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Mentalizing Errors in Patients with Schizophrenia Who Received Psychosocial Rehabilitation: a Case-Control Study

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Abstract

The main objective of this study was to evaluate the mentalizing performance of patients with schizophrenia who received daily psychosocial rehabilitation treatment compared with healthy controls. Differences in mentalizing performance between men and women, and the relationship between mentalizing deficits, cognitive impairment, symptoms, and global functioning of patients were also examined. A case-control study design was utilized (N = 95). Adults with schizophrenia were recruited from psychosocial rehabilitation clinics (n = 53) and healthy controls were recruited from the community (n = 42). Mentalizing was evaluated with the Movie for the Assessment of Social Cognition, an audiovisual measure with good ecological validity. Measures of cognitive functioning, symptoms, and global functioning were also administered. Patients exhibited significant mentalizing deficits. Specifically, patients made more undermentalizing errors and more no mentalizing errors compared with healthy controls. In patients and healthy controls, no differences were found between men and women in mentalizing abilities. In patients with schizophrenia, lower cognitive functioning (i.e., immediate and delayed verbal learning, verbal fluency, and processing speed) were associated with poorer mentalizing. In patients, processing speed explained 31% of the variance in total mentalizing errors and mentalizing deterioration was associated with poorer overall functioning. Psychosocial rehabilitation interventions in people with schizophrenia should consider mentalizing deficits (especially undermentalizing and no mentalizing difficulties) and their relationship with reduced processing speed in treatment delivery (e.g., direct and organized communication). Integration of treatments targeting mentalizing deficits in a psychosocial rehabilitation setting is recommended to improve functioning in schizophrenia.

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Contributors

All authors have seen, approved, and contributed significantly to this manuscript.

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Authors and Affiliations

  1. Relational Processes and Psychotherapy Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Campus Universitario, Carretera Madrid-Barcelona Km. 33,600, 28871, Alcalá de Henares, Madrid, Spain

    Nelson Andrade-González

  2. Moncayo Mental Health Centre, Tarazona, Aragón, Spain

    Miriam Sarasa

  3. Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain

    Araceli García-López & Guillermo Lahera

  4. Can Misses Hospital, Ibiza, Balearic Islands, Spain

    Israel Leonés

  5. Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, USA

    Tate F. Halverson

  6. Faculty of Medicine and Health Sciences, University of Alcalá, Campus Universitario, Carretera Madrid-Barcelona Km. 33,600, 28871, Alcalá de Henares, Madrid, Spain

    Guillermo Lahera

  7. IRyCIS. CIBERSAM, Madrid, Spain

    Guillermo Lahera

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  1. Nelson Andrade-González
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  2. Miriam Sarasa
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  3. Araceli García-López
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  4. Israel Leonés
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  5. Tate F. Halverson
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  6. Guillermo Lahera
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Corresponding authors

Correspondence to Nelson Andrade-González or Guillermo Lahera.

Ethics declarations

Human Participants

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Declarations of Interest

Dr. Andrade-González, Miss Sarasa, Miss García-López, Mr. Leones, and Miss Halverson, have no conflict of interest to declare.

Dr. Lahera has been a consultant to or has received honoraria or grants from Janssen-Cilag, Otsuka-Lundbeck, Lilly, Astra-Zeneca, CIBERSAM, and Instituto de Salud Carlos III.

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Andrade-González, N., Sarasa, M., García-López, A. et al. Mentalizing Errors in Patients with Schizophrenia Who Received Psychosocial Rehabilitation: a Case-Control Study. Psychiatr Q 92, 947–959 (2021). https://doi.org/10.1007/s11126-020-09863-x

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