Qualitative Differences in Attribution of Mental States to Other People in Autism and Schizophrenia: What are the Tools for Differential Diagnosis?

J Autism Dev Disord. 2022 Mar;52(3):1283-1298. doi: 10.1007/s10803-021-05035-3. Epub 2021 Apr 28.

Abstract

The differential diagnosis between schizophrenia spectrum disorders (SSD) and autism spectrum disorders (ASD) remains an important clinical question, because they have overlap in clinical diagnosis. This study explored the differences between ASD (n = 44) and SSD patients (n = 59), compared to typically developing peers (n = 63), in completing an advanced Theory of Mind (ToM) task. The outcome found several differences between groups. The SSD patients showed greater difficulty in understanding social scenarios, while ASD individuals understood the stories, but did not correctly identify the protagonist's intention. The interesting aspect of the results is that some ToM stories are more informative about the mentalistic reasoning of the two clinical groups, namely, the stories that investigate pretend, persuasion, double bluff and ironic joke constructs.

Keywords: Autism spectrum disorder (ASD); Differential diagnosis; Schizophrenia spectrum disorders (SSD); Theory of Mind (ToM).

MeSH terms

  • Autism Spectrum Disorder* / diagnosis
  • Autistic Disorder*
  • Diagnosis, Differential
  • Humans
  • Schizophrenia* / diagnosis
  • Theory of Mind*