Theory of mind in schizophrenia: Meta-analysis
Open accessAbstract
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 < 0.001) 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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Prior meta-analyses of theory of mind have consistently found large deficits in schizophrenia.
“Theory of mind is one aspect of cognitive empathy, and meta-analyses of this construct have consistently shown large deficits in people with schizophrenia (Bora et al., 2009;Savla et al., 2013;Sprong et al., 2007).”
From Empathy in schizophrenia: A meta-analysis of the Interpersonal Reactivity Index (2017) · cites this paper as Sprong et al., 2007
The perspective-taking effect (g = .55) was smaller than those in prior theory-of-mind meta-analyses (1.10, .96, and 1.26).
“Our effect is somewhat smaller (g = .55,compared to 1.10, .96,and 1.26 found in the previous 3 cited meta-analyses).”
From Empathy in schizophrenia: A meta-analysis of the Interpersonal Reactivity Index (2017) · cites this paper as Sprong et al., 2007
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- Authors
- Sprong, M., Schothorst, P., Vos, E., Hox, J., & Van Engeland, H.
- Affiliations
- University Medical Center Utrecht (NL)
- Utrecht University (NL)
- Corresponding author
- Sprong, Mirjam
- ORCID
- Schothorst, Patricia
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2007-07
- Volume
- 191
- Issue
- 1
- Pages
- 5-13
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2096486434
- Cited by
- 832
- References
- 64
- Citations by year
- 2026: 21 · 2025: 22 · 2024: 18 · 2023: 31 · 2022: 24 · 2021: 40 · 2020: 45 · 2019: 56 · 2018: 57 · 2017: 51 · 2016: 53 · 2015: 59 · 2014: 57 · 2013: 72 · 2012: 54
- FWCI
- 5.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- theory of mind, schizophrenia, symptom subtypes, remission, trait markers, meta-analysis of effect sizes
- MeSH terms
- Adult, Child, Child, Preschool, Cognition Disorders, Humans, Schizophrenia, Schizophrenic Psychology, Severity of Illness Index, Social Perception, Statistics as Topic, Effect Modifier, Epidemiologic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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