Social cognition throughout the three phases of bipolar disorder: A state-of-the-art overview

Theory of mind, empathy and moral emotions in patients with affective disorders

“…The profile of social cognition shaping during the course of three phases of the disease and the nature of its changes remain vaguely defined. An important contribution to this topic was made by Cecilia Samamé [12], who reviewed more than 50 studies (from the years 1990-2012) comparing the quality of social cognition of bipolar patients and healthy volunteers. The review identified a number of important issues: (1) in the first of these groups we can observe deficits in emotion recognition and in ToM (see also: [17 -19]), (2) these deficits are present during each of the phases of the disease: in (hypo)mania, depression and euthymia, and (3) difficulties in performance of certain tasks measuring ToM (and some structural changes in the brain, which may be their biological substrate) are observable both in the group of euthymic bipolar patients and in healthy individuals with increased risk of developing BD (because of family history).…”

“…The key finding of neuropsychological studies conducted nowadays is showing the fact that the deficits associated with emotional processing and ToM are present even in euthymic patients, suggesting that they could be included in the payment of BD's endophenotypes [12]. However, drawing conclusions on this topic requires some caution: it turns out that the results are largely dependent on what aspect of ToM was measured, and what tool was selected for this purpose.…”

“…This is due to the fact that ToM is not a single construct, but a diverse set of processes, each of which can be in a different extent affected by the specific nature of BD. Therefore, ToM should not be considered in terms of the ability that subject has a hundred percent or does not have at all, but rather in terms of continuum [12]. The sources of valuable data on the impact of BD on ToM, are studies of neuropsychological abnormalities (constituting a potential biological substrate of disturbances of ToM) in patients' first-degree relatives.…”

“…The sources of valuable data on the impact of BD on ToM, are studies of neuropsychological abnormalities (constituting a potential biological substrate of disturbances of ToM) in patients' first-degree relatives. The functioning of healthy relatives is not modified by long-term use of drugs, the incidence of acute symptoms of the disease and its chronicity, therefore it can provide a reliable overview of the mechanism of BD [12]. An interesting research in this paradigm was conducted by a group led by Jane Whitney [13].…”

Increased affective empathy in bipolar patients during a manic episode

“…3,4 Significantly fewer studies have addressed empathy, a domain which can include cognitive and affective constructs. Cognitive empathy means cognitive understanding of the emotional state and point of view of the other person, hidden behind the emotion expressed.…”