Objective: To conduct a meta-analysis of Theory of Mind studies exclusively in euthymic patients with bipolar disorder. Method: After the exclusion of studies evaluating symptomatic patients during acute episodes, we performed a meta-analysis including a total of 30 studies, comparing 1294 euthymic bipolar disorder patients and 1116 healthy controls. Results: Patients with bipolar disorder presented a significant impairment in Theory of Mind performance when compared to controls (Hedge’s g = −0.589, 95% confidence interval: −0.764 to −0.414, Z = −6.594, p < 0.001). When compared to controls, Theory of Mind was impaired in patients with both bipolar disorder I (Hedge’s g = −0.663, 95% confidence interval: −0.954 to −0.372, Z = −4.462, p < 0.001) and bipolar disorder II (Hedge’s g = −1.165, 95% confidence interval: −1.915 to −0.415, Z = −3.044, p = 0.002). Theory of Mind impairments were also significantly more severe in verbal tasks (Hedge’s g = −1.077, 95% confidence interval: −1.610 to −0.544, Z = −3.961 p < 0.001) than visual tasks (Hedge’s g =−0.614, 95% confidence interval: −0.844 to −0.384, Z = −5.231, p < 0.001) when compared to controls. Conclusion: The results obtained confirm that Theory of Mind is impaired in remitted bipolar disorder patients, being a potential endophenotype for bipolar disorder. Moreover, we found higher deficits in verbal Theory of Mind, compared with visual Theory of Mind. Since most studies were cross-sectional, there is a need for longitudinal studies to evaluate whether the deficits detected in Theory of Mind are progressive over the course of the illness.

In the past few months, many lives have been impacted by the new COVID‐19 pandemic, which generateda need for social isolation and quarantine, impacting personal freedom, financial stability, and mental health. During this period, it is expected that many people willexperience higher levels of anxiety and depression.Individualswith pre‐existing anxiety disorders (AD) and other psychiatric conditions are more vulnerable to the negative psychological consequences of pandemics.Individuals with bipolar disorder (BD) are at increased risk of developing AD, with roughlyhalf of this population exhibitingitduring the course of illness 1 .Recently published guidelines focus mainly on general mental health issues, whereas our clinical care review aims to provide specific guidelines for BD treatment during the COVID‐19 pandemic.All mental health approaches cited in this article are based on scientific evidence.

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