Theory of mind and epilepsy: what clinical implications?

Epilepsia. 2013 Sep;54(9):1639-46. doi: 10.1111/epi.12255. Epub 2013 Jun 28.

Abstract

Purpose: Epilepsy can impair theory of mind (ToM), but the clinical significance of such a deficit is unknown. This study evaluated the influence of selective ToM deficits on self-appraisal, coping, and quality of life (QoL) in patients with focal epilepsy.

Methods: Data were collected from 66 patients with temporal or frontal lobe epilepsy, and from 42 healthy controls. The Faux Pas Task (FPT), Multiple Ability Self-report Questionnaire (MASQ), Coping Responses Inventory-Adult (CRI-Adult), and World Health Organization QoL 100 (WHOQoL 100) evaluated ToM, self-rated cognitive abilities, coping to stressful events, and QoL. Different tests and inventories assessed other cognitive functions, depression, and anxiety.

Key findings: Patients were impaired in the recognition and comprehension of social faux pas. The FPT scores contributed to predict the MASQ, CRI-Adult, and WHOQoL overall scores; the comprehension of others' mental states and interactions score exerted a prominent influence.

Significance: In patients with focal epilepsy, selective ToM deficits may have clinical implications, with specific influence on self-appraisal, coping, and overall QoL. ToM evaluation may contribute in explaining some psychobehavioral difficulties and to plan nonpharmacological treatment.

Keywords: Cognitive self-evaluation; Coping; Epilepsy; Psychobehavioral disturbances; Quality of life; Theory of mind.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cognition / physiology*
  • Cognition Disorders / psychology*
  • Comprehension / physiology
  • Epilepsy / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Quality of Life*
  • Social Behavior
  • Social Perception
  • Theory of Mind / physiology*
  • Young Adult