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Schizophrenia patients believe mind impairments stem from difficulty understanding others

Dr. Tshetiz Dahal

General Physician, Clinical Researcher and Writer, Lugansk State Medical University, Luhansk Oblast, 93000 Luhansk, Ukraine



People suffering from schizophrenia (SZ) frequently exhibit problems in theory of mind (ToM) and speech output. While a link between ToM abilities and symptoms of thought disorder has been established, considerably less is known about other elements of speech output in SZ.

Study Design

In this case-control study, 25 stable outpatients with recent-onset SZ (27.1 years, 22 men) and 22 matched healthy controls (25.6 years, 16 men) participated in a collaborative, verbal production task with a real interaction partner. Blind raters rated how easy it was for participants to comprehend them (Facility evaluations), how fascinating they were to listen to (Interest ratings), and how expressive they were (Expression ratings) (Expressivity ratings). The Combined Stories Test and Sarfati's cartoon assignment were used to evaluate ToM. The PANSS five-factor version was used to assess symptoms.

Study Results

SZ obtained considerably lower scores for all three dimensions of their verbal performances (Facility, Interest, and Expressivity) when compared to healthy controls, despite the raters being blind to group membership. Interestingly, in the SZ group, Facility ratings were related to ToM performance, implying that SZ participants who have difficulty understanding others (ToM deficits) also make it difficult for others to understand them. Other interesting findings include a strong association between Expressivity and Interest ratings for both groups, as well as substantial correlations between Facility ratings and Cognitive/Disorganization symptoms, and Expressivity ratings with both Negative and Depression/Anxiety symptoms in SZ.


Studying speech production during genuine, collaborative social interactions may assist move beyond the individual approach to SZ deficiencies, allowing interaction partners to be involved in promoting more efficient communication for people with schizophrenia.

Keywords: Discourse, Dialogue, Social interaction, Psychosis, Communication, Theory of mind

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