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Theory of mind in adolescents with early-onset schizophrenia: correlations with clinical assessment and executive functions

Published online by Cambridge University Press:  26 February 2016

Soumaya Bourgou ,
Soumeyya Halayem ,
Isabelle Amado ,
Racha Triki ,
Marie Chantal Bourdel ,
Nicolas Franck ,
Marie Odile Krebs ,
Karim Tabbane  and
Asma Bouden
Soumaya Bourgou*
Affiliation:
Child Psychiatry Department, Mongi Slim Hospital, Marsa, Tunisia Research Unit UR 02/04, Razi Hospital, Mannouba, Tunisia Faculty of Medicine of Tunis, Tunis, Tunisia
Soumeyya Halayem
Affiliation:
Research Unit UR 02/04, Razi Hospital, Mannouba, Tunisia Faculty of Medicine of Tunis, Tunis, Tunisia Child Psychiatry Department, Razi Hospital, Mannouba, Tunisia
Isabelle Amado
Affiliation:
University Psychiatry Department, Saint Anne Hospital, Paris, France Psychiatric Physiopathology Laboratory, UMR894, INSERM, Paris, France Paris Descartes Faculty of Medicine, Paris, France
Racha Triki
Affiliation:
Research Unit UR 02/04, Razi Hospital, Mannouba, Tunisia Faculty of Medicine of Tunis, Tunis, Tunisia Psychiatry Department (B), Razi Hospital, Mannouba, Tunisia
Marie Chantal Bourdel
Affiliation:
University Psychiatry Department, Saint Anne Hospital, Paris, France Psychiatric Physiopathology Laboratory, UMR894, INSERM, Paris, France Paris Descartes Faculty of Medicine, Paris, France
Nicolas Franck
Affiliation:
Le Vinatier Hospital Center, Lyon, France Claude Bernard University, Lyon 1, France
Marie Odile Krebs
Affiliation:
University Psychiatry Department, Saint Anne Hospital, Paris, France Psychiatric Physiopathology Laboratory, UMR894, INSERM, Paris, France Paris Descartes Faculty of Medicine, Paris, France
Karim Tabbane
Affiliation:
Research Unit UR 02/04, Razi Hospital, Mannouba, Tunisia Faculty of Medicine of Tunis, Tunis, Tunisia Psychiatry Department (B), Razi Hospital, Mannouba, Tunisia
Asma Bouden
Affiliation:
Research Unit UR 02/04, Razi Hospital, Mannouba, Tunisia Faculty of Medicine of Tunis, Tunis, Tunisia Child Psychiatry Department, Razi Hospital, Mannouba, Tunisia
*
Soumaya Bourgou, Child Psychiatry Department, Mongi Slim Hospital, La Marsa 2046, Tunisia. Tel: +216 9786 3881; Fax: +216 7160 1555; E-mail: soumaya_bourgou@yahoo.fr
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Abstract

Objective

We examined Theory of Mind (ToM) abilities in adolescents with early-onset schizophrenia (EOS) and their correlation with clinical findings and Executive Functions (EF).

Methods

The ToM abilities of 12 adolescents with EOS were compared with those of healthy participants matched in age and educational level. The Moving Shapes Paradigm was used to explore ToM abilities in three modalities: random movement, goal-directed movement and ToM – scored on the dimensions of intentionality, appropriateness and length of each answer. EF was tested using Davidson’s Battery and the clinical psychopathology with the Positive and Negative Syndrome Scale (PANSS).

Results

Adolescents with EOS were significantly more impaired than controls in the three dimensions evaluated for the goal-directed and ToM modalities. Regarding the random movement modality, the only difference was in appropriateness (p<0.01). No correlation with age or level of education was evident for ToM skills. Total PANSS score was negatively correlated with appropriateness score for the goal-directed (p=0.02) and ToM modalities (p=0.01). No correlation existed between performance in the ToM Animated Tasks and positive, negative or disorganisation PANSS subscores. No correlations were found among the three scores in the Moving Shapes Paradigm and any measures of the accuracy of the three tasks assessing EF.

Conclusion

Our results confirm previous findings of ToM deficits in adult individuals with schizophrenia and attest the severity of these deficits in patients with EOS.

Keywords

cognitionperceptionpsychosisschizophrenia
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 28 , Issue 4 , August 2016 , pp. 232 - 238
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Copyright
© Scandinavian College of Neuropsychopharmacology 2016 

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References

1. Regier, DA, Narrow, WE, Rae, DS, Manderscheid, RW, Locke, BZ, Goodwin, FK. The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry 1993;50:85–94.Google Scholar
2. Mcclellan, J, Werry, J. Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. J Am Acad Child Adolesc Psychiatry 2001;33:616–635.CrossRefGoogle Scholar
3. Karno, M, Norquist, GS. Schizophrenia: epidemiology. In Kaplan HI, Sadok BJ, editors. Comprehensive textbook of psychiatry. Baltimore: Williams & Wilkins, 1989. p. 699–704.Google Scholar
4. Bellino, S, Rocca, P, Patria, L et al. Relationships of age at onset with clinical features and cognitive functions in a sample of schizophrenia patients. J Clin Psychiatry 2004;65:908–914.CrossRefGoogle Scholar
5. Sato, T, Bottlender, R, Schroter, A, Moller, HJ. Psychopathology of early-onset versus late-onset schizophrenia revisited: an observation of 473 neuroleptic-naive patients before and after first-admission treatments. Schizophr Res 2004;67:175–183.Google Scholar
6. Schurhoff, F, Bellivier, F, Jouvent, R et al. Early and late onset bipolar disorders: two different forms of manic depressive illness. J Affect Disord 2000;58:215–221.CrossRefGoogle ScholarPubMed
7. Green, MF, Horan, WP, Lee, J. Social cognition in schizophrenia. Rev Neurosci 2015;16:620–631.Google Scholar
8. Korkmaz, B. Theory of mind and neurodevelopmental disorders of childhood. Pediatr Res 2011;69:101–108.Google Scholar
9. Sprong, M, Schohorst, P, VOS, E. Theory of mind in schizophrenia: metaanalysis. Br J Psychiatry 2007;191:5–13.Google Scholar
10. Pilowsky, T, Yirmiya, N, Arbelle, S, Mozes, T. Theory of mind abilities of children with schizophrenia, children with autism and normally developing children. Schizophr Res 2000;42:145–155.Google Scholar
11. Russell, TA, Reynaud, E, Herba, C, Morris, R, Corcoran, R. Do you see what I see? Interpretations of intentional movement in schizophrenia. Schizophr Res 2006;81:101–111.Google Scholar
12. Koelkebeck, K, Pedersen, A, Suslow, T, Kueppers, KA, Arolt, V, Ohrmann, P. Theory of Mind in first-episode schizophrenia patients: correlations with cognition and personality traits. Schizophr Res 2010;119:115–123.Google Scholar
13. Nora, SV, Neva, HP, Basant, KP. Neurobiology and phenotypic expression in early onset schizophrenia. Early Interv Psychiatry 2011;5:3–14.Google Scholar
14. Basso, MR, Nasrallah, HA, Olson, SC, Bornstein, RA. Cognitive deficits distinguish patients with adolescent- and adult-onset schizophrenia. Neuropsychiatr Neuropsychol Behav Neurol 1997;10:107–112.Google Scholar
15. Tuulio-Henriksson, A, Partonen, T, Suviusaari, J, Haukka, J, Lo, J. Age at onset and cognitive functioning in schizophrenia. Br J Psychiatry 2004;185:215–229.CrossRefGoogle ScholarPubMed
16. Rajji, TK, Ismail, Z, Mulsant, H. Age at onset and cognition in schizophrenia: meta-analysis. Br J Psychiatry 2009;195:286–293.CrossRefGoogle ScholarPubMed
17. Zelazo, PD, Carter, A, Reznick, JS, Frye, D. Early development of executive function: a problem-solving framework. Rev Gen Psychol 1997;1:1–29.CrossRefGoogle Scholar
18. Carlson, SM, Mandell, D, Williams, L. Executive function and theory of mind: stability and prediction from ages 2 to 3. Dev Psychol 2004;40:1105–1122.CrossRefGoogle ScholarPubMed
19. Duval, C, Piolino, P, Bejanin, A, Eustache, F, Desgranges, B. Age effects on different components of theory of mind. Conscious Cogn 2011;20:627–642.Google Scholar
20. Flynn, E. The role of inhibitory control in false belief understanding. Infant Child Dev 2007;16:53–69.Google Scholar
21. Frye, D, Zelazo, P, Palfai, T. Theory of mind and rule-based reasoning. Cogn Dev 1995;10:483–527.CrossRefGoogle Scholar
22. Hala, S, Hug, S, Henderson, A. Executive function and false-belief understanding in preschool children: two tasks are harder than one. J Cogn Dev 2003;4:275–298.Google Scholar
23. Hughes, C, Ensor, R. Theory of mind and executive function in 2-year-olds: a family affair? Dev Neuropsychol 2005;28:645–668.Google Scholar
24. Hughes, C, Ensor, R. Executive function and theory of mind: predictive relations from ages 2 to 4. Dev Psychol 2007;43:1447–1459.CrossRefGoogle Scholar
25. Perner, J, Lang, B. Development of theory of mind and cognitive control. Cogn Sci 1999;3:337–344.Google Scholar
26. Perner, J, Lang, B, Kloo, D. Theory of mind and self control: more than a common problem of inhibition. Child Dev 2002;73:752–767.CrossRefGoogle ScholarPubMed
27. Chasiotis, A, Kiessling, F, Hofer, J, Campos, D. Theory of mind and inhibitory control in three cultures: conflict inhibition predicts false belief understanding in Germany, Costa Rica, and Cameroon. Int J Behav Dev 2006;30:192–204.CrossRefGoogle Scholar
28. Pickup, GJ. Relationship between theory of mind and executive function in schizophrenia: a systematic review. Psychopathology 2008;41:206–213.Google Scholar
29. Bora, E, Yucel, M, Pantelis, C. Theory of mind impairment in schizophrenia: meta analysis. Schizo Res 2009;109:1–9.Google Scholar
30. Langdon, R, Coltheart, M, Ward, PB, Catts, SV. Mentalising, executive planning and disengagement in schizophrenia. Cogn Neuropsychiatry 2001;6:81–108.Google Scholar
31. Bozikas, VP, Giannakou, M, Kosmidis, MH. et al. Insights into theory of mind in schizophrenia: the impact of cognitive impairment. Schizo Res 2011;130:130–136.Google Scholar
32. Fine, C, Lumsden, J, Blair, RJ. Dissociation between theory of mind and executive functions in a patient with early left amygdale damage. Brain 2001;124:287–298.Google Scholar
33. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th edn (DSM IV). Washington, DC: APA, 1994.Google Scholar
34. Kaufman, J, Birmaher, B, Brendt, D et al. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity. Adolesc Psychiatry 1997;36:980–988.Google Scholar
35. Kay, SR, Fiszbein, A, Opler, LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261–276.Google Scholar
36. Rijcken, CA, Monster, TB, Brouwers, JR, De Jong-Van Den Berg, LT. Chlorpromazine equivalents versus defined daily doses: how to compare antipsychotic drug doses? . J Clin Psychopharmacol 2003;23:657–659.CrossRefGoogle ScholarPubMed
37. Atkins, M, Burgess, A, Bottomley, C, Riccio, M. Chlorpromazine equivalents: a consensus of opinion for both clinical and research applications. Psychiatric Buletin 1997;21:224–226.Google Scholar
38. Abell, F, Happé, FG, Frith, U. Do triangles play tricks? Attribution of mental states to animated shapes in normal and abnormal development. Cogn Dev 2000;15:1–16.Google Scholar
39. Castelli, F, Happé, F, Frith, U, Frith, C. Movement and mind. A functional imaging study of perception and interpretation of complex intentional movement patterns. NeuroImage 2000;12:314–325.Google Scholar
40. Castelli, F, Frith, C, Happé, F, Frith, U. Autism, Asperger syndrome and brain mechanisms for the attribution of mental states to animated shapes. Brain 2002;125:1839–1849.Google Scholar
41. Gallagher, S. Philosophical conceptions of the self: implication for cognitive science. Cogn Sci 2000;4:14–21.Google Scholar
42. Pouilles, L, Tiberghien, G, Georgieff, N, Franck, N. Perception de la causalité et théorie de l’esprit dans la schizophrénie. Revue Française de Psychiatrie et de Psychologie Médicale 2007;11:9–17.Google Scholar
43. Davidson, MC, Amso, D, Anderson, LC, Diamond, A. Development of cognitive control and executive functions from 4 to 13 years: evidence from manipulations of memory, inhibition, and task switching. Neuropsychologia 2006;44:2037–2078.CrossRefGoogle ScholarPubMed
44. Diamond, A, Barnett, WS, Thomas, J, Munro, S. Preschool program improves cognitive control. Science 2007;318:1387–1388.CrossRefGoogle ScholarPubMed
45. Zarchi, O, Diamond, A, Weinberger, R et al. A comparative study of the neuropsychiatric and neurocognitive phenotype in two microdeletion syndromes: Velocardiofacial (22q11.2 deletion) and Williams (7q11.23 deletion) syndromes). Eur Psychiatry 2014;29:203–210.CrossRefGoogle ScholarPubMed
46. Chan, RCK, Chen, EYH, Law, CW. Specific executive dysfunction in patients with first-episode medication-naîve schizophrenia. Schizophr Res 2006;82:51–64.Google Scholar
47. Frangou, S. Cognitive function in early onset schizophrenia: a selective review. Front Hum Neurosci 2010;3:79.Google ScholarPubMed
48. Pedersen, A, Koelkebeck, K, Brandt, M et al. Theory of mind in patients with schizophrenia: is mentalizing delayed? Schizophr Res 2012;137:224–229.CrossRefGoogle ScholarPubMed
49. Moriguchi, Y, Ohnishi, T, Mori, T, Matsuda, H, Komaki, G. Changes of brain activity in the neural substrates for theory of mind during childhood and adolescence. Psychiatry Clin Neurosci 2007;61:355–363.Google Scholar
50. Pickup, GJ. Relationship between theory of mind and executive function in schizophrenia: a systematic review. Psychopathology 2008;41:206–213.CrossRefGoogle ScholarPubMed
51. Frith, CD. Schizophrenia and theory of mind: editorial. Psychol Med 2004;34:385–389.Google Scholar
52. Abdel-Hamid, M, Lehmkämper, C, Sonntag, C, Juckel, G, Daum, I, Brüne, M. Theory of mind in schizophrenia: the role of clinical symptomatology and neurocognition in understanding other people’s thoughts and intentions. Psychiatry Res 2009;165:19–26.Google Scholar
53. Brune, M. ‘Theory of Mind’ in schizophrenia: a review of the literature. Schizophr Bull 2005;31:21–42.Google Scholar
54. Greig, TC, Bryson, GJ, Bell, MD. Theory of mind performance in schizophrenia: diagnostic, symptom, and neuropsychological correlates. J Nerv Ment Dis 2004;192:12–18.CrossRefGoogle ScholarPubMed
55. Shamay-Tsoory, SG, Shur, S, Barcai-Goodman, L, Medlovich, S, Harari, H, Levkovitz, Y. Dissociation of cognitive from affective components of theory of mind in schizophrenia. Psychiatry Res 2007;149:11–23.CrossRefGoogle ScholarPubMed
56. Remberk, B, Namysłowska, I, Rybakowski, F. Cognition and communication dysfunctions in early-onset schizophrenia: effect of risperidone. Prog Neuropsychopharmacol Biol Psychiatry 2012;39:348–354.Google Scholar
57. Hassan, GAM, Taha, GRA. Long term functioning in early onset psychosis: two years prospective follow-up study. Behav Brain Funct 2011;30:7–28.Google Scholar
58. Remschmidt, H. Early-onset schizophrenia as a progressive-deteriorating developmental disorder: evidence from child psychiatry. J Neural Transm 2002;109:101–117.CrossRefGoogle ScholarPubMed