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Theory of mind - not emotion recognition - mediates the relationship between executive functions and social functioning in patients with schizophrenia.

BACKGROUND
Dysfunction of social-cognitive abilities is one of the hallmark features of schizophrenia and is associated with neurocognition and social functioning. The Green and Nuechterlein model proposed that social cognition mediates the relationship between neurocognition and functional outcome. We tested this hypothesis in schizophrenia patients in the everyday clinical setting.


SUBJECTS AND METHODS
Social cognition, executive function and social functioning were assessed in a group of 43 patients with schizophrenia or schizoaffective disorder using a range of measures.


RESULTS
Theory of mind was associated with executive functions and social functioning. Results of our mediation analysis suggested that the relationship between executive functions and social functioning was mediated by theory of mind. No relationships between emotion recognition and the domains of social functioning were found.


CONCLUSIONS
In line with prior research, zero-order associations were found between theory of mind and social functioning. Theory of mind was a mediator of the relationships between neurocognition and social functioning. Our results suggest that theory of mind should be a potential target of interventions to improve social functioning.