title: Mental state attribution in schizophrenia: what distinguishes patients with "poor" from patients with "fair" mentalising skills?
abstract: OBJECTIVE
  Although many patients with schizophrenia are impaired in mental states attribution abilities, a significant number perform within normal or near-normal ranges in mental state attribution tasks. No studies have analysed cognitive or behavioural differences between patients with - to some extent - preserved mental state attribution skills and those with poor mentalising abilities.
  
  
  METHODS
  To examine characteristics of "poor" and "fair" mentalisers, 58 patients with schizophrenia performed a mental state attribution task, a test of general intelligence, and two executive functioning tests. "Poor" and "fair" mentalising skills were defined according to a median-split procedure; the median score in the patient group was also within two standard deviations of the control group. In addition, patients' social behavioural skills and psychopathological profiles were rated.
  
  
  RESULTS
  Patients performing within normal or near normal ranges on the mental state attribution task had fewer social behavioural abnormalities than patients with poor mentalising abilities (even when controlled for intelligence), but did not differ in executive functioning. Fair mental state performers showed less disorganisation and excitement symptoms than poor performers. The degree of disorganisation mediated the influence of mental state attribution on social behavioural skills.
  
  
  CONCLUSIONS
  Schizophrenia patients with (partially) preserved mentalising skills have fewer behavioural problems in the social domain than patients with poor mentalising abilities. Conceptual disorganisation mediates the prediction of social behavioural skills through mentalising skills, suggesting that disorganised patients may require special attention regarding social-cognitive skills training.
authors.affiliation: Research Department of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, LWL University Hospital, Department of Psychiatry, Psychotherapy, and Preventive Medicine, Ruhr University Bochum, Germany. martin.bruene@rub.de
authors.forename: M
authors.initials: M
authors.lastname: Brüne
authors.forename: D
authors.initials: D
authors.lastname: Schaub
mesh_terms: D000328:Adult; D056344:Executive Function; D005260:Female; D006801:Humans; D007360:Intelligence; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D012938:Social Perception; D056345:Theory of Mind