- Email: [email protected]
P.3.b.007 Insight in schizophrenia: the role of neurocognitive functioning in relation to psychopathology
S466
P.3.b. Psychotic disorders and treatment − Psychotic disorders (clinical)
Conclusions: According to previous studies, we observed that ToM processing is negatively correlated with negative symptoms. This correlation gets stronger when the most experiential aspects of negative symptoms are considered. This would support the hypothesis that social cognition impairment and the deficit syndrome are core elements of schizophrenia. In fact, the most experiential areas of the two constructs are those which are closer in phenomenological terms. Further studies should be conducted to assess this interrelation. References [1] Bora E., Pantelis C. 2013 Theory of mind impairments in first-episode psychosis, individuals at ultra-high risk for psychosis and in firstdegree relatives of schizophrenia: systematic review and meta-analysis. Schizophr Res 144, 31−36. [2] Csulky G., Polg´ar P., L´aszl´o T., Benkovits J., R´ethely J. 2014 Theory of mind impairments in patients with deficit schizophrenia. Compr Psychiatry 55, 349–356. [3] Llerena, K., Park, G.P., McCarthy, J.M., Couture, S.M., Bennet, M.E., Blanchard, J.J. 2013 The Motivation and Pleasure Scale–Self-Report (MAP-SR): Reliability and validity of a self-report measure of negative symptoms. Compr Psychiatry 54, 568–574.
P.3.b.006 The effect of thought disorders on psychosocial functioning in schizophrenia B. Yalincetin1 ° , H. Ulas2 , T. Binbay2 , B.B. Akdede2 , K. Alptekin2 Eylul University, Department of Neuroscience, Izmir, Turkey; 2 Dokuz Eyl¨ul University − School of Medicine, Department of Psychiatry, Izmir, Turkey 1 Dokuz
Objective: In severe mental disorders such as schizophrenia, psychosocial functioning is an important dimension as well along with symptoms in phases of diagnosis and assessment. Psychosocial functioning of patients with schizophrenia may not improve entirely, even the remission of the symptoms have been attained [1]. Disconnected speech was found to be associated with socially impolite behavior and verbal underproductivity was found to be associated with social disengagement [2]. Idiosyncratic thinking was related to occupational functioning [3]. The aim of this study is to investigate the effect of thought disorders on psychosocial functioning in schizophrenia. Methods: The study included 117 patients (40 female, 77 male) selected from the Schizophrenia Outpatient Unit of Psychiatry Department of Dokuz Eylul University, School of Medicine. The patients were diagnosed as schizophrenia according to DSM-IV. Severity of the schizophrenia symptoms was assessed with the Positive and Negative Syndrome Scale (PANSS). Thought disorders were evaluated using the Thought and Language Index (TLI) and the Personal and Social Performance Scale (PSP) was used for detecting psychosocial functioning. The Thought and Language Index comprises of impoverishment of thought and disorganization of thought subscales. Impoverishment of thought category includes poverty of speech, weakening of goal and perseveration. Disorganization of thought category includes looseness, peculiar word use, peculiar sentence construction, peculiar logic and distractibility. The Personal and Social Performance Scale examines the four dimensions of psychosocial functioning; socially useful activities (including occupation and education), personal and social relationships, self-care, disturbing and aggressive behaviours. We used linear regression to determine the effect of thought disorders on psychosocial functioning domains while controlling for sociodemographic and and other clinical characteristics.
Results: Poverty of speech and peculiar logic were found to be the strongest statistically significant predictors of socially useful activities (B = 0.22, t = 2.35, p = 0.02 and B = 0.20, t = 2.24, p = 0.03 respectively) and personal and social relationships (B = 0.34, t = 3.08, p = 0.003 and B = 0.27, t = 2.50, p = 0.014 respectively) in linear regression analyses. Self-care was found to be associated with poverty of speech (B = 0.25, t = 2.10, p = 0.04). Disturbing and aggressive behaviours were found to be predicted by poverty of speech (B = 0.34, t = 2.96, p = 0.004) and peculiar sentence construction (B = 0.28, t = 2.56, p = 0.01). Conclusion: These findings suggest that psychosocial functioning is influenced by positive and negative thought disorders in patients with schizophrenia. Poverty of speech and peculiar logic contributed to the prediction of socially useful activities (including occupation and education) and personal and social relationships. Self-care seems to be influenced by a single domain of thought disorders, poverty of speech. Disturbing and aggressive behaviours are affected by poverty of speech and peculiar sentence construction. Peculiar logic and peculiar sentence construction representing positive thought disorder are associated with some specific domains of psychosocial functioning. Poverty of speech representing negative thought disorder seems to help predict psychosocial functioning in all dimensions. References [1] Robinson, D.G., Woerner, M.G., McMeniman, M., Mendelowitz, A., Bilder, R.M., 2004 Symptomatic and functional recovery from a first episode of schizophrenia or schizoaffective disorder. Am J Psychiatry 161, 473–479. [2] Bowie, C.R., Harvey, P.D., 2008 Communication abnormalities predict functional outcomes in chronic schizophrenia: Differential associations with social and adaptive functions. Schizophrenia Research 103, 240– 247. [3] Racenstein, J.M., Penn, D., Harrow, M., Schleser, R. 1999 Thought disorder and psychosocial functioning in schizophrenia: The concurrent and predictive relationships. J. Nerv. Ment. Disabil 187(5), 281–289.
P.3.b.007 Insight in schizophrenia: the role of neurocognitive functioning in relation to psychopathology T. Youn1 ° , I. Chung1 , S.S. Hwang2 , Y.M. Ahn3 , Y.S. Kim1 University International Hospital, Neuropsychiatry, Goyang, South-Korea; 2 Chonnam National University, Department Psychology, Gwangju, South-Korea; 3 Seoul National University Hospital, Department of Neuropsychiatry, Seoul, South-Korea 1 Dongguk
Purpose: The neuropsychological deficit model of insight in schizophrenia conceives the lack of awareness of illness as the product of neurocognitive impairments or deficits. In our study, we examined the relationships among psychopathology, neurocognitive function, and insight to examine the validity of such a model. Method: Fifty-six Korean patients in acute stage of schizophrenia completed the Positive and Negative Syndrome Scale and a comprehensive neurocognitive test battery including variables pertaining to general intelligence, digit span, vocabulary, arithmetic, picture arrangement, and block design, controlled oral word association test (COWAT), verbal and nonverbal memory, attention, and psychomotor speed at the baseline, 8-weeks, and 1-year. We first examined the cross-sectional and longitudinal relationships among psychopathology (positive, negative, autistic preoccupation and activation symptoms), neurocognitive function, and insight variables and then constructed prediction models of
P.3.b. Psychotic disorders and treatment − Psychotic disorders (clinical) insight to test for their relative fit. Using structural equation modeling method, we then constructed exploratory prediction models of insight designating neurocognitive measures as intermediary variables between psychopathology and insight, following the rationale that psychopathology causes neurocognitive deficits which is turn contribute to the lack of insight. Results: At the baseline, only COWAT perseverative response showed significant correlations with activation, positive, and autistic preoccupation factors of the PANSS. K-WAIS picture arrangement showed significant correlations with only activation and positive factors while CPT SE reaction time was correlated with only activation and autistic preoccupation factors. At 8-week, only CPT SE reaction time significantly correlated with positive and autistic preoccupation factors. In terms of longitudinal changes, COWAT perseverative response was significantly correlated with negative, activation, and positive symptoms. Changes in K-WAIS picture arrangement and CPT SE reaction time on the other hand were not significantly correlated with the changes in any symptom domains. Significance of relationships was limited to baseline to 8-week assessments and the following model construction was carried out for those assessments. In constructing the predictive model of insight, the cognitive variables of the K-WAIS picture arrangement, COWAT perseverative response, and CPT SE reaction time were designated as the intermediary variable between insight and negative, positive, autistic preoccupation, and activation factors, respectively. The cross-sectional prediction model at baseline that included COWAT perseverative response explained the most variance of insight (R2 = 0.55) and had a markedly higher predictive power on insight (beta = 0.27) as compared with that of K-WAIS picture arrangement (beta = −0.04) and CPT SE reaction time (beta = 0.05). The total variance (R2) of insight explained without the inclusion of COWAT perseverative response was 0.47. These results demonstrated the partial mediating role COWAT perseverative response between these symptoms and insight, but not other variables. Similar results were obtained in baseline to 8-week longitudinal change. Conclusion: Overall, the relationship between neurocognitive function and insight was modest at best and limited to acute stage of illness. The relationship between COWAT perseverative response and insight warrant further investigation. References [1] Aleman, A., Agrawal, N., Morgan, K.D., David, A.S., 2006. Insight in psychosis and neuropsychological function: Meta-analysis. Br J Psychiatry 189, 204–212. [2] Joseph, B., Narayanaswamy, J.C., Venkatasubramanian, G., 2015. Insight in Schizophrenia: Relationship to Positive, Negative and Neurocognitive Dimensions, Indian J Psychol Med. 37. 5−11.
P.3.b.008 Perception of sarcasm in the course of psychosis and its correlation to clinical symptomatology E. Ntouros1 ° , E. Karanikas1 , D. Nasioudis1 , A. Tsoura2 , V.P. Bozikas2 , G. Garyfallos3 1 424 Military Hospital − Thessaloniki − Greece, Psychiatric Clinic, Thessaloniki, Greece; 2 Aristotle University of Thessaloniki, A Psychiatric Cinic, Thessaloniki, Greece; 3 Aristotle University of Thessaloniki, B Psychiatric Cinic, Thessaloniki, Greece Purpose of the study: It is well known that patients suffering from psychotic spectrum disorders are limited in their Theory of
S467
Mind (ToM) abilities in general, sarcasm perception being one of them [1]. These impairments are found in the course of psychosis and evidence suggests those are linked to psychotic symptoms and are present even before the begging of overt symptomatology [2]. Some authors even suggest the correlation of sarcasm perception to poor empathy and functional outcome in schizophrenia [3]. Our goal was to investigate the sarcasm perception abilities in samples of patients in the course of psychosis (from first episode to chronic patients) and its correlation to clinical symptomatology. Methods used: We examined 32 First Episode Psychosis patients (FEP), 16 patients with a diagnosis of chronic schizophrenia (CHRONIC), and 23 healthy controls (HEALTHY). We used the Perception of Social Inference Test (PESIT) to measure Theory of Mind and Positive and Negative Symptom Scale (PANNS) to assess psychotic symptomatology. We calculated total Theory of Mind score (PESIT ToM score) and separately Sarcasm perception score (ToM Sarcasm score). PANSS was calculated with its new 5-factor parameters (Positive, Negative, Cognitive, Excitement and Depressive Factor). FEP patients were examined with PESIT soon after their admission and were under medication for a few weeks only. Summary of results: PESIT ToM score and ToM Sarcasm score were statistically significant different between 3 groups [Kruskal-Wallis test: PESIT ToM score (p < 0.001) and ToM sarcasm score (p < 0.001)]. The PESIT ToM scores were for HEALTHY group (60.57), for FEP group (49.25) and for CHRONIC group (44.19). As far as ToM Sarcasm scores were concerned the results were for HEALTHY group (31.35), for FEP group (23.66) and for CHRONIC group (22.25). There was no difference in PESIT ToM and ToM Sarcasm scores between the patient groups [Post hoc analysis with Mann Whitney U revealed p = 0.084 for PESIT ToM and p = 0.584 for ToM Sarcasm. The only statistically significant correlations of ToM Sarcasm were with PANSS Excitement Factor in FEP group (p = 0.037) and PANSS Cognitive Factor in CHRONIC group (p = 0.016). Conclusions: Sarcasm perception and ToM ability in general were found impaired in FEP and Chronic patients compared to healthy controls but no difference was found between the patient groups. This adds to the notion that Sarcasm perception and ToM deficits are trait characteristics of psychosis which is in accordance with results of other investigators [1]. The correlation Sarcasm perception with some psychotic symptoms is also confirmed and is underlining the importance of differentiation of endofenotypes in psychotic disorders and schizophrenia. The importance of endofenotypes detection could be the clinical tool for the better assessment and management of psychosis and schizophrenia in the future. Sarcasm perception as part of the Theory of Mind abilities can contribute to the early detection of at risk persons. References [1] Green, M.F., Bearden, C.E., Cannon, T.D., Fiske, A.P., Hellemann, G.S., Horan, W.P., Kee, K., Kern, R.S., Lee, J., Sergi, M.J., Subotnik, K.L., Sugar, C.A., Ventura, J., Yee, C.M., Nuechterlein, K.H., 2011. Social Cognition in Schizophrenia, Part 1: Performance Across Phase of Illness. Schizophrenia Bulletin 38, 854−64. [2] Abdel-Hamid, M., Lehmkamper, C., Sonntag, C., Juckel, G., Daum, I., Brune, M., 2009. Theory of mind in schizophrenia: the role of clinical symptomatology and neurocognition in understanding other people’s thoughts and intentions. Psychiatry Research 165, 19−26. [3] Sparks, A., McDonald, S., Lino, B., O’Donnell, M., Green, M.J., 2010, Social cognition, empathy and functional outcome in schizophrenia. Schizophrenia Research 122, 172−8.
P.3.b. Psychotic disorders and treatment − Psychotic disorders (clinical)
Conclusions: According to previous studies, we observed that ToM processing is negatively correlated with negative symptoms. This correlation gets stronger when the most experiential aspects of negative symptoms are considered. This would support the hypothesis that social cognition impairment and the deficit syndrome are core elements of schizophrenia. In fact, the most experiential areas of the two constructs are those which are closer in phenomenological terms. Further studies should be conducted to assess this interrelation. References [1] Bora E., Pantelis C. 2013 Theory of mind impairments in first-episode psychosis, individuals at ultra-high risk for psychosis and in firstdegree relatives of schizophrenia: systematic review and meta-analysis. Schizophr Res 144, 31−36. [2] Csulky G., Polg´ar P., L´aszl´o T., Benkovits J., R´ethely J. 2014 Theory of mind impairments in patients with deficit schizophrenia. Compr Psychiatry 55, 349–356. [3] Llerena, K., Park, G.P., McCarthy, J.M., Couture, S.M., Bennet, M.E., Blanchard, J.J. 2013 The Motivation and Pleasure Scale–Self-Report (MAP-SR): Reliability and validity of a self-report measure of negative symptoms. Compr Psychiatry 54, 568–574.
P.3.b.006 The effect of thought disorders on psychosocial functioning in schizophrenia B. Yalincetin1 ° , H. Ulas2 , T. Binbay2 , B.B. Akdede2 , K. Alptekin2 Eylul University, Department of Neuroscience, Izmir, Turkey; 2 Dokuz Eyl¨ul University − School of Medicine, Department of Psychiatry, Izmir, Turkey 1 Dokuz
Objective: In severe mental disorders such as schizophrenia, psychosocial functioning is an important dimension as well along with symptoms in phases of diagnosis and assessment. Psychosocial functioning of patients with schizophrenia may not improve entirely, even the remission of the symptoms have been attained [1]. Disconnected speech was found to be associated with socially impolite behavior and verbal underproductivity was found to be associated with social disengagement [2]. Idiosyncratic thinking was related to occupational functioning [3]. The aim of this study is to investigate the effect of thought disorders on psychosocial functioning in schizophrenia. Methods: The study included 117 patients (40 female, 77 male) selected from the Schizophrenia Outpatient Unit of Psychiatry Department of Dokuz Eylul University, School of Medicine. The patients were diagnosed as schizophrenia according to DSM-IV. Severity of the schizophrenia symptoms was assessed with the Positive and Negative Syndrome Scale (PANSS). Thought disorders were evaluated using the Thought and Language Index (TLI) and the Personal and Social Performance Scale (PSP) was used for detecting psychosocial functioning. The Thought and Language Index comprises of impoverishment of thought and disorganization of thought subscales. Impoverishment of thought category includes poverty of speech, weakening of goal and perseveration. Disorganization of thought category includes looseness, peculiar word use, peculiar sentence construction, peculiar logic and distractibility. The Personal and Social Performance Scale examines the four dimensions of psychosocial functioning; socially useful activities (including occupation and education), personal and social relationships, self-care, disturbing and aggressive behaviours. We used linear regression to determine the effect of thought disorders on psychosocial functioning domains while controlling for sociodemographic and and other clinical characteristics.
Results: Poverty of speech and peculiar logic were found to be the strongest statistically significant predictors of socially useful activities (B = 0.22, t = 2.35, p = 0.02 and B = 0.20, t = 2.24, p = 0.03 respectively) and personal and social relationships (B = 0.34, t = 3.08, p = 0.003 and B = 0.27, t = 2.50, p = 0.014 respectively) in linear regression analyses. Self-care was found to be associated with poverty of speech (B = 0.25, t = 2.10, p = 0.04). Disturbing and aggressive behaviours were found to be predicted by poverty of speech (B = 0.34, t = 2.96, p = 0.004) and peculiar sentence construction (B = 0.28, t = 2.56, p = 0.01). Conclusion: These findings suggest that psychosocial functioning is influenced by positive and negative thought disorders in patients with schizophrenia. Poverty of speech and peculiar logic contributed to the prediction of socially useful activities (including occupation and education) and personal and social relationships. Self-care seems to be influenced by a single domain of thought disorders, poverty of speech. Disturbing and aggressive behaviours are affected by poverty of speech and peculiar sentence construction. Peculiar logic and peculiar sentence construction representing positive thought disorder are associated with some specific domains of psychosocial functioning. Poverty of speech representing negative thought disorder seems to help predict psychosocial functioning in all dimensions. References [1] Robinson, D.G., Woerner, M.G., McMeniman, M., Mendelowitz, A., Bilder, R.M., 2004 Symptomatic and functional recovery from a first episode of schizophrenia or schizoaffective disorder. Am J Psychiatry 161, 473–479. [2] Bowie, C.R., Harvey, P.D., 2008 Communication abnormalities predict functional outcomes in chronic schizophrenia: Differential associations with social and adaptive functions. Schizophrenia Research 103, 240– 247. [3] Racenstein, J.M., Penn, D., Harrow, M., Schleser, R. 1999 Thought disorder and psychosocial functioning in schizophrenia: The concurrent and predictive relationships. J. Nerv. Ment. Disabil 187(5), 281–289.
P.3.b.007 Insight in schizophrenia: the role of neurocognitive functioning in relation to psychopathology T. Youn1 ° , I. Chung1 , S.S. Hwang2 , Y.M. Ahn3 , Y.S. Kim1 University International Hospital, Neuropsychiatry, Goyang, South-Korea; 2 Chonnam National University, Department Psychology, Gwangju, South-Korea; 3 Seoul National University Hospital, Department of Neuropsychiatry, Seoul, South-Korea 1 Dongguk
Purpose: The neuropsychological deficit model of insight in schizophrenia conceives the lack of awareness of illness as the product of neurocognitive impairments or deficits. In our study, we examined the relationships among psychopathology, neurocognitive function, and insight to examine the validity of such a model. Method: Fifty-six Korean patients in acute stage of schizophrenia completed the Positive and Negative Syndrome Scale and a comprehensive neurocognitive test battery including variables pertaining to general intelligence, digit span, vocabulary, arithmetic, picture arrangement, and block design, controlled oral word association test (COWAT), verbal and nonverbal memory, attention, and psychomotor speed at the baseline, 8-weeks, and 1-year. We first examined the cross-sectional and longitudinal relationships among psychopathology (positive, negative, autistic preoccupation and activation symptoms), neurocognitive function, and insight variables and then constructed prediction models of
P.3.b. Psychotic disorders and treatment − Psychotic disorders (clinical) insight to test for their relative fit. Using structural equation modeling method, we then constructed exploratory prediction models of insight designating neurocognitive measures as intermediary variables between psychopathology and insight, following the rationale that psychopathology causes neurocognitive deficits which is turn contribute to the lack of insight. Results: At the baseline, only COWAT perseverative response showed significant correlations with activation, positive, and autistic preoccupation factors of the PANSS. K-WAIS picture arrangement showed significant correlations with only activation and positive factors while CPT SE reaction time was correlated with only activation and autistic preoccupation factors. At 8-week, only CPT SE reaction time significantly correlated with positive and autistic preoccupation factors. In terms of longitudinal changes, COWAT perseverative response was significantly correlated with negative, activation, and positive symptoms. Changes in K-WAIS picture arrangement and CPT SE reaction time on the other hand were not significantly correlated with the changes in any symptom domains. Significance of relationships was limited to baseline to 8-week assessments and the following model construction was carried out for those assessments. In constructing the predictive model of insight, the cognitive variables of the K-WAIS picture arrangement, COWAT perseverative response, and CPT SE reaction time were designated as the intermediary variable between insight and negative, positive, autistic preoccupation, and activation factors, respectively. The cross-sectional prediction model at baseline that included COWAT perseverative response explained the most variance of insight (R2 = 0.55) and had a markedly higher predictive power on insight (beta = 0.27) as compared with that of K-WAIS picture arrangement (beta = −0.04) and CPT SE reaction time (beta = 0.05). The total variance (R2) of insight explained without the inclusion of COWAT perseverative response was 0.47. These results demonstrated the partial mediating role COWAT perseverative response between these symptoms and insight, but not other variables. Similar results were obtained in baseline to 8-week longitudinal change. Conclusion: Overall, the relationship between neurocognitive function and insight was modest at best and limited to acute stage of illness. The relationship between COWAT perseverative response and insight warrant further investigation. References [1] Aleman, A., Agrawal, N., Morgan, K.D., David, A.S., 2006. Insight in psychosis and neuropsychological function: Meta-analysis. Br J Psychiatry 189, 204–212. [2] Joseph, B., Narayanaswamy, J.C., Venkatasubramanian, G., 2015. Insight in Schizophrenia: Relationship to Positive, Negative and Neurocognitive Dimensions, Indian J Psychol Med. 37. 5−11.
P.3.b.008 Perception of sarcasm in the course of psychosis and its correlation to clinical symptomatology E. Ntouros1 ° , E. Karanikas1 , D. Nasioudis1 , A. Tsoura2 , V.P. Bozikas2 , G. Garyfallos3 1 424 Military Hospital − Thessaloniki − Greece, Psychiatric Clinic, Thessaloniki, Greece; 2 Aristotle University of Thessaloniki, A Psychiatric Cinic, Thessaloniki, Greece; 3 Aristotle University of Thessaloniki, B Psychiatric Cinic, Thessaloniki, Greece Purpose of the study: It is well known that patients suffering from psychotic spectrum disorders are limited in their Theory of
S467
Mind (ToM) abilities in general, sarcasm perception being one of them [1]. These impairments are found in the course of psychosis and evidence suggests those are linked to psychotic symptoms and are present even before the begging of overt symptomatology [2]. Some authors even suggest the correlation of sarcasm perception to poor empathy and functional outcome in schizophrenia [3]. Our goal was to investigate the sarcasm perception abilities in samples of patients in the course of psychosis (from first episode to chronic patients) and its correlation to clinical symptomatology. Methods used: We examined 32 First Episode Psychosis patients (FEP), 16 patients with a diagnosis of chronic schizophrenia (CHRONIC), and 23 healthy controls (HEALTHY). We used the Perception of Social Inference Test (PESIT) to measure Theory of Mind and Positive and Negative Symptom Scale (PANNS) to assess psychotic symptomatology. We calculated total Theory of Mind score (PESIT ToM score) and separately Sarcasm perception score (ToM Sarcasm score). PANSS was calculated with its new 5-factor parameters (Positive, Negative, Cognitive, Excitement and Depressive Factor). FEP patients were examined with PESIT soon after their admission and were under medication for a few weeks only. Summary of results: PESIT ToM score and ToM Sarcasm score were statistically significant different between 3 groups [Kruskal-Wallis test: PESIT ToM score (p < 0.001) and ToM sarcasm score (p < 0.001)]. The PESIT ToM scores were for HEALTHY group (60.57), for FEP group (49.25) and for CHRONIC group (44.19). As far as ToM Sarcasm scores were concerned the results were for HEALTHY group (31.35), for FEP group (23.66) and for CHRONIC group (22.25). There was no difference in PESIT ToM and ToM Sarcasm scores between the patient groups [Post hoc analysis with Mann Whitney U revealed p = 0.084 for PESIT ToM and p = 0.584 for ToM Sarcasm. The only statistically significant correlations of ToM Sarcasm were with PANSS Excitement Factor in FEP group (p = 0.037) and PANSS Cognitive Factor in CHRONIC group (p = 0.016). Conclusions: Sarcasm perception and ToM ability in general were found impaired in FEP and Chronic patients compared to healthy controls but no difference was found between the patient groups. This adds to the notion that Sarcasm perception and ToM deficits are trait characteristics of psychosis which is in accordance with results of other investigators [1]. The correlation Sarcasm perception with some psychotic symptoms is also confirmed and is underlining the importance of differentiation of endofenotypes in psychotic disorders and schizophrenia. The importance of endofenotypes detection could be the clinical tool for the better assessment and management of psychosis and schizophrenia in the future. Sarcasm perception as part of the Theory of Mind abilities can contribute to the early detection of at risk persons. References [1] Green, M.F., Bearden, C.E., Cannon, T.D., Fiske, A.P., Hellemann, G.S., Horan, W.P., Kee, K., Kern, R.S., Lee, J., Sergi, M.J., Subotnik, K.L., Sugar, C.A., Ventura, J., Yee, C.M., Nuechterlein, K.H., 2011. Social Cognition in Schizophrenia, Part 1: Performance Across Phase of Illness. Schizophrenia Bulletin 38, 854−64. [2] Abdel-Hamid, M., Lehmkamper, C., Sonntag, C., Juckel, G., Daum, I., Brune, M., 2009. Theory of mind in schizophrenia: the role of clinical symptomatology and neurocognition in understanding other people’s thoughts and intentions. Psychiatry Research 165, 19−26. [3] Sparks, A., McDonald, S., Lino, B., O’Donnell, M., Green, M.J., 2010, Social cognition, empathy and functional outcome in schizophrenia. Schizophrenia Research 122, 172−8.