Social performance is more closely associated with theory of mind and autobiographical memory than with psychopathological symptoms in clinically stable patients with schizophrenia-spectrum disorders.

The purpose of this study was to examine the association of deficits in theory of mind ability (ToM), deficits in recalling autobiographical memories (AM) and social performance in patients with psychosis. Furthermore, the study aimed to investigate if deficits in ToM and AM are better predictors of social performance than psychopathological symptoms and other neurocognitive variables. In a cross-sectional design, patients with schizophrenia-spectrum disorders (n=55) and healthy controls (n=45) completed a ToM movie paradigm in which they had to infer the characters' intentions and emotions in movies displaying social situations and a first- and second-order false belief ToM paradigm. Recall of AM was investigated using a structured interview. Social performance was assessed in a standardized role-play situation, which was later rated by trained raters, blind to diagnosis. Deficits in AM were associated with deficits in the ability to infer intentions of movie characters and in social performance in patients with schizophrenia-spectrum disorders. ToM ability to infer emotions of movie characters and recalling of AM were better predictors of social performance than psychopathological symptoms and other neurocognitive deficits. The results suggest that interventions aiming to enhance ToM deficits and deficits in AM might result in improvement of social performance. Copyright 2009 Elsevier Ltd. All rights reserved.