Exploratory study of the association between insight and theory of mind in stable schizophrenia patients

• Autores: Esther Pousa Tomás
• Directores de la Tesis: Jordi Obiols Llandrich (dir. tes.), David Anthony S. (codir. tes.), Ada Inmaculada Ruiz Ripoll (codir. tes.)
• Lectura: En la Universitat Autònoma de Barcelona ( España ) en 2008
• Idioma: inglés
• Tribunal Calificador de la Tesis: André Aleman (presid.), Diego Palao (secret.), Rafael Penadés Rubio (voc.), Julio Sanjuan Chia (voc.), Judith Usall i Rodié (voc.)
• Materias:
  • Psicología
    • Patológica
      • Psicopatología
• Enlaces
  • Tesis en acceso abierto en:  TDX  DDD 
• Resumen

  • Background: Poor insight and impairment in Theory of Mind (ToM) reasoning are common in schizophrenia, predicting poorer clinical and functional outcomes. The presently study aimed to explore the relationship between these phenomena.

    Methods: 61 individuals with a DSM -IV diagnosis of schizophrenia during a stable phase were included. ToM was assessed using a picture-sequencing task developed by Langdon and Coltheart (1999), and insight with the Scale to Assess Unawareness of Mental Disorder (SUMD, Amador et. al., 1993). Multivariate linear regression analysis was carried out to estimate the predictive value of insight on ToM, taking into account several possible confounders and interaction variables.

    Results: No direct significant associations were found between any of the insight dimensions and ToM using bivariate analysis. However, a significant linear regression model which explained 48% of the variance in ToM was revealed in the multivariate analysis. This included the 5 insight dimensions and 3 interaction variables. Misattribution of symptoms-in aware patients with age at onset >20 years-and unawareness of need for medication-in patients with GAF>60-were significantly predictive of better ToM.

    Conclusion: Insight an ToM are two complex and distinct phenomena in schizophrenia. Relationships between them are mediated by psychosocial, clinical and neurocognitive variables. Intact ToM may be a prerequisite for aware patients to attribute their symptoms to causes other than mental illness, which could be in turn associated with denial of need for medication.