Mentalizing ability is impaired in patients with schizophrenia. Most studies in schizophrenia report hypoactivation of the core-mentalizing network including the medial prefrontal cortex (mPFC) and bilateral temporoparietal junction (TPJ). In our study, in patients with first episode schizophrenia treatment as usual with atypical antipsychotics (TAU) was compared to the add-on effect of a mentalization-based treatment program (MBT) on the mentalizing network in the brain.

12 patients diagnosed with schizophrenia according to DSM-IV-TR criteria participated in the study (6 males, mean age: 30.43, SD = 9.35 years, years of education 13.23, SD =2.45). A modified treatment program for psychoses was used based on the mentalization-based therapy developed by Bateman and Fonagy (2009). Before and after the treatment fMRI analyses (fixed effects analyses) were carried out (3 Tesla, 5 blocks on/off, 36s, TR = 3.62, SPM) using the n-back task.

Preliminary results show single analyses due to the small sample size. Comparing the fMRI scans before and after treatment, increases in the activation patterns were found in first episode patients treated with MBT. In patients with TAU a reduction in the activation patterns was demonstrated (mean changes in the activation clusters in the MBT group was 5.53, SD 12.79, in the TAU group -5.80, SD 6.91).

Mentalization-based treatment is a promising approach in the treatment of schizophrenia and can have an impact on social networks in the brain. Further studies are needed for a better understanding of social cognition and the related neural mechanisms in schizophrenia.

The authors declare that they have no competing interest.