Theory of mind and language comprehension in schizophrenia

Background: Theory of mind (ToM) is the natural ability to attribute/infer mental states about ourselves and others. The study of the limits of this capacity in autism-spectrum disorders has been projected more recently to the case of schizophrenia. Method: We review the studies on ToM deficiency in schizophrenia, based on the link observed by Chris Frith between psychotic symptoms and mentalizing anomalies, with particular attention to the implications of ToM in linguistic communication in the field of figurative language comprehension. Results: The data support a connection between ToM deficits and psychotic symptoms. In schizophrenia, the deficit in ToM appears to be specific and not dependent on more general cognitive abilities, and according to the evidence examined, it resembles a trait more than a state condition. The analysis of results shows that anomalies in ToM have projections on pragmatic aspects of language comprehension. Conclusions: ToM deficits showed by schizophrenic patients are especially linked to difficulties in understanding figurative language, beyond the influence of intelligence and executive functions.