Deficit in theory of mind is a risk for relapse of major depression

Background: Recently, we reported that patients with depression have theory of mind (ToM) deficit during remission from acute episodes. ToM deficit means difficulty in social adjustment and thus may indicate a poorer prognosis. Methods: We evaluated ToM ability of 50 patients during remission from major depressive episodes. The patients were followed for 1 year and their outcome observed. Results: After 1 year, patients who had ToM deficit in a second order false question relapsed significantly more frequently as compared with patients who did not have a deficit (Fisher's exact test p < 0.0001; relative risk (RR) = 8.105; CI 2.020, 32.524). Significant differences were shown in scores of the Global Assessment of Functioning Scale (p < 0.0001) between the two groups. Conclusions: Patients with ToM deficit in second order false belief during remission may be a high risk group for recurrence and lower social function 1 year after recovering from a major depressive episode.