“Mentalising” and Executive Functioning in Schizophrenia: A Comparison between Forensic and Non-forensic Patients

Abstract

Previous studies in forensic patients with schizophrenia have shown that delinquent patients may outperform non-delinquent patients with regards to their ability to appreciate mental states. Findings were, however, confounded by a lack of control for neurocognitive functioning. We examined 33 forensic patients with schizophrenia regarding their mentalising abilities, intelligence, executive functioning and psychopathology. Results were compared with a non-forensic schizophrenia sample and a group of healthy controls. Both patient groups performed more poorly on most measures compared to controls. Forensic and non-forensic patients did not differ in task performance. In the forensic group mentalising correlated inversely with “excitement” and cognitive symptom scores of the PANSS. When “excitement” was co-varied out, forensic patients outperformed non-forensic patients with regards to their mentalising abilities. This study supports the hypothesis that schizophrenic patients with a criminal record are equally impaired in their ability to infer mental states compared to non-forensic patients, but for different reasons associated with a divergent psychopathological profile.