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Stix K, Dalkner N, Bengesser SA, Birner A, Fellendorf FT, Häussl A, Lenger M, Maget A, Painold A, Platzer M, Queissner R, Schmiedhofer F, Schönthaler E, Schwerdtfeger A, Stross T, Tmava-Berisha A, Weber B, Unterrainer HF, Reininghaus EZ. Theory of mind abilities during the course of bipolar disorder: A longitudinal study using mixed models. Psychiatry Res 2024; 339:116039. [PMID: 38924901 DOI: 10.1016/j.psychres.2024.116039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 03/11/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
Theory of mind (ToM) deficits, difficulties in recognizing the intentions, propensities, and beliefs of others have been shown in individuals with bipolar disorder in several studies; however, it is not yet elucidated how ToM abilities changes over the course of bipolar disorder and is related to illness symptoms. This is one of the first longitudinal studies to compare the ToM abilities of euthymic bipolar individuals and healthy controls over a four and a half years period. ToM abilities were measured using the Reading the Mind in the Eyes Test (RMET). A total of 91 euthymic bipolar individuals and 91 healthy controls were included in the analyses. Linear mixed models were used to compare ToM abilities of bipolar individuals and healthy controls. It was found that bipolar individuals scored lower on average on the RMET than healthy controls and that these RMET scores were stable over four and a half years. The results of this study suggest that ToM deficits are a stable (possibly endophenotypic) trait of bipolar disorder. This understanding can contribute to better identification, assessment, and treatment strategies for individuals with bipolar disorder, ultimately improving their overall care and outcome.
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Affiliation(s)
- Katharina Stix
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria.
| | - Susanne A Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Armin Birner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Frederike T Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Alfred Häussl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Melanie Lenger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Alexander Maget
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Annamaria Painold
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Martina Platzer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Robert Queissner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Franziska Schmiedhofer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Elena Schönthaler
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | | | - Tatjana Stross
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | - Adelina Tmava-Berisha
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
| | | | - Human-F Unterrainer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria; Institute of Psychology, University of Graz, Austria; Faculty of Psychotherapy Science, Sigmund Freud University, Vienna, Austria; Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria; Department of Religious Studies, University of Vienna, Austria
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, 8036 Graz, Austria
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Kjærstad HL, de Siqueira Rotenberg L, Macoveanu J, Coello K, Faurholt-Jepsen M, Bjertrup AJ, Knudsen GM, Fisher PM, Vinberg M, Kessing LV, Lafer B, Miskowiak KW. Stable neural underpinnings of emotional cognition subgroups in patients newly diagnosed with bipolar disorder: A prospective fMRI study. Bipolar Disord 2024. [PMID: 38698448 DOI: 10.1111/bdi.13444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
OBJECTIVES This study aimed to investigate the neural underpinnings of emotional cognition subgroups in recently diagnosed patients with bipolar disorder (BD) and change over time over a 15-month follow-up period. METHODS Patients and healthy controls (HC) underwent emotional and nonemotional cognitive assessments and functional magnetic resonance imaging (fMRI) at the baseline (BD n = 87; HC n = 65) and at 15-month follow-up (BD n = 44; HC n = 38). Neural activity during emotion reactivity and regulation in response to aversive pictures was assessed during fMRI. Patients were clustered into subgroups based on their emotional cognition and, with HC, were compared longitudinally on cognition and neural activity during emotion reactivity and regulation. RESULTS Patients were optimally clustered into two subgroups: Subgroup 1 (n = 40, 46%) was characterized by heightened emotional reactivity in negative social scenarios, which persisted over time, but were otherwise cognitively intact. This subgroup exhibited stable left amygdala hyper-activity over time during emotion reactivity compared to subgroup 2. Subgroup 2 (n = 47, 54%) was characterized by global emotional cognitive impairments, including stable difficulties with emotion regulation over time. During emotion regulation across both time points, this group exhibited hypo-activity in the left dorsolateral prefrontal cortex. Additionally, patients in subgroup 2 had poorer nonemotional cognition, had more psychiatric hospital admissions and history of psychotic episodes than those in subgroup 1. CONCLUSIONS Broad impairments in emotional cognition in approximately half of BD patients and associated nonemotional cognitive deficits may originate from insufficient recruitment of prefrontal resources, contributing to poorer clinical outcomes.
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Affiliation(s)
- Hanne Lie Kjærstad
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Luisa de Siqueira Rotenberg
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Julian Macoveanu
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Klara Coello
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Maria Faurholt-Jepsen
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne Juul Bjertrup
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Gitte M Knudsen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Denmark
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Maj Vinberg
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Mental Health Center, Northern Zealand, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Beny Lafer
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Kamilla Woznica Miskowiak
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
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Bora E, Eyuboglu MS, Cesim E, Demir M, Yalincetin B, Ermis C, Özbek Uzman S, Sut E, Demirlek C, Verim B, Baykara B, İnal N, Akdede BB. Social cognition and neurocognition in first-episode bipolar disorder and psychosis: The effect of negative and attenuated positive symptoms. J Affect Disord 2024; 351:356-363. [PMID: 38290586 DOI: 10.1016/j.jad.2024.01.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/13/2024] [Accepted: 01/26/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Schizophrenia and bipolar disorder are associated with neurocognitive and social-cognitive impairments. To date very few studies investigated social cognition in first-episode bipolar disorder (FEBD). Our main aim was to investigate the differences in social cognition and neurocognition between FEBD and first-episode psychosis (FEP). Another aim was to investigate neurocognitive correlates of negative symptoms and attenuated psychotic symptoms in FEBD. METHODS This study included 55 FEBD, 64 FEP and 43 healthy controls. A comprehensive neuropsychological battery assessing social cognition, processing speed, verbal and visual memory, working memory, sustained attention, and executive functions was administered to all participants. RESULTS Both FEBD and FEP were associated with widespread deficits in all neurocognitive domains and social cognition. Both FEP (d = -1.19) and FEBP (d = -0.88) were also impaired in social cognition. In FEP, effect sizes (Cohen's d) of neurocognitive deficits ranged from -0.71 to -1.56. FEBD was also associated with relatively milder but similar neurocognitive deficits (d = -0.61 to-1.17). FEBD group performed significantly better than FEP group in verbal and visual memory, processing speed, and executive function domains (d = -0.40 to-0.52). Negative symptoms and social functioning were associated with neuropsychological impairment in both groups. The severity of attenuated psychotic symptoms was associated with poorer verbal memory in FEBD (r = -0.39, p < 0.01). LIMITATIONS The cross-sectional nature of the current study is the main limitation. CONCLUSIONS Neurocognitive and social-cognitive deficits are evident in both FEBD and FEP. In FEBD, more severe memory deficits might be markers of clinical overlap and shared neurobiological vulnerability with psychotic disorders.
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Affiliation(s)
- E Bora
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia.
| | - M S Eyuboglu
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - E Cesim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - M Demir
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - B Yalincetin
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - C Ermis
- Queen Silvia Children's Hospital, Department Child and Adolescent Psychiatry, Gothenburg, Sweden
| | - S Özbek Uzman
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - E Sut
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - C Demirlek
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - B Verim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - B Baykara
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - N İnal
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - B B Akdede
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
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Bora E, Eyuboglu MS, Cesim E, Demir M, Yalincetin B, Ermis C, Özbek Uzman S, Sut E, Demirlek C, Verim B, Baykara B, Akay A, İnal N, Akdede BB. Neurocognition and social cognition in youth and young adults at ultra-high-risk for psychosis and bipolar disorder. Schizophr Res 2024; 266:58-65. [PMID: 38368706 DOI: 10.1016/j.schres.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 02/01/2024] [Accepted: 02/11/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Schizophrenia and bipolar disorder are associated with significant deficits in neurocognition and social cognition. Unlike the studies in chronic stages of these disorders, very limited information is available regarding neurocognitive and social-cognitive impairment before the onset of bipolar disorder. Our main aim was to investigate the differences in neurocognition and social cognition between individuals at ultra-high risk for psychosis (UHR-P) and bipolar disorder (UHR-BD). METHODS This study included 152 help-seeking individuals identified as UHR-P (n = 78) and UHR-BD (n = 74), who were compared with a healthy control group (n = 43). A comprehensive neuropsychological battery was administered to all participants. RESULTS UHR-P was associated with widespread deficits in all neurocognitive and social-cognitive domains. Effect sizes (Cohen's d) of these deficits ranged from -0.57 to -1.34. UHR-BD was associated with significant deficits in processing speed, executive functions, sustained attention and social cognition (d = -0.48 to-0.70, p < 0.05). UHR-P performed significantly worse than UHR-BD in social cognition, processing speed, verbal memory and executive function domains (d = -0.39 to-0.64, p < 0.05). Negative symptoms were associated with impaired social cognition in the UHR-P group and verbal memory deficits in the UHR-BD group. Cognitive impairment was associated with functional impairment in both groups. CONCLUSIONS While UHR-P is associated with more widespread cognitive impairment, deficits in processing speed, executive functions, sustained attention and social cognition might be common features of both UHR groups. In early intervention services, cognition should be considered as a target for assessment and intervention not only for individuals at high risk for psychosis but also for bipolar disorder.
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Affiliation(s)
- E Bora
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia.
| | - M S Eyuboglu
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - E Cesim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - M Demir
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - B Yalincetin
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - C Ermis
- Queen Silvia Children's Hospital, Department Child and Adolescent Psychiatry, Gothenburg, Sweden
| | - S Özbek Uzman
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - E Sut
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - C Demirlek
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - B Verim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - B Baykara
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - A Akay
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - N İnal
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - B B Akdede
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
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Mariani F, Calandri I, Dansilio S. Criminal behaviors: A theory of mind problem? APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-10. [PMID: 38466873 DOI: 10.1080/23279095.2024.2326935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Theory of mind (ToM) has been addressed in relation to functional alterations of certain brain regions and their connections. The objective is to evaluate ToM in imprisoned criminal offenders and to analyze their relationship with the functions linked to the prefrontal cortex according to their expression in neuropsychological tests. The sample was composed of 52 subjects. 27 committed instrumental homicides and 25 crimes of sale and/or possession of narcotics. A control group was taken, 19 healthy subjects at liberty. The Faux-Pas (FP) and the Reading the Mind in the Eyes tests were used. A neuropsychological battery of executive functions and functions related to the frontal lobes and Hare's Psychopathy Checklist-Revised (PCL-R) was also applied. The criminal groups have comparable performances in all measures. The control group (in freedom) showed higher performance, with statistical significance, in the Faux-Pas test. Moderate negative correlations were found between the FP and the PCL-R. A distinction between affective and cognitive ToM could be affirmed, with people deprived of liberty presenting deficient functioning in the cognitive ToM test. This difference in performance could be linked to the disruptive event with the social norm and not so much with the violent homicide act itself.
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Affiliation(s)
- Francesca Mariani
- Institute of Fundamentals in Psychology, Faculty of Psychology
- Department of Neuropsychology Clinical Hospital, Faculty of Medicine, University of the Republic, Montevideo, Uruguay
| | | | - Sergio Dansilio
- Institute of Fundamentals in Psychology, Faculty of Psychology
- Department of Neuropsychology Clinical Hospital, Faculty of Medicine, University of the Republic, Montevideo, Uruguay
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Herold M, Kovács GX, Herold R, Pótó Z, Fekete JD, Varga E, Hajnal A, Csulak T, Pethő B, Hebling D, Albert N, Tényi T. Patients with chronic bipolar disorder show impairments in interpreting literary fiction - A preliminary explorative study with the short story task. J Psychiatr Res 2024; 171:238-245. [PMID: 38316104 DOI: 10.1016/j.jpsychires.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 12/30/2023] [Accepted: 01/15/2024] [Indexed: 02/07/2024]
Abstract
INTRODUCTION Theory of mind (ToM) is a crucial skill in navigating and functioning in the social world. Significant ToM impairment was consistently found in bipolar disorder; it can be both a state and trait marker of the disorder. However, most of the ToM tests are not sensitive enough to detect subtle individual differences, which would be necessary for an individualized treatment plan. The Short Story Task (SST) is a new way to sensitively assess individual differences in ToM performance. The aim of the study was to test the feasibility of SST in patients with bipolar disorder. METHOD 31 persons (11 male, 20 female) with bipolar I disorder and 31 healthy individuals (15 males and 16 females) as a control group were recruited. SST was used to evaluate ToM performance. The SST uses a Hemingway novel, in which the patient is presented with a realistic social situation, where the motivations of the characters and the underlying relationships of events are not explicitly described. RESULTS In the explicit mental state reasoning questions the CG (M = 8.06) had significantly higher (p < 0.001) scores than the persons with bipolar I disorder (M = 5.03). There was no ceiling effect for explicit ToM scores in either group. Participants in CG (M = 8.03) also significantly outperformed (p = 0.006) the BG participants (M = 6.55) in the comprehension questions. The spontaneous mental state inference question was performed equally (M = 0.23) in both groups. Group assignment (t = -3.503, p < 0.001), comprehension score (t = 2.864, p = 0.006), and spontaneous mentalization (t = 2.846, p = 0.006) significantly predicted the explicit ToM performance. CONCLUSIONS Overall, we found that the Short Story Task is a promising tool for measuring ToM in patients with bipolar disorder without ceiling effect. Primarily explicit ToM was found to be deficient, which corresponds well with the ToM literature in bipolar disorder. Contrary to our hypothesis we could not detect impairment in spontaneous ToM and found that patients living with bipolar disorder also showed deficits in comprehension. The lack of assessment of neurocognitive skills is a significant limitation of the current study.
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Affiliation(s)
- Márton Herold
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Hungary.
| | - Gyöngyvér X Kovács
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Hungary
| | - Róbert Herold
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Hungary
| | - Zsuzsanna Pótó
- Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, Hungary
| | - Judit Diána Fekete
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Hungary
| | - Eszter Varga
- Department of Pediatrics, Medical School, University of Pécs, Hungary
| | - András Hajnal
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Hungary
| | - Tímea Csulak
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Hungary
| | - Borbála Pethő
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Hungary
| | - Dóra Hebling
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Hungary
| | - Noémi Albert
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Hungary
| | - Tamás Tényi
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Hungary
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de Sales SC, Philippsen M, de Jesus LS, Carriello MA, Alvim PHP, Costa DFB, da Rosa LC, Hasse-Sousa M, Czepielewski LS, Massuda R. Social cognition and psychosocial functioning in schizophrenia and bipolar disorder: Theory of mind as a key to understand schizophrenia dysfunction. Eur Neuropsychopharmacol 2023; 77:12-20. [PMID: 37660439 DOI: 10.1016/j.euroneuro.2023.08.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 09/05/2023]
Abstract
Functional impairment is a common symptom in schizophrenia (SZ) and bipolar disorder (BD). Pharmacological treatments have limited functional recovery in both disorders. Social cognition, a cognitive process, has been associated with functioning in mental disorders. Theory of mind (ToM) is considered a key factor in understanding the social cognitive deficits in SZ and BD. Our study aimed to investigate the relationship between ToM and functioning in SZ, BD, and healthy controls (HC) and compare ToM and functioning impairments between groups. A total of 208 participants (HC n = 69; BD n = 89; SZ n = 50) were evaluated with the Functioning Assessment Short Test (FAST), Reading the Mind in the Eyes Test (RMET), the Vocabulary subtest of the Wechsler Abbreviated Scale for Intelligence (WASI) and the Hopkins Verbal Learning Test - Revised (HVLT-R). Comparisons of RMET between low- and high-functioning individuals and multiple linear regression analyses were conducted for each group. Multiple regression analysis revealed that the association between ToM and psychosocial functioning was observed only in SZ (β = -1.352, p = 0.008). Low-functioning SZ participants showed a lower ToM performance compared to participants with high-functioning SZ (t = 1.80, p = 0.039, Cohen's d = 0.938). No significant associations were found in the other groups. ToM is essential to understand the functional impairment in SZ, more than in BD. Furthermore, ToM may be a primary target for intervention strategies in improving functioning in SZ.
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Affiliation(s)
| | | | | | | | | | | | - Laura Canani da Rosa
- Departamento de Psicologia do Desenvolvimento e da Personalidade da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mathias Hasse-Sousa
- Departamento de Psicologia do Desenvolvimento e da Personalidade da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Letícia Sanguinetti Czepielewski
- Departamento de Psicologia do Desenvolvimento e da Personalidade da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Raffael Massuda
- Departamento de Psiquiatria da Universidade Federal do Paraná
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Oliva V, De Prisco M, Fico G, Possidente C, Fortea L, Montejo L, Anmella G, Hidalgo-Mazzei D, Grande I, Murru A, Fornaro M, de Bartolomeis A, Dodd A, Fanelli G, Fabbri C, Serretti A, Vieta E, Radua J. Correlation between emotion dysregulation and mood symptoms of bipolar disorder: A systematic review and meta-analysis. Acta Psychiatr Scand 2023; 148:472-490. [PMID: 37740499 DOI: 10.1111/acps.13618] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Emotion dysregulation (ED) is a transdiagnostic construct characterized by difficulties regulating intense emotions. People with bipolar disorder (BD) are more likely to show ED and use maladaptive emotion regulation strategies than adaptive ones. However, little is known about whether ED in BD is a trait or it is rather an epiphenomenon of mood symptoms. METHODS We conducted a systematic review and meta-analysis of the evidence across major literature databases reporting correlations between measures of emotion regulation (overall ED and different emotion regulation strategies) and measures of depressive and (hypo)manic symptoms in BD from inception until April 12th, 2022. RESULTS Fourteen studies involving 1371 individuals with BD were included in the qualitative synthesis, of which 11 reported quantitative information and were included in the meta-analysis. ED and maladaptive strategies were significantly higher during periods with more severe mood symptoms, especially depressive ones, while adaptive strategies were lower. CONCLUSION ED significantly correlates with BD symptomatology, and it mainly occurs during mood alterations. ED may be a target for specific psychotherapeutic and pharmacological treatments, according to precision psychiatry. However, further studies are needed, including patients with mood episodes and longitudinal design, to provide more robust evidence and explore the causal direction of the associations.
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Affiliation(s)
- Vincenzo Oliva
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Michele De Prisco
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Giovanna Fico
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Chiara Possidente
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Lydia Fortea
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura Montejo
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Gerard Anmella
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Diego Hidalgo-Mazzei
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Iria Grande
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Andrea Murru
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Michele Fornaro
- Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Andrea de Bartolomeis
- Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Alyson Dodd
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
| | - Giuseppe Fanelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Eduard Vieta
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Joaquim Radua
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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9
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Dalkner N, Moore RC, Depp CA, Ackerman RA, Pinkham AE, Harvey PD. Immediate post performance judgements about cognitive performance in schizophrenia and bipolar disorder: associations with test performance and subjective overall judgments regarding abilities. Cogn Neuropsychiatry 2023; 28:450-466. [PMID: 37942934 PMCID: PMC10841634 DOI: 10.1080/13546805.2023.2276972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/28/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION The study explored associations between the accuracy of post assessment judgements of cognitive performance with global self-assessments of psychosocial functioning compared to evaluations generated by observers in schizophrenia and bipolar disorder. METHODS An abbreviated cognitive assessment based on the MATRICS Consensus Cognitive Battery was administered to 122 individuals with schizophrenia and 113 with bipolar disorder. They provided self-estimates of their performance after each subtest. In addition, self-reports on cognition, social cognition, and everyday functioning were collected and compared to observer ratings. RESULTS Both groups overestimated their cognitive function, but in bipolar disorder, there was 30% shared variance between task performance and self-rated task performance (vs. 5% in schizophrenia). Significant correlations were found between self-reported everyday outcomes and both actual and self-assessed performance. In schizophrenia, immediate judgements were only related to self-rated functioning, not to observer rated functioning. In bipolar disorder, impairments in self-assessment of performance correlated with observer ratings of cognitive ability, which was not observed in schizophrenia. CONCLUSIONS While both groups showed correlations between cognitive performance and introspective accuracy, individuals with bipolar disorder showed higher accuracy in assessing their cognitive performance and other outcomes. Notably, impairments in introspective accuracy were associated with observer-rated functioning exclusively in bipolar disorder.
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Affiliation(s)
- Nina Dalkner
- Medical University Graz, Austria
- University of Miami Miller School of Medicine, Miami, FL
| | | | - Colin A. Depp
- UCSD Health Sciences Center, La Jolla, CA
- San Diego VA Medical Center La Jolla, CA
| | | | - Amy E. Pinkham
- University of Texas at Dallas, Richardson, TX
- University of Texas Southwestern Medical Center, Dallas TX
| | - Philip D. Harvey
- University of Miami Miller School of Medicine, Miami, FL
- Bruce W. Carter VA Medical Center, Miami, FL
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10
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Reis JAS, Rossi GN, L Osório F, Bouso JC, Hallak JEC, Dos Santos RG. Interventions for deficits in recognition of emotions in facial expressions in major depressive disorder: An updated systematic review of clinical trials. Neurosci Biobehav Rev 2023; 153:105367. [PMID: 37619644 DOI: 10.1016/j.neubiorev.2023.105367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/11/2023] [Accepted: 08/20/2023] [Indexed: 08/26/2023]
Abstract
The recognition of emotions in facial expressions (REFE) is a core construct of social cognition. In the last decades, studies have showed that REFE is altered in major depressive disorder (MDD), but the evidence is conflicting. Thus, we conducted a systematic review of clinical trials involving therapeutic interventions in MDD and any evaluation of REFE to update (2018-2023) and systematically evaluate the evidence derived from controlled clinical trials on the effects of therapeutic strategies to MDD on the REFE. Eleven studies were included in the final review. Some interventions, including drugs (ketamine, bupropion, psylocibin) and non-pharmacological strategies (psychotherapy) seem to be able to reduce pre-existing REFE biases in MDD patients. However, there was a high heterogeneity in the evaluated studies, in terms of sample, interventions, tasks and results. Further studies and more consistent evaluation tools are highly needed to better understand nuanced deficits and specific actions of different treatment options.
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Affiliation(s)
- José Augusto Silva Reis
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University São Paulo, SP, Brazil.
| | - Giordano Novak Rossi
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University São Paulo, SP, Brazil.
| | - Flávia L Osório
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
| | - José Carlos Bouso
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University São Paulo, SP, Brazil; International Center for Ethnobotanical Education, Research, and Service (ICEERS), Barcelona, Spain; Universitat Rovira i Virgili, Department of Psychology and Research Center for Behavior Assessment (CRAMC), Tarragona, Spain.
| | - Jaime Eduardo Cecílio Hallak
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil; International Center for Ethnobotanical Education, Research, and Service (ICEERS), Barcelona, Spain.
| | - Rafael Guimarães Dos Santos
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil; International Center for Ethnobotanical Education, Research, and Service (ICEERS), Barcelona, Spain.
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11
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Petrovic SA, Kaurin N, Knezevic J, Maric NP. Theory of Mind in Typical Adults: Sex-Differences and Its Associations with Anxiety and Depression Symptoms. Arch Clin Neuropsychol 2023; 38:913-921. [PMID: 36715310 DOI: 10.1093/arclin/acad007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2023] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE Despite an increased interest in research of theory of mind (ToM) in recent years - both related to psychopathology (depression and anxiety spectrum disorders) and within the typical adults, the existing literature is scarce and presents some conflicting results. Present study aimed to explore sex differences in ToM, alongside its associations with current anxiety and depression symptoms, in a large sample of typical adults collected online. METHOD Participants completed the 15-minutes survey obtaining socio-demographic data, current self-reported depression and anxiety symptom severity, and ToM ability (the Reading the Mind in the Eyes Task). The sample comprised 605 participants -mostly younger adults, women, and high school graduate/student population. RESULTS The majority of participants reported minimal/mild depressive and anxiety symptoms that were significantly more severe in women. Women also displayed significantly better overall ToM ability than men. Significant negative correlation between the severity of current depressive and anxiety symptoms and ToM ability was also observed, but only in individuals expressing the symptoms requiring clinical attention (such association was absent in those exhibiting minimal/mild symptoms). CONCLUSIONS Present research adds to the existing knowledge on the association between ToM ability, anxiety, and depressive symptoms in typical adults as well as on the sex-differences in this important social cognitive domain. Exploring the factors representing indicators of vulnerability for depression-anxiety spectrum disorders is important for their timely detection and treatment.
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Affiliation(s)
- Sanja Andric Petrovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
| | - Nina Kaurin
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Knezevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nadja P Maric
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
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12
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Song Z, Jones A, Corcoran R, Daly N, Abu-Akel A, Gillespie SM. Psychopathic Traits and Theory of Mind Task Performance: A Systematic Review and Meta-analysis. Neurosci Biobehav Rev 2023; 151:105231. [PMID: 37172923 DOI: 10.1016/j.neubiorev.2023.105231] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/24/2023] [Accepted: 05/09/2023] [Indexed: 05/15/2023]
Abstract
This meta-analysis aims to examine the relationship between psychopathic traits and theory of mind (ToM), which is classically and broadly defined as competency in representing and attributing mental states such as emotions, intentions, and beliefs to others. Our search strategy gathered 142 effect sizes, from 42 studies, with a total sample size of 7463 participants. Random effects models were used to analyze the data. Our findings suggested that psychopathic traits are associated with impaired ToM task performance. This relationship was not moderated by age, population, psychopathy measurement (self-report versus clinical checklist) or conceptualization, or ToM task type (cognitive versus affective). The effect also remained significant after excluding tasks that did not require the participant to 1) mentalize or 2) differentiate self and other perspectives. However, interpersonal/affective traits were associated with a more pronounced impairment in ToM task performance compared to lifestyle/antisocial traits. Future research should investigate the effects of distinct psychopathy facets that will allow for a more precise understanding of the social-cognitive bases of relevant clinical presentations in psychopathy.
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Affiliation(s)
- Zhaorong Song
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom.
| | - Andrew Jones
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom.
| | - Rhiannon Corcoran
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom.
| | - Natasha Daly
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom.
| | - Ahmad Abu-Akel
- Institute of Psychology, University of Lausanne, 1015, Lausanne, Switzerland.
| | - Steven M Gillespie
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom.
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13
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Meyer K, Hindi Attar C, Fiebig J, Stamm T, Bassett TR, Bauer M, Dannlowski U, Ethofer T, Falkenberg I, Jansen A, Juckel G, Kircher T, Mulert C, Leicht G, Rau A, Ritter D, Ritter P, Trost S, Vogelbacher C, Walter H, Wolter S, Hautzinger M, Bermpohl F. Boosting the Theory of Mind Network: Specific Psychotherapy Increases Neural Correlates of Affective Theory of Mind in Euthymic Bipolar Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:572-580. [PMID: 36087699 DOI: 10.1016/j.bpsc.2022.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 05/09/2023]
Abstract
BACKGROUND In bipolar disorder, impaired affective theory of mind (aToM) performance and aberrant neural activation in the ToM brain network partly explain social functioning impairments. However, it is not yet known whether psychotherapy of bipolar disorder influences neuroimaging markers of aToM. METHODS In this study, conducted within the multicentric randomized controlled trial of the BipoLife consortium, patients with euthymic bipolar disorder underwent 2 group interventions over 6 months (mean = 28.45 weeks): 1) a specific, cognitive behavioral intervention (specific psychotherapeutic intervention [SEKT]) (n = 31) targeting impulse regulation, ToM, and social skills and 2) an emotion-focused intervention (FEST) (n = 28). To compare the effect of SEKT and FEST on neural correlates of aToM, patients performed an aToM task during functional magnetic resonance imaging before and after interventions (final functional magnetic resonance imaging sample of pre- and postcompleters, SEKT: n = 16; FEST: n = 17). Healthy control subjects (n = 32) were scanned twice with the same time interval. Because ToM was trained in SEKT, we expected an increased ToM network activation in SEKT relative to FEST postintervention. RESULTS Both treatments effectively stabilized patients' euthymic state in terms of affective symptoms, life satisfaction, and global functioning. Confirming our expectations, SEKT patients showed increased neural activation within regions of the ToM network, bilateral temporoparietal junction, posterior cingulate cortex, and precuneus, whereas FEST patients did not. CONCLUSIONS The stabilizing effect of SEKT on clinical outcomes went along with increased neural activation of the ToM network, while FEST possibly exerted its positive effect by other, yet unexplored routes.
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Affiliation(s)
- Kristina Meyer
- Department of Psychiatry and Neurosciences, CCM, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Catherine Hindi Attar
- Department of Psychiatry and Neurosciences, CCM, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jana Fiebig
- Department of Psychiatry and Neurosciences, CCM, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Thomas Stamm
- Department of Psychiatry and Neurosciences, CCM, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Clinical Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Tyler R Bassett
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Thomas Ethofer
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
| | - Irina Falkenberg
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Andreas Jansen
- Department of Psychiatry, University of Marburg, Marburg, Germany; Core-Facility Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL, University Hospital, Bochum, Germany
| | - Tilo Kircher
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Christoph Mulert
- Center for Psychiatry, Justus Liebig University, Giessen, Germany; Center for Psychiatry, Justus Liebig University, Giessen, Germany
| | - Gregor Leicht
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Rau
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
| | - Dirk Ritter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Sarah Trost
- Department of Psychiatry and Psychotherapy, Georg-August-University Göttingen, Göttingen, Germany; Universitäre Altersmedizin FELIX PLATTER, Basel, Switzerland
| | | | - Henrik Walter
- Department of Psychiatry and Neurosciences, CCM, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sarah Wolter
- Department of Psychiatry and Psychotherapy, Georg-August-University Göttingen, Göttingen, Germany; Department of Psychiatry and Psychotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Martin Hautzinger
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Neurosciences, CCM, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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14
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Kjærstad HL, Haldorsen T, Vinberg M, Kessing LV, Miskowiak KW. Associations between emotional and non-emotional cognition and subsequent mood episodes in recently diagnosed patients with bipolar disorder: A 16-month follow-up study. J Affect Disord 2023; 324:16-23. [PMID: 36565963 DOI: 10.1016/j.jad.2022.12.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/09/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is associated with impairments in both emotional and non-emotional cognition. Recently, cognitive impairments have attracted increasing research interest as markers of prognosis and possible treatment targets in patients with BD. However, there is a paucity of studies investigating cognitive predictors of prognosis in BD. METHODS We assessed 148 recently diagnosed, symptomatically stable patients with BD with a battery of emotional and non-emotional cognitive tests and followed them up over 16 months as part of an ongoing cohort study. Multiple linear regression analyses were conducted to examine the associations between cognitive performance at baseline and the recurrence and duration of (hypo)manic and depressive episodes, respectively, with adjustment for age, sex, subsyndromal symptoms and time between assessments. RESULTS Poorer recognition of negative facial expressions and more negative emotions in neutral daily life scenarios were associated with greater frequency (ps ≤ .04) and longer duration (ps ≤ .03) of subsequent (hypo)manic episodes over the 16-month follow-up period. In addition, poorer global cognition, attention and psychomotor speed, and verbal fluency were associated with more (hypo)manic episodes (ps ≤ .04). Finally, more difficulty down-regulating emotion in negative social scenarios was associated with depressive relapse (p = .007). It was a limitation that patients had a delayed diagnosis of seven years from their first mood episode despite being recently diagnosed. CONCLUSION Trait-related cognitive impairments influence the early course in recently diagnosed patients with BD, particularly (hypo)manic relapse. Early prophylactic strategies targeting cognitive impairments may increase resilience and the course of illness in recently diagnosed patients with BD.
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Affiliation(s)
- Hanne Lie Kjærstad
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark.
| | - Thea Haldorsen
- Department of Psychology, University of Copenhagen, Denmark
| | - Maj Vinberg
- Mental Health Centre, Northern Zealand, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Psychology, University of Copenhagen, Denmark
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15
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Bora E, Verim B, Akgul O, Ildız A, Ceylan D, Alptekin K, Özerdem A, Akdede BB. Clinical and developmental characteristics of cognitive subgroups in a transdiagnostic sample of schizophrenia spectrum disorders and bipolar disorder. Eur Neuropsychopharmacol 2023; 68:47-56. [PMID: 36640733 DOI: 10.1016/j.euroneuro.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023]
Abstract
Evidence suggests that neurocognitive dysfunction is a transdiagnostic feature of individuals across the continuum between schizophrenia and bipolar disorder. However, there is significant heterogeneity of neuropsychological and social-cognitive abilities in schizophrenia, schizoaffective disorder, and bipolar disorder. The current study aimed to investigate the clinical and developmental characteristics of cognitive subgroups within the schizo-bipolar spectrum. 147 clinically stable patients with schizophrenia, schizoaffective or bipolar disorder were assessed using clinical rating scales for current psychotic and affective symptoms, and a comprehensive neuropsychological battery including measures of social cognition (Hinting and Reading the mind from the Eyes (RMET) task)). Developmental history and premorbid academic functioning were also evaluated. The study also included 36 healthy controls. Neurocognitive subgroups were investigated using latent class analysis (LCA). The optimal number of clusters was determined based on the Bayesian information criterion. A logistic regression analysis was conducted to investigate the predictors of membership to the globally impaired subgroup. LCA revealed two neurocognitive clusters including globally impaired (n = 89, 60.5%) and near-normal cognitive functioning (n = 58, 39.5%) subgroups. The near-normal cognitive functioning subgroup was not significantly different from healthy controls. The globally impaired subgroup had a higher score of developmental abnormalities (p<0.001), poorer premorbid academic functioning, mothers who were less educated and more severe disorganized speech (p = 0.001) and negative symptoms (p = 0.004) compared to the near-normal cognitive functioning group. History of developmental abnormalities and persistent disorganization rather than diagnosis are significant predictors of the subgroup of individuals with global cognitive impairment in the schizophrenia-bipolar disorder continuum.
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Affiliation(s)
- Emre Bora
- Department of Psychiatry, Faculty of Medicine, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia; Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey.
| | - Burcu Verim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Ozge Akgul
- Department of Psychology, İzmir Demokrasi University, İzmir, Turkey
| | - Ayşegül Ildız
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Deniz Ceylan
- Department of Psychiatry and Psychology, Koc University, Istanbul, Turkey
| | - Köksal Alptekin
- Department of Psychiatry, Faculty of Medicine, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Ayşegül Özerdem
- Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Berna Binnur Akdede
- Department of Psychiatry, Faculty of Medicine, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
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16
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The Relationship among Dyadic Adjustment and Disease Burden in Patients with Bipolar Disorder and Their Spouses. Behav Sci (Basel) 2023; 13:bs13020091. [PMID: 36829320 PMCID: PMC9952473 DOI: 10.3390/bs13020091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/25/2023] Open
Abstract
(1) Background: Spouses of individuals with bipolar disorder (BD) experience significant burdens, and the perception of the burden may affect dyadic adjustment. We aimed to investigate the sexual functions, alexithymic traits, marital satisfaction, and burden in patients with BD and their spouses. We also aimed to assess the mediating role of sexual functions and alexithymia in the relationship between burden and dyadic adjustment. (2) Methods: We included 81 patients with BD type 1 (40.69 ± 8.55 years, 65.4% female, and 34.6% male) and their healthy spouses (40.95 ± 7.30 years, 34.6% female, and 65.4% male) and 78 healthy controls (38.90 ± 5.88, 48.7% female, and 51.3% male). The participants were evaluated using the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), Dyadic Adjustment Scale (DAS), Hamilton Depression Rating Scale (HDRS), Toronto Alexithymia Scale-20 (TAS-20), and Burden Assessment Scale (BAS). (3) Results: The GRISS scores of the control group were significantly lower than the spouses and BD groups. The DAS total score of the control group was significantly higher than that of the spouses and BD groups. Regression analyses revealed that TAS, GRISS, and HDRS scores were associated with DAS scores in the BD group. In the spouse group, TAS and BAS scores were associated with DAS scores. The GRISS scores partially mediated the relationship between dyadic adjustment and burden in the spouses of patients with BD. (4) Conclusions: Mental health professionals should regularly scan caregivers' perceptions of burden. Appropriate psychosocial interventions could help spouses of patients with BD to cope better with the burden and improve dyadic adjustment.
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17
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Olivito G, Siciliano L, Clausi S, Lupo M, Baiocco R, Gragnani A, Saettoni M, Delle Chiaie R, Laghi F, Leggio M. The Cerebellum Gets Social: Evidence from an Exploratory Study of Cerebellar, Neurodevelopmental, and Psychiatric Disorders. Biomedicines 2023; 11:309. [PMID: 36830846 PMCID: PMC9953169 DOI: 10.3390/biomedicines11020309] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
Social prediction is a key feature of social cognition (SC), a function in which the modulating role of the cerebellum is recognized. Accordingly, cerebellar alterations are reported in cerebellar pathologies, neurodevelopmental disorders, and psychiatric conditions that show SC deficits. Nevertheless, to date, no study has directly compared populations representative of these three conditions with respect to SC and cerebellar alterations. Therefore, the present exploratory study aimed to compare the SC profiles of individuals with cerebellar neurodegenerative disorders (CB), autism (ASD), bipolar disorder type 2 (BD2), or healthy subjects (HS) using a battery of social tests requiring different degrees of prediction processing. The patterns of cerebellar gray matter (GM) alterations were compared among the groups using voxel-based morphometry. Compared to HS, the clinical groups showed common SC deficits in tasks involving a moderate to high level of prediction. The behavioral results of the clinical groups are consistent with the presence of overlapping GM reduction in cerebellar right Crus II, an area notably involved in complex social processing and prediction. Although exploratory and preliminary, these results deepen the cerebellar role in social prediction and highlight the transdiagnostic value of the cerebellum in social functioning and prediction in pathologies of different aetiologies, forecasting novel possibilities for shared interventions.
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Affiliation(s)
- Giusy Olivito
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Libera Siciliano
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Silvia Clausi
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
- Klinikos Center for Psychodiagnostics and Psychotherapy, Viale delle Milizie 38, 00192 Roma, Italy
| | - Michela Lupo
- Servizio di Tutela della Salute Mentale e Riabilitazione dell’Età Evolutiva ASL, Roma 2, 00145 Rome, Italy
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Roma, Italy
| | - Andrea Gragnani
- Scuola di Psicoterapia Cognitiva SPC, 58100 Grosseto, Italy
- Associazione Psicologia Cognitiva (APC)/Scuola di Psicoterapia Cognitiva (SPC), 00185 Rome, Italy
| | - Marco Saettoni
- Scuola di Psicoterapia Cognitiva SPC, 58100 Grosseto, Italy
- Unità Funzionale Salute Mentale Adulti ASL Toscana Nord-Ovest Valle del Serchio, 56121 Pisa, Italy
| | - Roberto Delle Chiaie
- Department of Neuroscience and Mental Health–Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Roma, Italy
| | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
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18
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Siciliano L, Olivito G, Lupo M, Urbini N, Gragnani A, Saettoni M, Delle Chiaie R, Leggio M. The role of the cerebellum in sequencing and predicting social and non-social events in patients with bipolar disorder. Front Cell Neurosci 2023; 17:1095157. [PMID: 36874211 PMCID: PMC9974833 DOI: 10.3389/fncel.2023.1095157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
Introduction Advances in the operational mode of the cerebellum indicate a role in sequencing and predicting non-social and social events, crucial for individuals to optimize high-order functions, such as Theory of Mind (ToM). ToM deficits have been described in patients with remitted bipolar disorders (BD). The literature on BD patients' pathophysiology reports cerebellar alterations; however, sequential abilities have never been investigated and no study has previously focused on prediction abilities, which are needed to properly interpret events and to adapt to changes. Methods To address this gap, we compared the performance of BD patients in the euthymic phase with healthy controls using two tests that require predictive processing: a ToM test that require implicit sequential processing and a test that explicitly assesses sequential abilities in non-ToM functions. Additionally, patterns of cerebellar gray matter (GM) alterations were compared between BD patients and controls using voxel-based morphometry. Results Impaired ToM and sequential skills were detected in BD patients, specifically when tasks required a greater predictive load. Behavioral performances might be consistent with patterns of GM reduction in cerebellar lobules Crus I-II, which are involved in advanced human functions. Discussion These results highlight the importance of deepening the cerebellar role in sequential and prediction abilities in patients with BD.
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Affiliation(s)
- Libera Siciliano
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Ataxia Laboratory, Fondazione Santa Lucia IRCCS, Rome, Italy
| | - Giusy Olivito
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Ataxia Laboratory, Fondazione Santa Lucia IRCCS, Rome, Italy
| | - Michela Lupo
- Servizio di Tutela della Salute Mentale e Riabilitazione dell'Età Evolutiva ASL, Rome, Italy
| | - Nicole Urbini
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Ataxia Laboratory, Fondazione Santa Lucia IRCCS, Rome, Italy
| | - Andrea Gragnani
- Scuola di Psicoterapia Cognitiva SPC, Grosseto, Italy.,Associazione Psicologia Cognitiva (APC)/Scuola di Psicoterapia Cognitiva (SPC), Rome, Italy
| | - Marco Saettoni
- Scuola di Psicoterapia Cognitiva SPC, Grosseto, Italy.,Unità Funzionale Salute Mentale Adulti ASL Toscana Nord-Ovest Valle del Serchio, Pisa, Italy
| | - Roberto Delle Chiaie
- Department of Neuroscience and Mental Health-Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Ataxia Laboratory, Fondazione Santa Lucia IRCCS, Rome, Italy
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19
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KULACAOĞLU F, ÜNVER H, YILDIRIM YE, ERZİN G. Relationship between theory of mind and metabolic parameters and functioning in patients with bipolar I disorder. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1179024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Purpose: We aimed to investigate the relationship theory of mind abilities with functionality and metabolic alteration in patients with bipolar disorder-1 (BD-1) during the remission period.
Materials and Methods: This cross-sectional study is consisted of 68 patients with bipolar disorder-1 and 45 healthy controls. Sociodemographic form, Reading the Mind in the Eyes Test (RMET), Bipolar Disorder Functioning Questionnaire (BDFQ) were administered to the participants. Body mass index (BMI), waist circumference (WC), fasting plasma glucose (FG), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), total cholesterol (TC), triglyceride (TG) levels were recorded.
Results: There were significant differences between the patient group and healthy control group in terms of WC, BMI, HDL, LDL, TG. The results of independent samples t-test indicated a statistically significant difference in RMET score between the two groups with control group significantly higher than patient group.
Conclusion: Patients with BD-1 during the remission period have lower performance on theory of mind abilities and more alteration in metabolic parameters than healthy controls. Metabolic alteration and theory of mind impairment should be potential treatment target for BD
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Affiliation(s)
- Filiz KULACAOĞLU
- UNIVERSITY OF HEALTH SCIENCES, İSTANBUL BAKIRKÖY PROF. DR. MAZHAR OSMAN APPLICATION AND RESEARCH CENTER FOR PSYCHIATRIC AND NERVE DISEASES
| | | | | | - Gamze ERZİN
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA DIŞKAPI YILDIRIM BEYAZIT SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, RUH SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI
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20
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Olivito G, Lupo M, Siciliano L, Gragnani A, Saettoni M, Pancheri C, Panfili M, Pignatelli F, Delle Chiaie R, Leggio M. Theory of mind profile and cerebellar alterations in remitted bipolar disorder 1 and 2: a comparison study. Front Behav Neurosci 2022; 16:971244. [PMID: 36160679 PMCID: PMC9492864 DOI: 10.3389/fnbeh.2022.971244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/18/2022] [Indexed: 11/21/2022] Open
Abstract
The literature on social cognition abilities in bipolar disorder (BD) is controversial about the occurrence of theory of mind (ToM) alterations. In addition to other cerebral structures, such as the frontal and limbic areas, the processing of socially relevant stimuli has also been attributed to the cerebellum, which has been demonstrated to be involved in the above-mentioned disorder. Nevertheless, the cerebellar contribution to ToM deficits in bipolar patients needs to be elucidated further. To this aim, two tests assessing different components of ToM were used to evaluate the ability to appreciate affective and mental states of others in 17 individuals with a diagnosis of BD type 1 (BD1) and 13 with BD type 2 (BD2), both in the euthymic phase, compared to healthy matched controls. Cerebellar gray matter (GM) volumes were extracted and compared between BD1 and controls and BD2 and controls by using voxel-based morphometry. The results showed that BD1 patients were compromised in the cognitive and advanced components of ToM, while the BD2 ToM profile resulted in a more widespread compromise, also involving affective and automatic components. Both overlapping and differing areas of cerebellar GM reduction were found. The two groups of patients presented a pattern of GM reduction in cerebellar portions that are known to be involved in the affective and social domains, such as the vermis and Crus I and Crus II. Interestingly, in both BD1 and BD2, positive correlations were detected between lower ToM scores and decreased volumes in the cerebellum. Overall, BD2 patients showed a more compromised ToM profile and greater cerebellar impairment than BD1 patients. The different patterns of structural abnormalities may account for the different ToM performances evidenced, thus leading to divergent profiles between BD1 and BD2.
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Affiliation(s)
- Giusy Olivito
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- *Correspondence: Giusy Olivito
| | - Michela Lupo
- Servizio di Tutela della Salute Mentale e Riabilitazione dell’Età Evolutiva ASL, Rome, Italy
| | - Libera Siciliano
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Andrea Gragnani
- Scuola di Psicoterapia Cognitiva (SPC), Grosseto, Italy
- Associazione Psicologia Cognitiva (APC)/Scuola di Psicoterapia Cognitiva (SPC), Rome, Italy
| | - Marco Saettoni
- Scuola di Psicoterapia Cognitiva (SPC), Grosseto, Italy
- Unità Funzionale Salute Mentale Adulti ASL Toscana Nord-Ovest Valle del Serchio, Pisa, Italy
| | - Corinna Pancheri
- Department of Neuroscience and Mental Health–Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Matteo Panfili
- Department of Neuroscience and Mental Health–Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Roberto Delle Chiaie
- Department of Neuroscience and Mental Health–Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Maria Leggio
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
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21
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Clausi S, Siciliano L, Olivito G, Leggio M. Cerebellum and Emotion in Social Behavior. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1378:235-253. [PMID: 35902475 DOI: 10.1007/978-3-030-99550-8_15] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Accumulating evidence suggests that the cerebellum plays a crucial role not only in the motor and cognitive domains but also in emotions and social behavior. In the present chapter, after a general introduction on the significance of the emotional components of social behavior, we describe recent efforts to understand the contributions of the cerebellum in social cognition focusing on the emotional and affective aspects. Specifically, starting from the description of the cerebello-cortical networks subtending the social-affective domains, we illustrate the most recent findings on the social cerebellum and the possible functional mechanisms by which the cerebellum modulate social-affective behavior. Finally, we discuss the possible consequences of cerebellar dysfunction in the social-affective domain, focusing on those neurological and psychopathological conditions in which emotional and social behavior difficulties have been described as being associated with cerebellar structural or functional alterations.
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Affiliation(s)
- Silvia Clausi
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy. .,Psychology Department, Sapienza University, Rome, Italy.
| | - Libera Siciliano
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy.,Psychology Department, Sapienza University, Rome, Italy
| | - Giusy Olivito
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy.,Psychology Department, Sapienza University, Rome, Italy
| | - Maria Leggio
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy.,Psychology Department, Sapienza University, Rome, Italy
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22
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Liang YS, Zhou SZ, Zhang YJ, Cai XL, Wang Y, Cheung EFC, Lui SSY, Yu X, Madsen KH, Ma YT, Chan RCK. Altered empathy-related resting-state functional connectivity in patients with bipolar disorder. Eur Arch Psychiatry Clin Neurosci 2022; 272:839-848. [PMID: 34282469 DOI: 10.1007/s00406-021-01305-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 07/12/2021] [Indexed: 10/20/2022]
Abstract
Empathy is the ability to generate emotional responses (i.e., cognitive empathy) and to make cognitive inferences (i.e., affective empathy) to other people's emotions. Empirical evidence suggests that patients with bipolar disorder (BD) exhibit impairment in cognitive empathy, but findings on affective empathy are inconsistent. Few studies have examined the neural mechanisms of cognitive and affective empathy in patients with BD. In this study, we examined the empathy-related resting-state functional connectivity (rsFC) in BD patients. Thirty-seven patients with BD and 42 healthy controls completed the self-report Questionnaires of Cognitive and Affective Empathy (QCAE), the Yoni behavioural task, and resting-sate fMRI brain scans. Group comparison of empathic ability was conducted. The interactions between group and empathic ability on seed-based whole brain rsFC were examined. BD patients scored lower on the Online Simulation subscale of the QCAE and showed positive correlations between cognitive empathy and the rsFC of the dorsal Medial Prefrontal Cortex (dmPFC) with the lingual gyrus. The correlations between cognitive empathy and the rsFC of the temporal-parietal junction (TPJ) with the fusiform gyrus, the cerebellum and the parahippocampus were weaker in BD patients than that in healthy controls. These findings highlight the underlying neural mechanisms of empathy impairments in BD patients.
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Affiliation(s)
- Yun-Si Liang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China.,Sino-Danish Center for Education and Research, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Shu-Zhe Zhou
- Peking University Sixth Hospital, 51 Huayuan Road, Haidian District, Beijing, 100191, China.,Peking University Institute of Mental Health, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China.,National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China
| | - Yi-Jing Zhang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xin-Lu Cai
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China.,Sino-Danish Center for Education and Research, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, Hong Kong, China
| | - Simon S Y Lui
- Castle Peak Hospital, Hong Kong Special Administrative Region, Hong Kong, China.,Department of Psychiatry, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Xin Yu
- Peking University Sixth Hospital, 51 Huayuan Road, Haidian District, Beijing, 100191, China.,Peking University Institute of Mental Health, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China.,National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China
| | - Kristoffer H Madsen
- Sino-Danish Center for Education and Research, Beijing, China.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Amager and Hvidovre, Hvidovre, Denmark.,Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Yan-Tao Ma
- Peking University Sixth Hospital, 51 Huayuan Road, Haidian District, Beijing, 100191, China. .,Peking University Institute of Mental Health, Beijing, China. .,Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China. .,National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China.
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China. .,Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China. .,Sino-Danish Center for Education and Research, Beijing, China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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23
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Christiani CJ, Hemager N, Ellersgaard D, Thorup AAE, Spang KS, Burton BK, Gregersen M, Søndergaard A, Greve A, Gantriis DL, Mors O, Plessen KJ, Nordentoft M, Jepsen JRM. Heterogeneity of social cognitive and language functions in children at familial high-risk of severe mental illness; The Danish High Risk and Resilience Study VIA 7. Eur Child Adolesc Psychiatry 2022; 31:991-1002. [PMID: 33559734 DOI: 10.1007/s00787-021-01722-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
Cognitive heterogeneity characterizes individuals with schizophrenia and bipolar disorder; however, little is known of cognitive heterogeneity within young children at familial high-risk of schizophrenia or bipolar disorder. This study aimed to investigate heterogeneity across social cognitive and language functions in children at familial high-risk of schizophrenia or bipolar disorder, i.e. severe mental illness (FHR-SMI). This may help designate subgroups in need of intervention initiatives. A data-driven, hierarchical cluster analysis was applied across a sample of 322 children at FHR-SMI (FHR-SZ, n = 200; FHR-BP, n = 120) on measures of Theory of Mind, facial emotion recognition, social cognitive processing speed, receptive and pragmatic language. We examined differences between subgroups as well as differences between subgroups and a control group. Exploratively, the subgroups were compared in terms of social responsiveness and global functioning. A Typical-High Functioning Subgroup with intact social cognitive and language functioning (34.5%), a Mildly Impaired Subgroup with selective impairments in explicit Theory of Mind and language functioning (58.7%), and a Significantly Impaired Subgroup with social cognitive and language functioning impairments (6.8%) were identified. The subgroups differed significantly from each other and overall compares to the controls. The Significantly and Mildly Impaired Subgroups presented with poorer social responsiveness and global functioning than the Typical-High Functioning Subgroup. In young children with FHR-SMI, three subgroups with relatively homogeneous social cognitive and language functioning profiles were observed. Only a small proportion of children at FHR-SMI displayed large social cognitive and language functioning impairments in middle childhood.
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Affiliation(s)
- Camilla Jerlang Christiani
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark. .,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.
| | - Nicoline Hemager
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark.,Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Ditte Ellersgaard
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Anne A E Thorup
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Katrine Søborg Spang
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Birgitte Klee Burton
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Maja Gregersen
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Anne Søndergaard
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Aja Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Ditte Lou Gantriis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Kerstin J Plessen
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospital, Lausanne, Switzerland
| | - Merete Nordentoft
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Risskov, Aarhus, Denmark
| | - Jens Richardt Møllegaard Jepsen
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark.,Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Mental Health Services-Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Glostrup, Denmark
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24
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Bi B, Che D, Bai Y. Neural network of bipolar disorder: Toward integration of neuroimaging and neurocircuit-based treatment strategies. Transl Psychiatry 2022; 12:143. [PMID: 35383150 PMCID: PMC8983759 DOI: 10.1038/s41398-022-01917-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 01/23/2023] Open
Abstract
Bipolar disorder (BD) is a complex psychiatric disorder characterized by dysfunctions in three domains including emotional processing, cognitive processing, and psychomotor dimensions. However, the neural underpinnings underlying these clinical profiles are not well understood. Based on the reported data, we hypothesized that (i) the core neuropathology in BD is damage in fronto-limbic network, which is associated with emotional dysfunction; (ii) changes in intrinsic brain network, such as sensorimotor network, salience network, default-mode network, central executive network are associated with impaired cognition function; and (iii) beyond the dopaminergic-driven basal ganglia-thalamo-cortical motor circuit modulated by other neurotransmitter systems, such as serotonin (subcortical-cortical modulation), the sensorimotor network and related motor function modulated by other non-motor networks such as the default-mode network are involved in psychomotor function. In this review, we propose a neurocircuit-based clinical characteristics and taxonomy to guide the treatment of BD. We draw on findings from neuropsychological and neuroimaging studies in BD and link variations in these clinical profiles to underlying neurocircuit dysfunctions. We consider pharmacological, psychotherapy, and neuromodulatory treatments that could target those specific neurocircuit dysfunctions in BD. Finally, it is suggested that the methods of testing the neurocircuit-based taxonomy and important limitations to this approach should be considered in future.
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Affiliation(s)
- Bo Bi
- Department of Clinical Psychology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China.
| | - Dongfang Che
- grid.452787.b0000 0004 1806 5224Neurosurgery department, Shenzhen Children’s Hospital, Shenzhen, China
| | - Yuyin Bai
- grid.12981.330000 0001 2360 039XDepartment of Clinical Psychology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
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25
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Navarra-Ventura G, Vicent-Gil M, Serra-Blasco M, Cobo J, Fernández-Gonzalo S, Goldberg X, Jodar M, Crosas JM, Palao D, Lahera G, Vieta E, Cardoner N. Higher order theory of mind in patients with bipolar disorder and schizophrenia/schizoaffective disorder. Eur Arch Psychiatry Clin Neurosci 2022; 272:497-507. [PMID: 33948693 DOI: 10.1007/s00406-021-01265-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 04/22/2021] [Indexed: 02/07/2023]
Abstract
Some evidence suggests that patients with bipolar disorder (BD) have better Theory of Mind (ToM) skills than patients with schizophrenia/schizoaffective disorder (SCH). However, this difference is not consistently reported across studies, so rather than being global, it may be restricted to specific aspects of ToM. Our primary objective was to compare higher order ToM performance between BD and SCH patients using the Hinting Task (HT). Ninety-four remitted patients were recruited (BD = 47, SCH = 47). Intelligence quotient (IQ), attention, memory, executive functions, and processing speed were also assessed. Patients with BD performed better on the HT than patients with SCH, even when the analysis was adjusted for IQ and neurocognition (p < 0.001, [Formula: see text] = 0.144). Regression analysis in the total sample showed that a diagnosis of SCH and lower IQ were associated with lower HT scores (R2 = 0.316, p < 0.001). In the BD group, verbal memory and processing speed were the main predictors of HT performance (R2 = 0.344, p < 0.001). In the SCH group, no variable was significant in explaining HT performance. In the context of previous studies that found no significant differences in the most basic aspects of ToM (e.g., understand other people's thoughts/beliefs), our results suggest that differences between the two disorders might be limited to the more challenging aspects (e.g., understand the intended meaning of indirect requests). No causal inferences can be made in this cross-sectional study. However, regression analyses show that whereas in BD patients, ToM functioning would be partially modulated by neurocognitive performance, in SCH patients, it could be largely independent of the well-known neurocognitive impairment.
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Affiliation(s)
- Guillem Navarra-Ventura
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, International Excellence Campus, Cerdanyola del Vallès, Bellaterra, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Muriel Vicent-Gil
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain
| | - Maria Serra-Blasco
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Jesús Cobo
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Sol Fernández-Gonzalo
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, International Excellence Campus, Cerdanyola del Vallès, Bellaterra, Catalonia, Spain
| | - Ximena Goldberg
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Jodar
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, International Excellence Campus, Cerdanyola del Vallès, Bellaterra, Catalonia, Spain.,Department of Neurology, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain
| | - Josep Maria Crosas
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain
| | - Diego Palao
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, International Excellence Campus, Cerdanyola del Vallès, Bellaterra, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Guillermo Lahera
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Faculty of Medicine and Health Sciences, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Institute of Neuroscience, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Narcís Cardoner
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain. .,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, International Excellence Campus, Cerdanyola del Vallès, Bellaterra, Catalonia, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
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Claeys EHI, Mantingh T, Morrens M, Yalin N, Stokes PRA. Resting-state fMRI in depressive and (hypo)manic mood states in bipolar disorders: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2022; 113:110465. [PMID: 34736998 DOI: 10.1016/j.pnpbp.2021.110465] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 10/01/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Abnormalities in spontaneous brain activity, measured with resting-state functional magnetic resonance imaging (rs-fMRI), may be key biomarkers for bipolar disorders. This systematic review compares rs-fMRI findings in people experiencing a bipolar depressive or (hypo)manic episode to bipolar euthymia and/or healthy participants. METHODS Medline, Web of Science and Embase were searched up until April 2021. Studies without control group, or including minors, neurological co-morbidities or mixed episodes, were excluded. Qualitative synthesis was used to report results and risk of bias was assessed using the National Heart, Lung and Blood Institute tool for case-control studies. RESULTS Seventy-one studies were included (3167 bipolar depressed/706 (hypo)manic). In bipolar depression, studies demonstrated default-mode (DMN) and frontoparietal network (FPN) dysfunction, altered baseline activity in the precuneus, insula, striatum, cingulate, frontal and temporal cortex, and disturbed regional homogeneity in parietal, temporal and pericentral areas. Functional connectivity was altered in thalamocortical circuits and between the cingulate cortex and precuneus. In (hypo)mania, studies reported altered functional connectivity in the amygdala, frontal and cingulate cortex. Finally, rs-fMRI disturbances in the insula and putamen correlate with depressive symptoms, cerebellar resting-state alterations could evolve with disease progression and altered amygdala connectivity might mediate lithium effects. CONCLUSIONS Our results suggest DMN and FPN dysfunction in bipolar depression, whereas local rs-fMRI alterations might differentiate mood states. Future studies should consider controlling rs-fMRI findings for potential clinical confounding factors such as medication. Considerable heterogeneity of methodology between studies limits conclusions. Standardised clinical reporting and consistent analysis approaches would increase coherence in this promising field.
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Affiliation(s)
- Eva H I Claeys
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, S.033, Universiteitsplein 1, 2610 Antwerpen, Belgium; Department of Psychiatry, University Psychiatric Centre Duffel, Stationsstraat 22, 2570 Duffel, Belgium
| | - Tim Mantingh
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Manuel Morrens
- Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, S.033, Universiteitsplein 1, 2610 Antwerpen, Belgium; Department of Psychiatry, University Psychiatric Centre Duffel, Stationsstraat 22, 2570 Duffel, Belgium
| | - Nefize Yalin
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Paul R A Stokes
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Gillissie ES, Lui LMW, Ceban F, Miskowiak K, Gok S, Cao B, Teopiz KM, Ho R, Lee Y, Rosenblat JD, McIntyre RS. Deficits of social cognition in bipolar disorder: Systematic review and meta-analysis. Bipolar Disord 2022; 24:137-148. [PMID: 34825440 DOI: 10.1111/bdi.13163] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The association between impaired social cognition and bipolar disorder (BD) is well established. However, to our knowledge, there has not been a recent systematic review that characterizes disparate dimensions of social cognition in BD. Herein, this systematic review and meta-analysis aimed to synthesize the literature on core aspects of social cognition (i.e., Theory of Mind, emotion recognition, and social judgment) to identify potential areas of impairment. METHODS Online databases (i.e., PubMed, Cochrane Libraries, PsycINFO) and Google Scholar were searched from inception to May 2021. Studies with populations ages ≥16 with DSM-IV or DSM-5 defined BD (I or II) either in a euthymic or symptomatic state were included. The risk of bias was measured using the ROBINS-1 tool, and the quality of the sources was evaluated using GRADE criteria. The results of the studies were quantitatively measured by synthesizing Hedge's g effect sizes through a random effects meta-analytic approach. RESULTS A total of 29 studies were included in the final review (i.e., 12 studies on the Theory of Mind, 11 on emotion recognition, and 6 on social judgment). Overall, results demonstrated social cognition to be moderately impaired in individuals with BD (d = 0.59). The individual domains ranged in effect size (0.38 < d < 0.70), providing evidence for variation in impairment within social cognition. DISCUSSION Individuals with BD exhibit clinically significant deficits in social cognition during euthymic and symptomatic states. Social cognition impairments in individuals with BD are an important therapeutic target for treatment discovery and development.
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Affiliation(s)
- Emily S Gillissie
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Leanna M W Lui
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Felicia Ceban
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Kamilla Miskowiak
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark.,Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Sena Gok
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, P. R. China
| | - Kayla M Teopiz
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Yena Lee
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Joshua D Rosenblat
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Roger S McIntyre
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada
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28
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Paans NP, Korten N, Orhan M, Ensing A, Schouws SN, Kupka R, van Oppen P, Dols A. Is social functioning in older age patients with bipolar disorder associated with affective and/or non-affective cognition? Int J Geriatr Psychiatry 2022; 37. [PMID: 34997778 DOI: 10.1002/gps.5676] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 12/21/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Previous research showed impairments in non-affective cognition, affective cognition, and social functioning in adult patients with bipolar disorder (BD). Only 37% of adult BD patients recovers in social functioning, and both aspects of cognition are important constructs of influence. The role of affective cognition in older age bipolar disorder (OABD) patients is still unclear. Therefore, the aim of our study was to examine the separate and combined effects of affective cognition and non-affective cognition on social functioning. METHODS The current study included 60 euthymic patients (aged >60) of the Dutch Older Bipolar Study. Affective cognition was measured by Theory of Mind and Emotion Recognition. Non-affective cognition was assessed through the measurements of attention, learning and memory, and executive functioning. Social functioning was examined through global social functioning, social participation, and meaningful contacts. The research questions were tested with linear and ordinal regression analyses. RESULTS Results showed a positive association of all non-affective cognitive domains with global social functioning. Associations between affective cognition and social functioning were non-significant. Results did show an interaction between non-affective and affective cognition. CONCLUSIONS Associations between non-affective cognition and social functioning were confirmed, associations between affective cognition and social function were not found. For generalizability, studies with a greater sample size are needed. Conducting additional research about OABD patients and affective cognition is important. It may lead to more insight in impairment and guide tailored treatment that focusses more on all aspects of recovery and the needs of OABD patients.
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Affiliation(s)
- Nadine Pg Paans
- Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, The Netherlands
| | - Nicole Korten
- Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, The Netherlands
| | - Melis Orhan
- Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, The Netherlands.,Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Anne Ensing
- Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, The Netherlands
| | | | - Ralph Kupka
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Altrecht GGZ, Utrecht, The Netherlands
| | - Patricia van Oppen
- Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, The Netherlands.,Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Annemiek Dols
- Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, The Netherlands.,Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands
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Seitz KI, Ehler N, Schmitz M, Schmitz SE, Dziobek I, Herpertz SC, Bertsch K. Affective and cognitive theory of mind in posttraumatic stress, major depressive, and somatic symptom disorders: Association with childhood trauma. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:680-700. [PMID: 35102575 DOI: 10.1111/bjc.12357] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 01/12/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Childhood trauma constitutes a major risk factor for adult psychopathology, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and somatic symptom disorder (SSD). One potential mechanism linking childhood trauma to adult psychopathology may be alterations in theory of mind (ToM). Given the lack of transdiagnostic studies on the association between childhood trauma and ToM, further research is needed to elucidate whether and how childhood trauma relates to ToM impairments across and within diagnostic boundaries. DESIGN A cross-sectional study design was applied. METHODS A total of 137 individuals with varying levels of childhood trauma took part in this study, encompassing individuals with PTSD (n = 33), MDD (n = 33), SSD (n = 36), and healthy volunteers (HVs; n = 35). To assess ToM performance and childhood trauma, the Movie for the Assessment of Social Cognition was administered along with the Childhood Trauma Questionnaire. RESULTS Only individuals with PTSD, but not individuals with MDD or SSD, showed a worse ToM performance compared to HVs. In the whole sample, childhood trauma correlated negatively with ToM performance. Exploratory group-specific analyses revealed higher levels of childhood trauma to be associated with more excessive ToM errors in individuals with SSD, and notably with an enhanced ToM performance in individuals with MDD. CONCLUSIONS Our results indicate associations between childhood trauma and ToM impairments in a large, transdiagnostic sample. Provided replication in future studies, our findings suggest ToM capacities as a promising treatment target for individuals exposed to severe childhood trauma, at least or particularly with a diagnosis of PTSD. PRACTITIONER POINTS Our results suggest that individuals with a history of severe childhood trauma, at least or particularly with a clinical diagnosis of posttraumatic stress disorder, may benefit from therapeutic approaches targeting theory of mind capacities. Our findings indicate that higher levels of childhood trauma may be linked to a specific 'hypermentalizing' bias in somatic symptom disorder. Our findings further point towards an association between higher levels of childhood trauma and a heightened - rather than a diminished - sensitivity towards interpersonal cues in major depressive disorder. Provided further confirmatory evidence, our findings may support diagnosis-specific approaches in ameliorating theory of mind abilities in individuals with different mental disorders and a history of severe childhood trauma.
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Affiliation(s)
- Katja I Seitz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany
| | - Nicola Ehler
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany
| | - Marius Schmitz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany.,Department of Psychology, Ludwig-Maximilians-University Munich, Germany
| | - Sara E Schmitz
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Isabel Dziobek
- Berlin School of Mind and Brain, Humboldt Universität zu Berlin, Germany.,Department of Psychology, Humboldt Universität zu Berlin, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany
| | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany.,Department of Psychology, Ludwig-Maximilians-University Munich, Germany
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30
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Miskowiak KW, Mariegaard J, Jahn FS, Kjærstad HL. Associations between cognition and subsequent mood episodes in patients with bipolar disorder and their unaffected relatives: A systematic review. J Affect Disord 2022; 297:176-188. [PMID: 34699850 DOI: 10.1016/j.jad.2021.10.044] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/13/2021] [Accepted: 10/20/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is highly recurrent and prevention of relapse and illness onset is an urgent treatment priority. This systematic review examined whether cognitive assessments can aid prediction of recurrence in patients with BD and/or illness onset in individuals at familial risk. METHODS The review included longitudinal studies of patients with BD or individuals at familial risk of mood disorder that examined the association between cognitive functions and subsequent relapse or illness onset, respectively. We followed the procedures of the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) 2020 statement. Searches were conducted on PubMed/MEDLINE, EMBASE and PsychInfo databases from inception up until May 10th 2021. RESULTS We identified 19 eligible studies; 12 studies investigated cognitive predictors of recurrence in BD (N = 36-76) and seven investigated cognitive predictors of illness onset in at-risk individuals (N = 84-234). In BD, general cognitive impairment, poorer verbal memory and executive function and positive bias were associated with subsequent (hypo)manic relapse -but with not depressive relapse or mood episodes in general. In first-degree relatives, impairments in attention, verbal memory and executive functions and positive bias were associated with subsequent illness onset. LIMITATIONS The findings should be considered preliminary given the small-to-moderate sample sizes and scarcity of studies. CONCLUSIONS Subject to replication, the associations between cognitive impairment and (hypo)mania relapse and illness onset may provide a platform for personalised treatment and prophylactic strategies.
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Affiliation(s)
- Kamilla Woznica Miskowiak
- Neurocognition and Emotion in Affective Disorder (NEAD) Group, Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University hospital, Rigshospitalet, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
| | - Johanna Mariegaard
- Neurocognition and Emotion in Affective Disorder (NEAD) Group, Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University hospital, Rigshospitalet, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Frida Simon Jahn
- Neurocognition and Emotion in Affective Disorder (NEAD) Group, Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University hospital, Rigshospitalet, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Hanne Lie Kjærstad
- Neurocognition and Emotion in Affective Disorder (NEAD) Group, Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University hospital, Rigshospitalet, Denmark
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31
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Aidelbaum R, Goghari V. A Visual Task-Based Assessment of Theory of Mind and Social Perception Within Bipolar Disorder. J Nerv Ment Dis 2022; 210:37-44. [PMID: 34743085 DOI: 10.1097/nmd.0000000000001408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Evidence suggests that theory of mind (TOM) and social perception (SP) may be impaired within bipolar disorder (BD). However, it remains unclear whether these deficits are facet specific and predictive of functioning. This study assessed the manifestation of TOM and SP in a BD sample. Twenty-six individuals diagnosed with BD and 25 controls were recruited and assessed for TOM, SP, and functioning. Whereas differences were observed regarding functional outcome, differences were not observed regarding social cognitive performance, regardless of facet. Correlations between social cognitive and functional outcome domains were nonsignificant, whereas significant associations were observed between the social cognitive measures. Results suggest that despite functional differences, TOM and SP, independent of facet assessed, seem preserved within the BD sample. Although evidence was not provided supporting the utility of TOM and SP in the prediction of functional outcome, evidence supports the possible dependence of these social cognitive domains on shared underlying processes.
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Affiliation(s)
- Robert Aidelbaum
- Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, ON, Canada
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32
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Maliske L, Kanske P. The Social Connectome - Moving Toward Complexity in the Study of Brain Networks and Their Interactions in Social Cognitive and Affective Neuroscience. Front Psychiatry 2022; 13:845492. [PMID: 35449570 PMCID: PMC9016142 DOI: 10.3389/fpsyt.2022.845492] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
Over the past 150 years of neuroscientific research, the field has undergone a tremendous evolution. Starting out with lesion-based inference of brain function, functional neuroimaging, introduced in the late 1980s, and increasingly fine-grained and sophisticated methods and analyses now allow us to study the live neural correlates of complex behaviors in individuals and multiple agents simultaneously. Classically, brain-behavior coupling has been studied as an association of a specific area in the brain and a certain behavioral outcome. This has been a crucial first step in understanding brain organization. Social cognitive processes, as well as their neural correlates, have typically been regarded and studied as isolated functions and blobs of neural activation. However, as our understanding of the social brain as an inherently dynamic organ grows, research in the field of social neuroscience is slowly undergoing the necessary evolution from studying individual elements to how these elements interact and their embedding within the overall brain architecture. In this article, we review recent studies that investigate the neural representation of social cognition as interacting, complex, and flexible networks. We discuss studies that identify individual brain networks associated with social affect and cognition, interaction of these networks, and their relevance for disorders of social affect and cognition. This perspective on social cognitive neuroscience can highlight how a more fine-grained understanding of complex network (re-)configurations could improve our understanding of social cognitive deficits in mental disorders such as autism spectrum disorder and schizophrenia, thereby providing new impulses for methods of interventions.
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Affiliation(s)
- Lara Maliske
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Philipp Kanske
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
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Tikka S, Walia T, Agashe S, Tikka D, Ram D, Das B. Irony comprehension in schizophrenia: Development, content validity and “Known-Groups” validity of an Indian, comic-based, computerized task. ANNALS OF INDIAN PSYCHIATRY 2022. [DOI: 10.4103/aip.aip_89_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Impaired complex theory of mind and low emotional self-awareness in outpatients with borderline personality disorder compared to healthy controls: A cross-sectional study. J Psychiatr Res 2021; 143:445-450. [PMID: 34656877 DOI: 10.1016/j.jpsychires.2021.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/02/2021] [Accepted: 10/10/2021] [Indexed: 11/21/2022]
Abstract
Studies on the theory of mind (TOM) and alexithymia in borderline personality disorder (BPD) have yielded inconsistent results. Also, the relationship between TOM abilities and alexithymia facets as two domains of social cognition has not been studied in BPD. This study aimed to fill this gap. Participants were 50 outpatients with BPD and 50 age and gender-matched healthy controls. Assessments performed using Reading the Mind in Eyes Task (RMET), Toronto Alexithymia Scale (TAS-20), Faux Pas Task (FPT), and Digit Span subtest of Wechsler Adult Intelligence Scale. Results showed that BPD patients scored lower on overall FPT (p < .001) and its cognitive (p < .001) and affective TOM (p < .001) subtests but were comparable with healthy controls in emotion recognition ability assessed by RMET (p = .241). The BPD group also scored significantly lower in overall alexithymia (p < .001) and subscales of difficulty identifying feelings (DIF; p < .001) and difficulty describing emotions (DDF; p = .001). However, they performed similarly to the healthy control group in externally oriented thinking (EOT; p = .164). Correlation analysis revealed a significant negative correlation between EOT and RMET in the BPD group (r = -0.33, p < .05). No association, however, was found between FPT and RMET. This study suggests that BPD patients are impaired in the complex TOM abilities and have lower self-awareness of emotions, but their recognition of others' emotions is intact. Also, the results demonstrate that a heightened level of EOT is associated with difficulties in facial emotion recognition in BPD patients.
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Varo C, Kjærstad HL, Poulsen E, Meluken I, Vieta E, Kessing LV, Vinberg M, Miskowiak KW. Emotional cognition subgroups in mood disorders: Associations with familial risk. Eur Neuropsychopharmacol 2021; 51:71-83. [PMID: 34098515 DOI: 10.1016/j.euroneuro.2021.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/23/2021] [Accepted: 05/11/2021] [Indexed: 01/19/2023]
Abstract
Patients with mood disorders show heterogeneity in non-emotional cognition. However, it is unclear whether emotional cognition (EC) is characterised by similar heterogeneity. We aimed to investigate the heterogeneity in EC among remitted patients with mood disorders and explore its association with familial risk. Data from 269 partially or fully remitted patients with mood disorders, 87 of their unaffected relatives (UR) and 203 healthy controls (HC) were pooled from two cohort studies. Hierarchical cluster analysis was conducted using the EC data from patients. UR were categorised into groups consistent with their affected relatives' cluster assignment. Clusters were compared to HC on EC, non-emotional cognition, clinical characteristics and functioning. We identified three clusters: an 'emotionally preserved' (57%), an 'emotionally blunted' (26%) and an 'emotionally volatile' cluster (17%). 'Emotionally blunted' and 'emotionally volatile' patients also presented more deficits in non-emotional cognition (global cognition read z=-0.3 and -0.5 respectively). Relatives of 'emotionally preserved' patients were more successful at dampening negative emotions (p=.01, d=0.39, 95% CI [-0.76,-0.09]), whereas UR of 'emotionally impaired' patients underperformed in verbal fluency (p=.03, d=0.46, 95% CI [.03, 0.68]) compared to HC. The existence of impaired EC groups in remitted mood disorder highlights a need to screen for and treat EC in mood disorders. Improved ability to dampen emotions in UR of 'emotionally preserved' patients may reflect a resilience marker while impaired verbal fluency in UR of 'emotionally impaired' patients may reflect distinct genetic risk profiles in these EC subgroups.
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Affiliation(s)
- Cristina Varo
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Hanne Lie Kjærstad
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Emilie Poulsen
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Iselin Meluken
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Lars Vedel Kessing
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Maj Vinberg
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Mental Health Services, Capital Region of Denmark, Psychiatric Centre North Zealand, Hillerød, Denmark
| | - Kamilla Woznica Miskowiak
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
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Tso IF, Burton CZ, Lasagna CA, Rutherford S, Yao B, Peltier SJ, Johnson TD, McInnis MG, Taylor SF. Aberrant activation of the mentalizing brain system during eye gaze discrimination in bipolar disorder. Psychiatry Res Neuroimaging 2021; 315:111340. [PMID: 34358977 PMCID: PMC8387449 DOI: 10.1016/j.pscychresns.2021.111340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/29/2021] [Accepted: 05/31/2021] [Indexed: 11/24/2022]
Abstract
Bipolar disorder (BD) is associated with a range of social cognitive deficits. This study investigated the functioning of the mentalizing brain system in BD probed by an eye gaze perception task during fMRI. Compared with healthy controls (n = 21), BD participants (n = 14) showed reduced preferential activation for self-directed gaze discrimination in the medial prefrontal cortex (mPFC) and temporo-parietal junction (TPJ), which was associated with poorer cognition/social cognition. Aberrant functions of the mentalizing system should be further investigated as marker of social dysfunction and treatment targets.
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Affiliation(s)
- Ivy F Tso
- Department of Psychiatry, University of Michigan, Ann Arbor, United States.
| | - Cynthia Z Burton
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - Carly A Lasagna
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - Saige Rutherford
- Department of Psychiatry, University of Michigan, Ann Arbor, United States; Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Beier Yao
- Department of Psychology, Michigan State University, United States
| | - Scott J Peltier
- Functional MRI Laboratory, University of Michigan, Ann Arbor, United States; Department of Biomedical Engineering, University of Michigan, Ann Arbor, United States
| | - Timothy D Johnson
- Department of Biostatistics, University of Michigan, Ann Arbor, United States
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - Stephan F Taylor
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
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Henry A, Raucher-Chéné D, Obert A, Gobin P, Vucurovic K, Barrière S, Sacré S, Portefaix C, Gierski F, Caillies S, Kaladjian A. Investigation of the neural correlates of mentalizing through the Dynamic Inference Task, a new naturalistic task of social cognition. Neuroimage 2021; 243:118499. [PMID: 34438254 DOI: 10.1016/j.neuroimage.2021.118499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 11/19/2022] Open
Abstract
Understanding others' intentions requires both the identification of social cues (e.g., emotional facial expressions, gaze direction) and the attribution of a mental state to another. The neural substrates of these processes have often been studied separately, and results are heterogeneous, in part attributable to the variety of paradigms used. The aim of the present study was to explore the neural regions underlying these sociocognitive processes, using a novel naturalistic task in which participants engage with human protagonists featured in videos. A total of 51 right-handed volunteers underwent functional magnetic resonance imaging while performing the Dynamic Inference Task (DIT), manipulating the degree of inference (high vs. low), the presence of emotion (emotional vs. nonemotional), and gaze direction (direct vs. averted). High nonemotional inference elicited neural activation in temporal regions encompassing the right posterior superior temporal sulcus. The presence (vs. absence) of emotion in the high-inference condition elicited a bilateral pattern of activation in internal temporal areas around the amygdala and orbitofrontal structures, as well as activation in the right dorsomedial part of the superior frontal gyrus and the left precuneus. On account of its dynamic, naturalistic approach, the DIT seems a suitable task for exploring social interactions and the way we interact with others, both in nonclinical and clinical populations.
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Affiliation(s)
- Audrey Henry
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, Reims Cedex 51571, France; Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 8 Rue Roger Aubry, Reims 51100, France.
| | - Delphine Raucher-Chéné
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, Reims Cedex 51571, France; Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 8 Rue Roger Aubry, Reims 51100, France; Douglas Mental Health University Institute, McGill University, 6875 Boulevard LaSalle, Montreal, Canada.
| | - Alexandre Obert
- Cognition Sciences, Technology & Ergonomics Laboratory, Champollion National University Institute, University of Toulouse, Place de Verdun, Albi 81000, France.
| | - Pamela Gobin
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, Reims Cedex 51571, France; Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 8 Rue Roger Aubry, Reims 51100, France.
| | - Ksenija Vucurovic
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, Reims Cedex 51571, France; Centre Rémois de Psychothérapie et Neuromodulation, 15 rue Baillia Rolland, Reims 51100, France
| | - Sarah Barrière
- Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 8 Rue Roger Aubry, Reims 51100, France.
| | - Séverine Sacré
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, Reims Cedex 51571, France
| | - Christophe Portefaix
- Radiology Department, Maison Blanche Hospital, Reims University Hospital, 45 rue Cognacq-Jay, Reims 51092, France; Université de Reims Champagne Ardenne, Laboratoire CReSTIC, Campus Moulin de la Housse, Chemin des Rouliers, Reims 51680, France.
| | - Fabien Gierski
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, Reims Cedex 51571, France; Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 8 Rue Roger Aubry, Reims 51100, France; INSERM U1247 GRAP, Research Group on Alcohol and Drugs, Université de Picardie Jules Verne, Avenue Laennec, Amiens 80054, France.
| | - Stéphanie Caillies
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, Reims Cedex 51571, France.
| | - Arthur Kaladjian
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, Reims Cedex 51571, France; Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 8 Rue Roger Aubry, Reims 51100, France; Faculty of Medicine, University of Reims Champagne-Ardenne, 51 rue Cognacq-Jay, Reims 51100, France.
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Group and sex differences in social cognition in bipolar disorder, schizophrenia/schizoaffective disorder and healthy people. Compr Psychiatry 2021; 109:152258. [PMID: 34252633 DOI: 10.1016/j.comppsych.2021.152258] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 06/11/2021] [Accepted: 06/21/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Impairment of social cognition is documented in bipolar disorder (BD) and schizophrenia/schizoaffective disorder (SCH). In healthy individuals, women perform better than men in some of its sub-domains. However, in BD and SCH the results are mixed. Our aim was to compare emotion recognition, affective Theory of Mind (ToM) and first- and second-order cognitive ToM in BD, SCH and healthy subjects, and to investigate sex-related differences. METHODS 120 patients (BD = 60, SCH = 60) and 40 healthy subjects were recruited. Emotion recognition was assessed by the Pictures of Facial Affect (POFA) test, affective ToM by the Reading the Mind in the Eyes Test (RMET) and cognitive ToM by several false-belief stories. Group and sex differences were analyzed using parametric (POFA, RMET) and non-parametric (false-belief stories) tests. The impact of age, intelligence quotient (IQ) and clinical variables on patient performance was examined using a series of linear/logistic regressions. RESULTS Both groups of patients performed worse than healthy subjects on POFA, RMET and second-order false-belief (p < 0.001), but no differences were found between them. Instead, their deficits were related to older age and/or lower IQ (p < 0.01). Subthreshold depression was associated with a 6-fold increased risk of first-order false-belief failure (p < 0.001). Sex differences were only found in healthy subjects, with women outperforming men on POFA and RMET (p ≤ 0.012), but not on first/second-order false-belief. LIMITATIONS The cross-sectional design does not allow for causal inferences. CONCLUSION BD and SCH patients had deficits in emotion recognition, affective ToM, and second-order cognitive ToM, but their performance was comparable to each other, highlighting that the differences between them may be subtler than previously thought. First-order cognitive ToM remained intact, but subthreshold depression altered their normal functioning. Our results suggest that the advantage of healthy women in the emotional and affective aspects of social cognition would not be maintained in BD and SCH.
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Lemvigh CK, Karantonis JA, Furlong LS, Carruthers SP, Pantelis C, Rossell SL, Van Rheenen TE. Characterization and interrelationships of theory of mind, socially competitive emotions and affective empathy in bipolar disorder. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:76-92. [PMID: 34232514 DOI: 10.1111/bjc.12318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/22/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Evidence shows impaired theory of mind (ToM) in patients with bipolar disorder (BD), yet research examining its cognitive and affective components simultaneously is sparse. Moreover, recognition of socially competitive 'fortune of others' emotions (e.g. envy/gloat) may be related to ToM, but has not been assessed in BD. Finally, if and how ToM and 'fortune of others' emotions relate to affective empathy in BD is currently unclear. This study aimed to address these points. METHODS 64 BD patients and 34 healthy controls completed the Yoni task, a visual task assessing first- and second-order cognitive and affective ToM as well as 'fortune of others' emotions. The Toronto Empathy Questionnaire was used to assess self-reported affective empathy. RESULTS Patients with BD showed no deficits in cognitive and affective ToM or recognition of 'fortune of others' emotions. The ability to infer 'fortune of others' emotions correlated with several ToM measures, indicating that these functions are part of the same system. Patients with BD reported similar levels of affective empathy to healthy controls, and this was not related to ToM or 'fortune of others' emotions, suggesting that affective empathy represents a separate social domain. CONCLUSIONS These findings highlight areas of spared social functioning in BD, which may be utilized in therapeutic strategies. PRACTITIONER POINTS Our results suggest theory of mind and empathy may represent areas of potentially spared cognitive functioning in BD. As many BD patients have experienced adversity during developmental periods in which theory of mind and empathy develop, our findings suggest that these abilities may be markers of resilience in the disorder. Our findings are important for the formulation of therapeutic interventions for BD, which may include considering practical ways that a patients' knowledge of intact ToM and empathy could be utilized to reduce self-stigma and promote self-efficacy, improved well-being and functioning.
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Affiliation(s)
- Cecilie K Lemvigh
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, Denmark.,Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark.,Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton, Victoria, Australia
| | - James A Karantonis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton, Victoria, Australia.,Faculty of Health, Arts and Design, Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Lisa S Furlong
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton, Victoria, Australia
| | - Sean P Carruthers
- Faculty of Health, Arts and Design, Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Christos Pantelis
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, Denmark.,Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton, Victoria, Australia.,Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Susan L Rossell
- Faculty of Health, Arts and Design, Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia.,Department of Psychiatry, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton, Victoria, Australia.,Faculty of Health, Arts and Design, Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia
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A Systematic Review of the Current Measures of Theory of Mind in Adults with Schizophrenia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137172. [PMID: 34281109 PMCID: PMC8297277 DOI: 10.3390/ijerph18137172] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/17/2021] [Accepted: 06/29/2021] [Indexed: 12/19/2022]
Abstract
Adults with schizophrenia usually have impairments in theory of mind (ToM), which subsequently cause them problems in social interaction. Therefore, it is important for healthcare providers to assess their ToM using adequate measures. This systematic review evaluated current ToM measures (or ToM tasks) for adults with schizophrenia and summarized their specific characteristics, including the concept and construct, administration, and psychometric properties. From a review of 117 articles, 13 types of ToM tasks were identified, and the findings from these articles were qualitatively synthesized. The results showed that ToM tasks are diverse in their presentation modalities, answer modes, strategies of controlling cognitive confounders, and scoring. Most tasks employ cognitive and affective dimensions and target a specific, single ToM concept. The present systematic review found that psychometric evidence supporting the ToM tasks, such as internal consistency, test–retest reliability, unidimensionality, and convergent, criterion, and ecological validities, is insufficient. Based on the results, we propose several principles for selecting appropriate ToM tasks in practice, e.g., selecting a task with multiple ToM concepts, or an exclusive ToM construct containing the cognitive and affective dimensions. Moreover, future studies are needed to provide more psychometric evidence on each type of ToM task applied in people with schizophrenia.
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Labalestra M, Stefaniak N, Lefebvre L, Besche-Richard C. Influence of Psychological Vulnerability Factors for Bipolar Disorders on a Semantic Mediated Priming Task. Front Psychol 2021; 12:598114. [PMID: 34177681 PMCID: PMC8219865 DOI: 10.3389/fpsyg.2021.598114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 05/11/2021] [Indexed: 11/22/2022] Open
Abstract
Hypomanic personality, hyperthymic temperament and irritable temperament are considered as psychological vulnerability factors to bipolar disorders. Semantic memory is impaired in bipolar patients. Spreading activation is among the probable candidates for accounting this impairment. The aim of this study was to assess spreading activation according to vulnerability factors continuum to determine whether it could be a factor of vulnerability to bipolar disorders. A sample of 61 healthy volunteers was recruited. Spreading activation was assessed by semantic mediated priming implemented in a double lexical decision task. Results shown that semantic mediated priming was negatively associated to hyperthymic temperament and irritable temperament. Impairment in semantic memory, and more specifically spreading activation, appear to be a cognitive factor of vulnerability to bipolar disorders. Our results can contribute to a better understanding of semantic impairment in vulnerable population and in bipolar disorder.
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Affiliation(s)
- Mélanie Labalestra
- Service de Psychologie Cognitive et Neuropsychologie, Université de Mons, Mons, Belgique
| | - Nicolas Stefaniak
- Laboratoire Cognition Santé Société, Université de Reims Champagne-Ardenne, Reims, France
| | - Laurent Lefebvre
- Service de Psychologie Cognitive et Neuropsychologie, Université de Mons, Mons, Belgique
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Impaired theory of mind and emotion recognition in pediatric bipolar disorder: A systematic review and meta-analysis. J Psychiatr Res 2021; 138:246-255. [PMID: 33866053 DOI: 10.1016/j.jpsychires.2021.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/16/2021] [Accepted: 04/05/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Social cognition is impaired in patients with severe mental disorders. We aimed to investigate impairments in social cognition in youth with pediatric bipolar disorder (PBD) through a systematic review of the literature and the meta-analysis. METHOD Following the PRISMA guidelines, we searched in PubMed, Scopus, and Cochrane CENTRAL for studies reporting on the theory of mind (ToM) and emotion recognition (ER) abilities of patients with PBD compared to healthy controls (HC). We conducted a random-effects model meta-analysis for the contrast between PBD and HC. Subgroup and meta-regression analyses were conducted for demographic and clinical variables as appropriate. RESULTS A total of thirteen studies involving 429 patients with PBD and 394 HC were included. Patients with PBD had significantly poorer social cognitive abilities (Hedges' g for ER, g = -0.74, CI = -0.91, -0.57; and for ToM, g = -0.98, CI = -1.41 to -0.55). Subgroup analysis also revealed significant impairment in ER for patients in a euthymic state (g = -0.75). Age, gender, sample size, the severity of mood symptoms, estimated IQ, the frequencies of bipolar-I disorder, attention-deficit hyperactivity disorder, medications, study quality and euthymia did not moderate the difference in meta-regression. Heterogeneity was low in all analyses and there was no evidence for publication bias. CONCLUSION The results of this meta-analysis supported the notion that PBD is associated with a deficit in social cognitive abilities at a medium to a large level. Impairments in social cognition could be an illness-related trait of PBD. Meta-regression results did not find a moderator of the deficits in social cognition.
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Nijssens L, Luyten P, Malcorps S, Vliegen N, Mayes L. Parental reflective functioning and theory of mind acquisition: A developmental perspective. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2021; 39:584-602. [PMID: 34056741 DOI: 10.1111/bjdp.12383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 04/30/2021] [Indexed: 12/31/2022]
Abstract
This study investigated theory of mind (ToM) development in 83 children aged 3-5 years and its associations with parental reflective functioning (PRF), using a multidimensional and developmental approach. Results showed that ToM dimensions (i.e., affective, belief-desire, and cognitive) gradually increased with age. All dimensions of PRF (i.e., prementalizing modes, certainty about mental states, and interest and curiosity in mental states) were associated with ToM dimensions, with different dimensions being differentially related to ToM, including age-related effects.
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Affiliation(s)
- Liesbet Nijssens
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium.,Research Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Saskia Malcorps
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | - Nicole Vliegen
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | - Linda Mayes
- Yale Child Study Center, New Haven, Connecticut, USA
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Palaniappan P, Easwaran K. Theory of Mind Deficits and Their Influence on Functional Impairment in Remitted Phase of Bipolar Disorder. Indian J Psychol Med 2021; 43:195-202. [PMID: 34345094 PMCID: PMC8287390 DOI: 10.1177/0253717620930315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 03/31/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Functional impairment has been convincingly established in the euthymic/ remitted phase of bipolar disorder (BD). Though deficits in social cognition, especially theory of mind (ToM), predict functional impairment, the association has not been consistently proven. METHODS Thirty remitted subjects with BD (as per DSM 5) and 30 age- and gender-matched healthy controls were screened for eligibility and the sociodemographic details and ToM scores, that is, first-order ToM, second-order ToM, and Faux pas, were collected. In subjects with BD, functioning was assessed using Functioning Assessment Short Test (FAST) and illness variables were collected. RESULTS No significant difference was found in occupation or education between the groups. Remitted subjects with BD had statistically significant deficits in all domains of ToM, that is, first-order ToM (r = 0.65), second-order ToM (r = 0.69), and Faux pas (r = 0.75). Significant correlations existed between first-order ToM and FAST total score, as well as second-order ToM and FAST total score, but the correlations dropped after controlling for duration of illness and number of depressive episodes. Quantile regression analysis showed that the only factors which predicted global functional impairment was a higher number of episodes (βτ= -0.45, SE = 3.51, t = 0.13, P = 0.04), while all other illness variables and ToM failed to predict the global functioning. CONCLUSION Though there seems to be an association between ToM and functioning, only illness variables predicted functional impairment in subjects with BD. We need prospective studies to delineate the contributors to functional impairment.
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Affiliation(s)
- Pradeep Palaniappan
- Dept. of Psychiatry, PSG Institute of Medical Sciences & Research, Coimbatore, India
| | - Krishnapriya Easwaran
- Dept. of Psychiatry, PSG Institute of Medical Sciences & Research, Coimbatore, India
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Ganesh UM, Shwetha Ts, Bhandary RP. Social Cognition and Neuro-cognition in Patients with Bipolar Disorder, Their First-Degree Relatives and Healthy Controls. Indian J Psychol Med 2021; 43:203-208. [PMID: 34345095 PMCID: PMC8287400 DOI: 10.1177/0253717620957936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Studies focusing on assessing social cognition deficits in schizophrenia have been expanded to bipolar disorder considering the similarities shared between the two conditions. Existing research has identified significant deficits in social cognitive skills independent of mood states and neurocognitive deficits, which could indicate the potentiality of this domain to be an endophenotype for bipolar disorder. METHODS The current study assesses the impairments in social cognition in patients with bipolar disorder and their first degree relatives, simultaneously testing for neurocognition as well, and comparing their performance to healthy controls. Fifty four participants were recruited, with 18 participants in each group. MATRICS Consensus Cognitive Battery was used to test neurocognition and Social Cognition Rating Tool in Indian Setting was administered for testing social cognition. RESULTS Significant deficits were found in social cognition and neurocognition (at p<.01) in the patient group when compared to both probands and healthy controls but no difference between probands and healthy controls. This finding established impairments in socio-cognitive functioning in remitted patients. Conclusion: The study has identified persistent deficits in social and neuro-cognition despite remission, having significant clinical implications in terms developing remediation programs for social cognition and planning early intervention as social cognition deficits have been identified as potential risk factors.
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Affiliation(s)
- Uma Maheswari Ganesh
- Dept. of Clinical Psychology, SriRamchandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India
| | - Shwetha Ts
- Dept. of Clinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rajeshkrishna P Bhandary
- Dept. of Psychiatry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Koo SJ, Kim YJ, Han JH, Seo E, Park HY, Bang M, Park JY, Lee E, An SK. "Reading the Mind in the Eyes Test": Translated and Korean Versions. Psychiatry Investig 2021; 18:295-303. [PMID: 33849244 PMCID: PMC8103020 DOI: 10.30773/pi.2020.0289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/28/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The Reading the Mind in the Eyes Test (RMET) was developed by using Caucasian eyes, which may not be appropriate to be used in Korean. The aims of the present study were 1) to develop a Korean version of the RMET (K-RMET) by using Korean eye stimuli and 2) to examine the psychometric properties of the Korean-translated version of the RMET and the K-RMET. METHODS Thirty-six photographs of Korean eyes were selected. A total of 196 (101 females) healthy subjects were asked to take the Korean-translated version of the RMET and K-RMET. To assess internal consistency reliability, Cronbach's alpha coefficients were computed, and test-retest reliability was assessed by the intraclass correlation coefficient (ICC) and Bland-Altman plots. Confirmatory factor analysis (CFA) and item analysis were also conducted. RESULTS Internal consistency, measured by Cronbach's alpha, was 0.542 for the Korean-translated version of the RMET, and 0.540 for the K-RMET. Test-retest reliability (n=25), measured by the ICC, was 0.787 for the Korean-translated version of the RMET, and 0.758 for the K-RMET. In CFA, the assumed single and 3-factor model fit indices were not good in the both types of RMETs. There was difficulty in discrimination in nine items of the Korean-translated version of the RMET and 10 items of the K-RMET. CONCLUSION The psychometric properties of both the Korean-translated version of the RMET and the K-RMET are acceptable. Both tests are applicable to the clinical population, as well as the general population in Korea.
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Affiliation(s)
- Se Jun Koo
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Graduate Program in Cognitive Science, Yonsei University, Seoul, Republic of Korea
| | - Ye Jin Kim
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Hwa Han
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eunchong Seo
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Hye Yoon Park
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Minji Bang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Jin Young Park
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin, Republic of Korea
| | - Eun Lee
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Suk Kyoon An
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Graduate Program in Cognitive Science, Yonsei University, Seoul, Republic of Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
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Matsuo J, Hori H, Ishida I, Hiraishi M, Ota M, Hidese S, Yomogida Y, Kunugi H. Performance on the Wechsler Adult Intelligence Scale (WAIS) in Japanese patients with bipolar and major depressive disorders in euthymic and depressed states. Psychiatry Clin Neurosci 2021; 75:128-137. [PMID: 33368739 PMCID: PMC8048446 DOI: 10.1111/pcn.13191] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/29/2020] [Accepted: 12/21/2020] [Indexed: 02/01/2023]
Abstract
AIM This study aimed to examine the cognitive performance of patients with bipolar disorder (BD) stratified by illness phase compared to that of patients with major depressive disorder (MDD) and healthy controls. METHODS Participants were 139 patients with BD (55 euthymic and 84 depressed), 311 patients with MDD (88 euthymic and 223 depressed), and 386 healthy controls who underwent the Wechsler Adult Intelligence Scale-Revised or the Third Edition. They were non-elderly Japanese individuals with normal estimated premorbid intelligence quotient (IQ; >90), group-matched for age, sex, and premorbid IQ. RESULTS The depressed BD group showed significantly lower scores on verbal IQ, performance IQ, full-scale IQ, and three group indexes of perceptual organization, working memory, and processing speed when compared with healthy controls (all P < 0.001). All IQs and working memory index were also significantly lower than those of the depressed MDD group. The depressed MDD group scored significantly lower than controls in performance IQ (P < 0.001), full-scale IQ, and only in the index of processing speed (P < 0.001). The euthymic BD group scored significantly lower than controls in performance IQ (P = 0.004), whereas the euthymic MDD group scored significantly lower than controls only in processing speed (P = 0.030). CONCLUSION Patients with BD appear to have global and more intense cognitive impairments in depressed states compared with those with MDD whose impairments seem to be apparent only in processing speed in the Wechsler Adult Intelligence Scale. Attenuated impairments appear to exist in euthymic states of both patients.
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Affiliation(s)
- Junko Matsuo
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroaki Hori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ikki Ishida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Moeko Hiraishi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Miho Ota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Shinsuke Hidese
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yukihito Yomogida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
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Social and Neurocognitive Deficits in Remitted Patients with Schizophrenia, Schizoaffective and Bipolar Disorder. Healthcare (Basel) 2021; 9:healthcare9040365. [PMID: 33805007 PMCID: PMC8063917 DOI: 10.3390/healthcare9040365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 11/17/2022] Open
Abstract
This study assesses the empathy level, cognitive performance and emotion recognition skills of remitted patients with schizophrenia, schizoaffective disorder and bipolar disorder, and also explores the relationship between impairments in the mentioned domains. The study was performed on 77 subjects divided into two groups: PAT sample (N = 37) included remitted patients with either schizophrenia, schizoaffective or bipolar disorder who were compared with healthy control subjects from the HC sample (N = 40). Along with sociodemographic and clinical data, empathy levels (using EQ (Empathy Quotient) scale), the ability to recognize another person’s emotional state (using RMET (Reading the Mind in the Eyes Test)), and cognitive performance (using MoCA (Montreal Cognitive Assessment) Scale) were investigated. The intensity of the psychiatric symptoms was measured with BPRS-E (Brief Psychiatric Rating Scale—Expanded). The remitted patients had lower EQ (p = 0.02) and RMET (p < 0.0001) scores than the healthy subjects. In the PAT group, RMET scores were positively correlated with MoCA total scores. Both EQ and RMET scores were negatively correlated with BPRS-E total scores. Psychiatric disorder was a significant predictor for deficits in emotion recognition. There were no significant differences in RMET, EQ and MoCA scores between patients with respect to diagnosis, the type of antipsychotic or the associated medication. In both samples, females had higher empathy levels (p = 0.04) and better emotion recognition abilities (p = 0.04) than males. Patients with schizophrenia, schizoaffective or bipolar disorder, currently in remission, displayed lower empathy levels and poorer emotion recognition skills than healthy subjects. Poor emotion recognition skills were associated with symptom severity and impairments in global cognition.
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Sayar-Akaslan D, Baskak B, Kir Y, Kusman A, Yalcinkaya B, Çakmak IB, Munir K. Cortical activity measured by functional near infrared spectroscopy during a theory of mind task in subjects with schizophrenia, bipolar disorder and healthy controls. J Affect Disord 2021; 282:329-339. [PMID: 33421860 DOI: 10.1016/j.jad.2020.12.094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/12/2020] [Accepted: 12/22/2020] [Indexed: 12/26/2022]
Abstract
Theory of Mind (ToM) deficits interfere in social cognitive functioning in schizophrenia (SCZ) and are increasingly recognized to do so in bipolar disorder (BD), however their clinical and neurobiological correlates remain unclear. This study represents the first direct comparison of subjects with SCZ (N = 26), BD (N = 26) and healthy controls (N = 33) in cortical activity during the Reading the Mind in the Eyes Task (RMET) using functional Near Infrared Spectroscopy (fNIRS) with the control condition (CC) involving gender identification via the same stimuli. The three groups were compared with a comprehensive ToM battery and assessed in terms of the relationship of ToM performance with clinical symptoms, insight and functioning. The controls scored higher than the SCZ and BD groups in ToM assessments, with SCZ group showing the worse performance in terms of meta-representation and empathy. The SCZ group ToM scores inversely correlated with negative symptom severity and positively correlated with insight; BD group ToM scores negatively correlated with subclinical mania symptoms and projected functioning. Cortical activity was higher during the ToM condition compared to the CC in the pre-motor and supplementary-motor cortices, middle and superior temporal gyri, and the primary somatosensory cortex. Group x Condition interaction was detected whereby activity was higher during the ToM condition among controls with no detected difference between SCZ and BD groups. The results suggest that ToM is represented similarly in cortical activity in SCZ and BD compared to healthy controls pointing to possible neurobiological convergence of SCZ and BD in underlying impairments of social cognition.
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Affiliation(s)
- Damla Sayar-Akaslan
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankara University Brain Research Center (AUBAUM), Ankara, Turkey
| | - Bora Baskak
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankara University Brain Research Center (AUBAUM), Ankara, Turkey; Neuroscience and Neurotechnology Center of Excellence, NÖROM, Ankara, Turkey.
| | - Yagmur Kir
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankara University Brain Research Center (AUBAUM), Ankara, Turkey
| | - Adnan Kusman
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankara University Brain Research Center (AUBAUM), Ankara, Turkey
| | - Busra Yalcinkaya
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankara University Brain Research Center (AUBAUM), Ankara, Turkey
| | - Işık Batuhan Çakmak
- University of Health Sciences, Ankara City Hospital, Department of Psychiatry, Turkey
| | - Kerim Munir
- Harvard Medical School, Developmental Medicine Center, Boston Children's Hospital, Boston, USA
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Giurgi-Oncu C, Bredicean C, Frandeș M, Enătescu V, Papavă I, Riviș I, Ursoniu S. Social Inferences as Mediators of Wellbeing in Depression. Neuropsychiatr Dis Treat 2021; 17:1679-1687. [PMID: 34079265 PMCID: PMC8166309 DOI: 10.2147/ndt.s309009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/29/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Depression is an increasingly prevalent chronic mental health condition that involves a range of potentially negative implications, in the long term. Theory of Mind (ToM) serves to form and maintain social relationships, by accurately identifying thoughts and emotions in others. Defective ToM abilities have been noted in people with a history of clinical depression. PURPOSE To identify whether impairments of emotion recognition are correlated with a lower subjective feeling of wellbeing in people diagnosed with a chronic depressive illness. PATIENTS AND METHODS In a cross-sectional analysis of a recurrent depressive disorder (RDD, as per WHO ICD-10 nosology) cohort (n=57), the BECK depression scale and the "Reading the mind in the eyes" test were employed for the diagnosis of clinical symptoms, and for the evaluation of individual ToM skills, respectively. Wellbeing was quantified using the FANLCT scale. RESULTS The wellbeing of service-users decreased significantly, in correlation with their defective emotion recognition abilities. Additionally, a low capacity for the correct perception of emotions in other people appears to significantly influence the social relationships status, with scores of 14.00 (10.00-18.50) at low capacity vs 23.00 (17.58-24.75) at normal capacity (Mann-Whitney U-test, p < 0.001). Our study findings indicate that a normal ability for a correct recognition of emotions in others is significantly and strongly correlated with adequate social relationships (Spearman r = 0.757, p < 0.05). CONCLUSION Wellbeing is significantly correlated with the individual ability for a correct recognition of emotions in others.
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Affiliation(s)
- Cătălina Giurgi-Oncu
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania.,"Pius Brînzeu" County Emergency Clinical Hospital, Timișoara, Romania
| | - Cristina Bredicean
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania.,"Dr. Victor Popescu" Military Clinical Emergency Hospital, Timișoara, Romania
| | - Mirela Frandeș
- Department of Functional Sciences, Discipline of Medical Informatics and Biostatistics, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Virgil Enătescu
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania.,"Pius Brînzeu" County Emergency Clinical Hospital, Timișoara, Romania
| | - Ion Papavă
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania.,"Pius Brînzeu" County Emergency Clinical Hospital, Timișoara, Romania
| | - Ioana Riviș
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Sorin Ursoniu
- Department of Functional Sciences, Discipline of Public Health, Center for Translational Research and Systems Medicine, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
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