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Selective Effect of Neurocognition on Different Theory of Mind Domains in First-Episode Psychosis

Fernandez-Gonzalo, Sol MD*†; Jodar, Merce PhD†‡; Pousa, Esther PhD†§; Turon, Marc MD*†; Garcia, Rebeca MD§; Rambla, Carla Hernandez MD§; Palao, Diego PhD§∥

The Journal of Nervous and Mental Disease: August 2014 - Volume 202 - Issue 8 - p 576–582
doi: 10.1097/NMD.0000000000000164
Original Articles

The aim of this study was to investigate the influence of neurocognition on affective and cognitive theory of mind (ToM) tasks in early phases of psychosis. In a cross-sectional study of 60 first-episode schizophrenia/schizoaffective disorder patients, the implication of neurocognition in first- and second-order ToM stories, Hinting Task, and Reading the Mind in the Eyes Test (RMET) was analyzed. Regression models were used, controlling for clinical symptoms and antipsychotic dose. Spatial span backward (odds ratio [OR], 0.34; p = 0.01) and intrusions in the Rey Auditory Verbal Learning Test (OR, 4.86; p = 0.04) were the best factors to predict second-order ToM failure. Trail Making Test B (B = 0.01; p = 0.04) and negative symptoms (B = 0.09; p = 0.01) predicted Hinting task performance while Block design (B = 0.1; p = 0.04) was related to RMET outcome. Executive functions and clinical symptoms were related to ToM performance in first-episode schizophrenia patients, although different patterns of relationship were observed in each ToM task.

*Research Department, Foundation Parc Taulí, Universitary Institute, Universitat Autònoma de Barcelona, Parc Taulí Sabadell, Universitary Hospital, Sabadell; †Department of Clinical and Health Psychology, Psychopathology and Neuropsychology Research Unit, Universitat Autònoma de Barcelona, Bellaterra; ‡Neurology Department Parc Taulí, Sabadell, University Hospital–Universitat Autònoma de Barcelona, Bellaterra; §Mental Health Department, Parc Taulí, Sabadell, University Hospital–Universitat Autònoma de Barcelona, Bellaterra; and ∥Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.

Send reprint requests to Sol Fernandez-Gonzalo, MD, Research Department, Fundació Parc Taulí, Corporació Sanitària i Universitària Parc Taulí, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain. E-mail:

© 2014 by Lippincott Williams & Wilkins