Theory of Mind in non-autistic psychiatric disorders of childhood and adolescence

The presence of Theory of Mind (ToM) deficits in autistic children clearly shows that alterations of neurodevelopment may affect the normal development of ToM abilities. From this perspective, other clinical conditions of childhood and adolescence with less-severe alterations of neurodevelopment in comparison to autism could also be associated with ToM impairment. This hypothesis has been scarcely investigated, considering that apart from studies on autism and other pervasive developmental disorders, empirical research on ToM impairment is mostly focused on adult clinical populations. This paper reviews empirical studies on ToM abilities in non-autistic developmental psychiatric disorders. Preliminary findings derived from this weak empirical evidence suggest that in comparison to typically developing subjects, the following may have altered ToM: (1) patients with disorders with typical onset in childhood or adolescence, such as attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder, and (2) patients with psychiatric disorders typical of adult subjects but with childhood or adolescent onset, such as psychotic disorders, mood disorders, and personality disorders. Findings are discussed, and limitations of these studies as regards sample selection, controls, settings, and ToM assessment are identified. Directions for further studies on this topic are suggested.