Damage And Intervention Of Theory Of Mind In Early-onset Schizophrenia

Objective In recent years, social cognitive of schizophrenia patients is a hot spot, TOM is an important part of social cognition, and they are closely related to adapt to the social life, however, many studies were focused on the adult schizophrenia patients, but compared with the adult schizophrenia patients, the early-onset schizophrenia with the characteristics of negative symptoms, illness repeatedly and lasting treatment, so that early-onset schizophrenia patients and their families not being able to shoulder increasing the economic burden and emotional. So the research about early-onset schizophrenia of social cognitive ability is profound, based on the test of the faux pas recognition task and ToM——PST two tests to investigate early-onset schizophrenia patients TOM ability, and on the basis of this study, to explore the use of group psychotherapy intervention to improve the TOM of early-onset schizophrenia patients.Methods (1) TOM:41 early-onset schizophrenia and 40 control match with age, gender, level of education, intelligence in the faux pas recognition task and ToM—PST, investigating subjects of cognitive TOM and affective TOM, first order belief, first order error belief, second order belief, second order error belief, third order error belief, sense of reality, reciprocity, fraud, detecting fraud. And to investigate the task of faux pas recognition and theory of mind ability scores and duration and symptom severity is even relevant. (2)Group psychotherapy:In this trail, totally 60 patients with early-onset schizophrenia were included and divided into the intervention group(n=30)and the health education group(n=30).The patients in the intervention group were offered 10 twice a week 2-hours sessions of group psychotherapy, and those in the control were offered group health education twice a week. All participants completed baseline measures and post-intervention measures with the eye emotion recognition and ToM— PST.Results Experiment one:?In faux pas recognition task, comparing with healthy subjects, EOS showed significantly less total scores (16.11±6.34 vs 20.86± 7.79,P<0.05)and subscores of understanding faux pas questions (9.88±4.11 vs 13.27 ±6.07,P<0.05).In faux pas recognition scores(6.72±2.60 vs 7.58±2.20) and control questions(9.83±0.44 vs 9.97±0.16)had no statistically significant difference (p>0.05). ?In ToM-PST task, early-onset schizophrenic patients also had significantly less total score(17.29±3.38 vs 21.48±1.73.P<0.01), subscores of understanding first order belief, first order error belief, second order belief, second order error belief, third order error belief, sense of reality, reciprocity, fraud, detecting fraud compared to normal controls had statistically significant difference (all P<0.05-0.01).?The correlation between clinical course time and PANSS score and its subscores of the theory of mind picture-sequencing and faux pas task was non-significant(p>0.05)except the subscores of understanding the first order belief (p<0.01)Experiment two:Totally 23 patients in the intervention group and 29 patients in the health education group finished the post-intervention measures. After 5-week intervention:?In intervention group, subscores of sad and fear emotion recognition, understanding first order error belief, second order error belief, third order error belief, sense of reality, detecting fraud compared to baseline had statistically significant difference, subscores of joy and anger emotion recognition, understanding first order belief, second order belief, reciprocity, fraud compared to baseline had no statistically significant difference.?In health education group, subscores of sad and fear and anger emotion recognition, understanding first order belief, second order belief, second order error belief, sense of reality, reciprocity, fraud, detecting fraud compared to baseline had no statistically significant difference, subscores joy of emotion recognition, understanding first order error belief, third order error belief, compared to baseline had statistically significant difference.Conclusion In faux pas recognition task, ability of identify faux pas sense was retain, ability of understand faux pas sense was impaired. The theory of mind was apparent damage in early onset schizophrenia and non-significant correlation with psychiatric symptoms. This study suggests the group psychotherapy could partially improve the theory of mind with early-onset schizophrenia, and promote their full recovery.