Assessment of social cognition in obsessive–compulsive disorder using dynamic and dimensional approaches

Abstract Background Obsessive–compulsive disorder (OCD) is an incapacitating disorder known to be associated with cognitive dysfunctions. Social cognition, an essential aspect of cognition that could be affected in patients with OCD, is under-investigated. Objectives We aimed to investigate social cognitive performance, theory of mind (ToM) in specific, in patients with OCD in comparison to healthy controls using static and dynamic approaches and to evaluate their performance in relation to the severity of symptoms dimensions of OCD. Methods Forty OCD patients and 40 matched controls were recruited. Symptom’s severity was assessed using Dimensional Yale-Brown Obsessive–Compulsive Scale (DY-BOCS). Social cognitive performance was assessed using Reading the Mind in the Eyes Test — revised version (RMET) and Movie for the Assessment of Social Cognition (MASC). Results OCD patients showed significantly lower social cognitive performance than control ( t = − 4.81, p < 0.001) as measured by RMET. In addition, they had significantly lower correct-mentalization scores ( t = − 5.27, p < 0.001) and higher over-mentalization scores ( t = 5.57, p < 0.001) as measured by MASC. The aggressive dimension of DYBOCS was positively correlated with over-mentalization ( r = 0.33, p = 0.038) and negatively with non-mentalization ( r = − 0.316, p = 0.047). Conclusion ToM domain of social cognition appears to be impaired in OCD. Using a dynamic approach in assessment of ToM revealed that mentalization process was evident to be related to several global obsessive–compulsive severity symptoms in the general and the aggressive dimension in specific. Thus, the integration of some of the social cognitive domains in the assessment and management plan of patients with OCD could be beneficial.