© 2007 The Royal College of Psychiatrists
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Theory of mind in schizophrenia
Meta-analysis
Department of Child and Adolescent Psychiatry, University Medical Centre Utrecht
Faculty of Social Sciences, Department of Methodology and Statistics, Utrecht University
Department of Child and Adolescent Psychiatry, University Medical Centre, The Netherlands
Correspondence: Ms M. Sprong, Department of Child and Adolescent Psychiatry, University Medical Centre, Heidelberglaan 100, HPA01.468, 3508 GA Utrecht, The Netherlands. Email: m.sprong-2{at}umcutrecht.nl
Funding detailed in Acknowledgements
Background Mentalising impairment (an impaired ability to think about people in terms of their mental states) has frequently been associated with schizophrenia.
Aims To assess the magnitude of the deficit and analyse associated factors.
Method Twenty-nine studies of mentalising in schizophrenia (combined n=1518), published between January 1993 and May 2006, were included to estimate overall effect size. Study descriptors predicted to influence effect size were analysed using weighted regression-analysis techniques. Separate analyses were performed for symptom subgroups and task types.
Results The estimated overall effect size was large and statistically significant (d=–1.255, P<0.0001) and was not significantly affected by sample characteristics. All symptom subgroups showed significant mentalising impairment, but participants with symptoms of disorganisation were significantly more impaired than the other subgroups (P<0.01).
Conclusions This meta-analysis showed significant and stable mentalising impairment in schizophrenia. The finding that patients in remission are also impaired favours the notion that mentalising impairment represents a possible trait marker of schizophrenia.
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