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Theory of Mind (ToM) and Depression - an explorative study including Narrative ToM-Performances


“Theory of Mind” contains seeing oneself and others in terms of mental states. Deficits of ToM-ability were found in patients with mood disorders, but have not yet been adequately explored. We assessed particularly ToM-ability in patients with chronic depression compared to a healthy control group. Using our new instrument “WE.EL”, which comprehends highly emotional and dynamic social interaction sequences in form of cartoon picture stories, we measured not only cognitive but also innovatively narrative ToM-abilities in order to 1) explore the ToM-expressions-structure, 2) analyse the kind of differences between groups and 3) characterise ToM-deficits more exactly.

Materials and methods

In 30 patients and 30 healthy controls ToM was assessed using Bróne's inventory for cognitive ToM-attainments (2003) and “WE.EL”, in which narrative ToM-performances were considered the better the more the stimulative nature of the sequence was captured.


Patients were significantly impaired in all ToM-tasks. Compared to healthy controls patients' narratives indicated a lack of mentalising affective states, emotions, intentions and reasons for actions and thoughts.


Patients with chronic depression seem to be severely afflicted in “reading” social interactions, clearly demonstrated by the deficient narrative ToM-attainments in WE.EL. A more appropriate method for assessing basic mentalising categories should be considered to understand depression more adequately and enhance psychotherapeutic treatment.


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Considerable correlations to neuropsychologic variables were not found.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Werden, D., Elikann, L., Linster, H. et al. Theory of Mind (ToM) and Depression - an explorative study including Narrative ToM-Performances. Ann Gen Psychiatry 7 (Suppl 1), S214 (2008).

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