Theory of Mind Abilities and Insight Dimension in Patients with Obsessive-Compulsive Disorder and Schizophrenia


Basar Ayribas, Gozde Ayhan, Volkan Topcuoglu, Samet Kose, Kemal Sayar 





Background: The present study aims to compare Theory of Mind (ToM) traits and insight among healthy controls, patients with OCD, and patients with schizophrenia.


Methods: Participants were 38 patients with OCD, 37 patients with a schizophrenia diagnosis, and 38 healthy controls. Sociodemographic information of the participants was collected, and Reading Mind in the Eyes Test (RMET), First Order False Belief (FOFB ) and Second-Order False Belief (SOFB), Hinting Task (HT) and Strange Stories (SS), Brown Assessment of Beliefs Scale (BABS) and the Hamilton Depression Scale (HAM-D) were administered. All statistical analyzes were performed using IBM SPSS Statistics 24.0 for Windows. All variables were screened for accuracy of data entry, missing values, and homoscedasticity.


Results: The healthy controls were found to be better in cognitive and affective ToM tests compared to OCD and schizophrenia patients. In the same tests, OCD patients scored higher compared to schizophrenia patients. In terms of insight dimension; insight was not found to be significantly correlated with ToM task scores in OCD patients, but negative and statistically significant correlations were found between insight and ToM task scores in patients with schizophrenia.


Conclusions: This cross-sectional study suggested that OCD and schizophrenia patients have different ToM profiles and insight level mainly evident with better ToM abilities in OCD patients compared to schizophrenia patients.. Understanding of ToM abilities–psychopathology relationship will have important implications for assessing and developing treatment strategies in patients with OCD and schizophrenia for clinical psychiatrists. 


Keywords: Theory of mind, obsessive-compulsive disorder, schizophrenia, insight