. Am J Psychiatry, 2005, 162(3): 495-506.
［6］ Zanello A, Curtis L, Badan B’ M, et al. Working memory impairments in first-episode psychosis and chronic schizophrenia［J］. Psychiatry Res, 2009, 165(1/2): 10-18.
［7］ Thibaudeau É, Cellard C, Turcotte M, et al. Functional impairments and theory of mind deficits in schizophrenia: a meta-analysis of the associations［J］. Schizophr Bull, 2021, 47(3): 695-711.
［8］ American Psychiatric Association. Diagnostic and statistical manual of mental disorders:DSM-Ⅳ［M］． 4th ed. Washington, D.C.: American Psychiatric Association， 1994.
［9］乔颖, 何燕玲, 赵靖平, 等. 个体和社会功能量表信效度研究［J］. 中国医药导报, 2012, 9(26): 11-14.
［10］张颖, 王若梅, 李刚. 精神分裂症认知功能损害的研究进展［J］. 中国慢性病预防与控制, 2021, 29(2): 158-160.
［11］ Mike L K, Guimond S, Kelly S, et al. Social cognition in early course of schizophrenia: exploratory factor analysis［J］. Psychiatry Res, 2019, 272: 737-743.
［12］ Mondragón-Maya A, Ramos-Mastache D, Román P D, et al. Social cognition in schizophrenia, unaffected relatives and ultra-high risk for psychosis: what do we currently know?［J］. Actas Esp Psiquiatr, 2017, 45(5): 218-226.
［13］ Mehta U M, Thirthalli J, Kumar C N, et al. Negative symptoms mediate the influence of theory of mind on functional status in schizophrenia［J］. Soc Psychiatry Psychiatr Epidemiol, 2014, 49(7): 1151-1156.
［14］ Mazza M, Pollice R, Pacitti F, et al. New evidence in theory of mind deficits in subjects with chronic schizophrenia and first episode: correlation with symptoms, neurocognition and social function［J］. Riv Psichiatr, 2012, 47(4): 327-336.
［15］ Ventura J, Ered A, Gretchen-Doorly D, et al. Theory of mind in the early course of schizophrenia: stability, symptom and neurocognitive correlates, and relationship with functioning［J］. Psychol Med, 2015, 45(10): 2031-2043.
［16］ Chen S Y, Liu Y X, Liu D, et al. The difference of social cognitive and neurocognitive performance between patients with schizophrenia at different stages and influencing factors［J］. Schizophr Res Cogn, 2021, 24: 100195.
［17］ Mizrahi R, Korostil M, Starkstein S E, et al. The effect of antipsychotic treatment on theory of mind［J］. Psychol Med, 2007, 37(4): 595-601.
［18］ Bürkner P C, Williams D R, Simmons T C, et al. Intranasal oxytocin may improve high-level social cognition in schizophrenia, but not social cognition or neurocognition in general: a multilevel bayesian meta-analysis［J］. Schizophr Bull, 2017, 43(6): 1291-1303.
［19］ Savina I, Beninger R J. Schizophrenic patients treated with clozapine or olanzapine perform better on theory of mind tasks than those treated with risperidone or typical antipsychotic medications［J］. Schizophr Res, 2007, 94(1/3): 128-138.
［20］ Zhong J, Zhu H, Yin D Q, et al. Paliperidone compared with haloperidol on the theory of mind tasks in schizophrenia: a pilot trial［J］. Neuropsychiatr Dis Treat, 2021, 17: 3683-3691.
［21］ Yeo H, Yoon S, Lee J, et al. A meta-analysis of the effects of social-cognitive training in schizophrenia: the role of treatment characteristics and study quality［J］. Br J Clin Psychol, 2022, 61(1): 37-57.
［22］ Yamada Y, Sueyoshi K, Yokoi Y, et al. Transcranial direct current stimulation on the left superior temporal sulcus improves social cognition in schizophrenia: an open-label study［J］. Front Psychiatry, 2022, 13: 862814.
［23］ Ventura J, Wood R C, Hellemann G S. Symptom domains and neurocognitive functioning can help differentiate social cognitive processes in schizophrenia: a meta-analysis［J］. Schizophr Bull, 2013, 39(1): 102-111.

[1]	Wang Qunsong, Yu Haiyan, Ji Xiangdong, Li Miao, Jiang Yiye. Intervention effect of electroacupuncture on metabolic syndrome induced by new antipsychotics [J]. Journal of Capital Medical University, 2023, 44(4): 614-619.
[2]	Li li, Liu Chaomeng, Ren Yanping, Yang Chunlin, Ma Xin. Research advances of modified electroconvulsive therapy for first-episode schizophrenia [J]. Journal of Capital Medical University, 2022, 43(2): 249-253.
[3]	Guo Chengwei, Zhou Jiaojiao, Feng Yuan, Yang Yunping. A comparative study of self esteem between schizophrenics and normal people [J]. Journal of Capital Medical University, 2022, 43(2): 294-298.
[4]	Ning Yanzhe, Zhu Hong, Song Nan, Zheng Sisi, Li Ziyan, Li Jiajia, Ma Rui, Jia Hongxiao. A preliminary study on efficacy for Shi-zhen-an-shen granules on cognitive impairments in prodromal schizophrenia [J]. Journal of Capital Medical University, 2021, 42(3): 404-407.
[5]	Li Ziyan, Liu Xinzi, Du Jian, Wang Hao, Yang Qiuli, Jia Hongxiao. Preliminary study on the characteristics of five-pattern personality in traditional Chinese medicine with bipolar disorder [J]. Journal of Capital Medical University, 2021, 42(3): 408-411.
[6]	Sha Sha, Zhao Xixi, Han Chuanliang, Peng Xing, Zhang Pei, Dong Wen, Yin Jingjing, Wang Changming. Correlation between alpha activity and cognitive in resting electroencephalogram of schizophrenia [J]. Journal of Capital Medical University, 2021, 42(1): 117-124.
[7]	Zhang Ying, Wang Ruomei, Li Gang. Cognitive function, emotion management and its influencing factors in stable schizophrenia [J]. Journal of Capital Medical University, 2021, 42(1): 143-147.
[8]	Liu Xinyao, Ma Chao, Jia Hongxiao. Current status of research concerning animal models of cognitive impairment of schizophrenia [J]. Journal of Capital Medical University, 2020, 41(1): 50-54.
[9]	Li Xue, Zhu Hong, Fang Meng, Ning Yanzhe, Zhao Shuang, Yin Dongqing. Clinical observation of abdominal acupuncture in the treatment of obesity caused by atypical antipsychotics [J]. Journal of Capital Medical University, 2020, 41(1): 75-79.
[10]	Zhuang Wenxu, Zhang Weibo, Zhu Youwei, Zhu Yi, Cai Jun. Lifestyle interventions for physical health conditions in patients with schizophrenia [J]. Journal of Capital Medical University, 2019, 40(5): 698-702.
[11]	Yin Dongqing, Huang Fang, Zhao Anquan, Wang Qunsong, MA Yanbing, Chen Jindong, Li Baojun, Du Hong, Jia Hongxiao. Establishing traditional Chinese medicine pattern elements diagnostic scale of schizophrenia [J]. Journal of Capital Medical University, 2018, 39(6): 821-827.
[12]	Bian Zhiming, Wang Changming, Liu Chenyang, Zhang Xiujun, Ma Xin. An event-related potential study of dysfunction of conflict monitoring in patients with schizophrenia [J]. Journal of Capital Medical University, 2018, 39(5): 625-629.
[13]	Sun Congcong, Zhou Danna, Ning Fangping, Ma Liang, Yan Liqiong, Ren Yanping, Ma Xin. Augmentation of rTMS in the treatment of refractory schizophrenia [J]. Journal of Capital Medical University, 2018, 39(5): 641-645.
[14]	Xu Yuanyuan, Zhou Song, Zhu Hong, Geng Haiyan, Jia Hongxiao. Relationship between insight and unconscious self-face recognition in patients with schizophrenia [J]. Journal of Capital Medical University, 2018, 39(2): 209-212.
[15]	Fan Yu, Yang Ningbo, Tian Qing, Zhu Xiuqiang, Wang Chuanyue. Prepulse inhibition and the related factors among healthy people and patients with chronic schizophrenia [J]. Journal of Capital Medical University, 2017, 38(2): 178-185.