Theory of mind in adults with pediatric onset multiple sclerosis: neuropsychological, emotional, and quality of life correlates

Background: Social cognition may be impaired in Multiple Sclerosis (MS) including the Theory of Mind (ToM), the capacity to understand others’ mental states across cognitive and affective components and first- and second-order attributions. Its relationship with neuropsychological functioning in Pediatric Onset Multiple Sclerosis (POMS) remains unclear. Objective: To investigate associations between neuropsychological functions and ToM in POMS. Methods: Thirty adults with POMS (mean age 25.90 ± 4.87 years; females 60%; disease duration 10.60 ± 5.83; median EDSS 2) completed the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), Modified Fatigue Impact Scale (MFIS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), 36-Item Health Survey Short Form (SF-36) and 48-Yoni Task. Spearman correlations examined relationships between clinical, cognitive and quality-of-life measures and ToM performance. Results: Mean accuracy was 0.80 ± 0.11, and 23.3% showed low ToM performance. Higher BAI correlated with longer cognitive ToM responses and reduced efficiency. Slower ToM responses were associated with reduced physical functioning, general and mental health. Conclusions: Anxiety correlates with slower ToM performance. Slower ToM responses relate to poorer quality of life. ToM response times may capture relevant aspects of functioning in adults with POMS.