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A systematic review and meta-analysis of implicit Theory of Mind in schizophrenia

Published online by Cambridge University Press:  01 September 2022

T. Csulak*
Affiliation:
University of Pécs, Department Of Psychiatry And Psychotherapy, Pécs, Hungary
A. Hajnal
Affiliation:
University of Pécs, Department Of Psychiatry And Psychotherapy, Pécs, Hungary
S. Kiss
Affiliation:
University of Pécs, Institute For Translational Medicine, Pécs, Hungary
F. Dembrovszky
Affiliation:
University of Pécs, Institute For Translational Medicine, Pécs, Hungary
Z. Sipos
Affiliation:
University of Pécs, Institute For Translational Medicine, Pécs, Hungary
M. Varjú-Solymár
Affiliation:
University of Pécs, Institute For Translational Medicine, Pécs, Hungary
M. Kovács
Affiliation:
University of Pécs, Department Of Psychiatry And Psychotherapy, Pécs, Hungary
M. Herold
Affiliation:
University of Pécs, Department Of Psychiatry And Psychotherapy, Pécs, Hungary
E. Varga
Affiliation:
University of Pécs, Department Of Paediatrics, Pécs, Hungary
P. Hegyi
Affiliation:
University of Pécs, Institute For Translational Medicine, Pécs, Hungary
T. Tényi
Affiliation:
University of Pécs, Department Of Psychiatry And Psychotherapy, Pécs, Hungary
R. Herold
Affiliation:
University of Pécs, Department Of Psychiatry And Psychotherapy, Pécs, Hungary
*
*Corresponding author.

Abstract

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Introduction

Everyday social interactions are based on Theory of Mind (ToM) or mentalizing, whose complex processes are involved in understanding, representing one’s own and other people’s mental states. ToM is supposed to have two systems. The implicit ToM seems to be a fast, automatic, non-verbal processing. The explicit ToM is characterized by a slower, but more flexible processing, which is mostly verbal, interpretative. Several studies have described explicit ToM deficit in schizophrenic patients. Less research has investigated implicit ToM in patients, however recently, there has been a growing number of articles examining implicit ToM of patients with schizophrenia.

Objectives

The aim of our systematic review and meta-analysis is to summarize the results of the implicit ToM in schizophrenia.

Methods

A systematic search was performed in four major databases. We included 11 publications. 7 studies; and 5 studies were included the quantitative synthesis and the qualitative synthesis, respectively.

Results

We found significant differences in accuracy, reaction time and brain activation patterns during implicit ToM between schizophrenic patients and controls. The systematic review revealed further alterations in visual scanning, cue fixation, face looking time, and difficulties in perspective taking.

Conclusions

Based on our results implicit ToM is affected in schizophrenia in addition to explicit ToM deficit. However, based on these results we cannot exclude the possibility, that implicit ToM or at least some elements of it might be relatively unaffected (e.g. detection of intentionality), however its effectiveness is limited by non-mentalizing deficits (e.g. certain neurocognitive impairments). Our results may have important implications for the remediation of mentalizing skills.

Disclosure

The research is supported by the Hungarian National Excellence Centrum Grant (FIKP II) and Hungarian Brain Research Program (KTIA-13-NAP-A-II/12).

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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