Theory of Mind in the Early Course of Schizophrenia

Theory of mind deficit is a core feature of schizophrenia and is considered a vulnerability marker of the disorder. The majority of studies measuring theory of mind in schizophrenia involve multiple-episode or chronic schizophrenia patients, and therefore it is important to delineate whether these deficits occur before or following illness-onset by assessing high-risk subjects (clinical high risk and ultra-high risk), early-onset psychosis, and first-degree relatives. We address the question of whether theory of mind impairment is specific or a facet of general cognitive impairment in these clinical populations, and incorporate genetic and neuroimaging studies on theory of mind. The review provides a succinct evaluation of the literature, discuss current limitations and propose future directions.