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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] [MESH Headings] [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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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: 1] [Impact Index Per Article: 1.0] [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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Ghanbari S, Asgarizadeh A, Vahidi E, Seyed Mousavi PS, Omidghaemi M. Emotion dysregulation as mediator between mentalizing capacity and affective states: An exploratory study. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e124. [PMID: 38867841 PMCID: PMC11114384 DOI: 10.1002/pcn5.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 06/25/2023] [Accepted: 07/05/2023] [Indexed: 06/14/2024]
Abstract
Aim We intended to elucidate the relationship between mentalizing capacity and affective states by investigating the mediatory role of emotion dysregulation. Methods A sample of nonclinical Iranian adults (N = 445) completed a battery of online self-report measures comprising the Positive and Negative Affect Schedule (PANAS), Mentalization Scale (MentS), and Difficulties in Emotion Regulation Scale (DERS). Results Correlational analyses demonstrated that self- and other-related mentalizing were significantly and inversely associated with emotion dysregulation, which in turn was strongly linked with positive and negative affects. Using structural equation modeling, the results delineated emotion dysregulation as a mediator between self- and other-related mentalizing and affective states, predicting higher negative and lower positive affects. However, motivation to mentalize failed to predict positive affects and only contributed to lower negative affects directly. Conclusion Mentalizing capacity was found to be indirectly linked with affective states through emotion dysregulation; hence, along with the previously substantiated association between emotion dysregulation and affective states and the partially established relationship between mentalizing capacity and affective states, we propose mentalizing incapacity to be at fault in the development of affective difficulties.
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Affiliation(s)
- Saeed Ghanbari
- Faculty of Education and PsychologyShahid Beheshti UniversityTehranIran
| | - Ahmad Asgarizadeh
- Faculty of Education and PsychologyShahid Beheshti UniversityTehranIran
| | - Elahe Vahidi
- Faculty of Education and PsychologyShahid Beheshti UniversityTehranIran
| | | | - Maryam Omidghaemi
- Faculty of Education and PsychologyShahid Beheshti UniversityTehranIran
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5
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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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6
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Dorris L, Young D, Barlow J, Byrne K, Hoyle R. Cognitive empathy across the lifespan. Dev Med Child Neurol 2022; 64:1524-1531. [PMID: 35594529 PMCID: PMC9790591 DOI: 10.1111/dmcn.15263] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 01/31/2023]
Abstract
AIM To describe the development of cognitive empathy across the lifespan from a very large cohort using a standardized measure of cognitive empathy ability. METHOD Participants (n=4545, age bands <5y to >75y, 60% female) were a convenience sample recruited voluntarily from visitors to the Glasgow Science Centre in the UK, who completed the Reading the Mind in the Eyes Test. RESULTS When compared to preceding age groups, we found significant developmental gains in empathy ability in children aged 6 to 7 years (p=0.048, d=0.45) and again at 10 to 12 years (p=0.042, d=0.23), followed by a slight reduction in ability during adolescence (p=0.087, d=-0.18), and functional maturity in those aged 19 to 25 years (p=0.001, d=0.76). Cognitive empathy abilities remained relatively stable across adulthood but gradually declined in people over 65 years, with notable decline in males over 75 years (p=0.001, d=-0.98). Females performed better than males at all ages. INTERPRETATION Understanding developmental issues in cognitive empathy could influence approaches to moral and social education for children, and health and social care support for older people. Standardized cognitive empathy tests could also provide novel approaches in the early detection of developmental vulnerabilities in a range of neurological conditions, and within neuropsychiatric and neurodegenerative disorders in which cognitive empathy is known to be impaired. WHAT THIS PAPER ADDS Cognitive empathy is a late-developing ability and changes across the lifespan. Cognitive empathy increases during childhood but with potentially altered abilities during adolescence. Cognitive empathy matures during early adulthood and gradually declines in older age. There is a female advantage in cognitive empathy abilities.
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Affiliation(s)
- Liam Dorris
- Paediatric Neurosciences Research GroupRoyal Hospital for ChildrenGlasgow,Institute of Health & Wellbeing, Medical Veterinary & Life SciencesUniversity of GlasgowGlasgow
| | - David Young
- Department of Mathematics and StatisticsUniversity of StrathclydeGlasgow
| | - Jill Barlow
- Department of Mathematics and StatisticsUniversity of StrathclydeGlasgow
| | - Karl Byrne
- Glasgow Science Centre, Pacific QuayGlasgowUK
| | - Robin Hoyle
- Glasgow Science Centre, Pacific QuayGlasgowUK
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Tang E, Zhang M, Chen Y, Lin Y, Ding H. Recognition of affective prosody in bipolar and depressive conditions: A systematic review and meta-analysis. J Affect Disord 2022; 313:126-136. [PMID: 35780961 DOI: 10.1016/j.jad.2022.06.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/16/2022] [Accepted: 06/23/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Inconsistent results have been reported about the affective prosody recognition (APR) ability in patients with bipolar (BD) and depressive (DD) disorders. We aimed to (i) evaluate the magnitude of APR dysfunction in BD and DD patients, (ii) identify moderators for heterogeneous results, and (iii) highlight research trends in this field. METHODS A computerized literature search was conducted in five electronic databases from the inception to May 9th, 2022 to identify behavioural experiments that studied APR in BD or DD patients. Effect sizes were calculated using a random-effect model and recalculated after removing outliers and adjusting publication bias. RESULTS Twelve eligible articles totalling 16 studies were included in the meta-analysis, aggregating 612 patients and 809 healthy controls. Individual r2 ranged from 0.008 to 0.355, six of which reached a medium-to-large association strength. A medium-to-large pooled effect size (Hedges g = -0.58, 95 % CI -0.75 to -0.40, p < 0.001) for overall APR impairment in BD and DD patients was obtained. The Beck Depression Inventory score and answer option number were significant moderators. Neuropsychological mechanisms, multi-modal interaction and comorbidity effects have become primary research concerns. LIMITATIONS Extant statistics were insufficient for disorder-specific analysis. CONCLUSIONS Current findings demonstrate deficits of overall APR in BD and DD patients at a medium-to-large magnitude. APR can clinically serve for early screening and prognosis, but the depression severity, task complexity and confounding variables influence patients' APR performance. Future studies should incorporate neuroimaging approaches and investigate the effects of tonal language stimuli and clinical interventions.
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Affiliation(s)
- Enze Tang
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, China
| | - Minyue Zhang
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, China
| | - Yu Chen
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, China
| | - Yi Lin
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, China
| | - Hongwei Ding
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, China.
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8
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Lai S, Zhong S, Wang Y, Zhang Y, Xue Y, Zhao H, Ran H, Yan S, Luo Y, He J, Zhu Y, Lv S, Song Z, Miao H, Hu Y, Huang X, Lu X, Zhou J, Jia Y. The prevalence and characteristics of MCCB cognitive impairment in unmedicated patients with bipolar II depression and major depressive disorder. J Affect Disord 2022; 310:369-376. [PMID: 35504401 DOI: 10.1016/j.jad.2022.04.153] [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: 10/20/2021] [Revised: 03/16/2022] [Accepted: 04/26/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cognitive impairment has been acknowledged as a core clinical manifestation of bipolar disorder (BD) as well as major depressive disorder (MDD). Determining the prevalence and characteristics of cognitive impairment is important for clinical interventions. This study investigated the prevalence and characteristics of cognitive impairment based on the Measurement and Treatment Research to Improve Cognition Schizophrenia Consensus Cognitive Battery (MCCB) in both BD and MDD. METHOD One hundred and forty-nine BD II depression, 147 MDD, and 124 demographically matched healthy controls (HC) underwent MCCB cognitive assessment. The prevalence of MCCB cognitive impairment and group difference comparisons were performed. Additionally, association analysis was performed to investigate the relationship between cognitive performance and clinical variables. RESULTS Compared to the HC group, both BD II depression and MDD groups had a significantly reduced performance for all MCCB cognitive domains (all p < 0.05). The numerical scores for visual learning were lower in the BD II depression group compared to the MDD group. 32.89% of the BD II depression patients had clinically significant impairment (>1.5 SD below the normal mean) in two or more MCCB domains compared to 23.13% for MDD patients. CONCLUSIONS A high percent of patients in the BD II depression and MDD group exhibited MCCB cognitive impairments with clinical significance. Cognitive impairments were more common in BD II depression patients compared to MDD patients, particularly for visual learning. These findings suggest that clinicians should be aware of the severe cognitive impairment in mood disorders and establish effective cognitive screening and intervention strategies.
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Affiliation(s)
- Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Ying Xue
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hui Zhao
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hanglin Ran
- School of Management, Jinan University, Guangzhou 510316, China
| | - Shuya Yan
- School of Management, Jinan University, Guangzhou 510316, China
| | - Yange Luo
- School of Management, Jinan University, Guangzhou 510316, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yunxia Zhu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Sihui Lv
- School of Management, Jinan University, Guangzhou 510316, China
| | - Zijing Song
- School of Management, Jinan University, Guangzhou 510316, China
| | - Haofei Miao
- School of Management, Jinan University, Guangzhou 510316, China
| | - Yilei Hu
- School of Management, Jinan University, Guangzhou 510316, China
| | - Xiaosi Huang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Xiaodan Lu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Jiansong Zhou
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
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9
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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: 23] [Impact Index Per Article: 11.5] [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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10
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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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11
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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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12
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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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