I can see what you feel, but I can't deal with it: Impaired theory of mind in depression

J Affect Disord. 2011 Jul;132(1-2):104-11. doi: 10.1016/j.jad.2011.02.010. Epub 2011 Mar 21.


Background: Even though unipolar depression is associated with considerably impaired social functioning, only a few studies so far have investigated Theory of Mind (ToM) abilities of unipolar depressed patients. Therefore, the main goal of this study is to examine whether depressed patients are impaired in their ToM as compared to healthy controls. Thereby, both aspects of ToM, i.e. decoding and reasoning, are examined separately.

Methods: Acutely depressed patients with unipolar affective disorder (n=24) and healthy controls (n=20) were examined with the 'Reading the Mind in the Eyes Test' (RMET) and the 'Movie for the Assessment of Social Cognition' (MASC) to address the two aspects of ToM.

Results: Patients compared to controls did not show impaired decoding ability in the RMET, but did show deficits in integrating contextual information about other people (reasoning) in the MASC. This impairment is independent of the mental state modality that had to be judged (emotional vs. cognitive).

Limitations: Possible differences between the diagnostic subgroups of depression, which play an important role in clarifying the opposing results concerning the association between ToM abilities and depression in the existing literature, have not been examined.

Conclusions: It is possible that the low level of social functioning associated with depression can be ascribed partially to a ToM deficit and should be addressed in the treatment of depression.

MeSH terms

  • Adult
  • Depressive Disorder, Major / classification
  • Depressive Disorder, Major / diagnosis*
  • Depressive Disorder, Major / psychology*
  • Dysthymic Disorder / classification
  • Dysthymic Disorder / diagnosis*
  • Dysthymic Disorder / psychology*
  • Emotions*
  • Facial Expression*
  • Female
  • Humans
  • Intention
  • Interpersonal Relations*
  • Male
  • Middle Aged
  • Neuropsychological Tests / statistics & numerical data
  • Pattern Recognition, Visual*
  • Personality Inventory / statistics & numerical data
  • Problem Solving*
  • Psychometrics
  • Reaction Time
  • Theory of Mind*