What your eyes tell me: Theory of mind in bipolar disorder

Espinós, Usue; Fernández-Abascal, Enrique García; Ovejero, Mercedes

doi:10.1016/j.psychres.2017.09.039

Cited by 10 publications

(8 citation statements)

References 38 publications

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“…A recent study has shown to overlap between impaired verbal memory function and poor RMET performance, especially in male BD patients (Dalkner et al, 2019). Certain emotional deficiencies in affective ToM in euthymic BD patients have been described in other studies (Espinós et al, 2018; Marotta et al, 2018; Martino et al, 2011; Wolf et al, 2010). These findings are in contrast with previous studies that stated that BD patients only showed Cognitive ToM deficits (Montag et al, 2010; Shamay-Tsoory et al, 2009).…”

Section: Discussionsupporting

confidence: 68%

Impaired social cognition in bipolar disorder: A meta-analysis of Theory of Mind in euthymic patients

Rotenberg

Beraldi

Belizário

et al. 2020

Aust N Z J Psychiatry

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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.

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Section: Discussionsupporting

confidence: 68%

Impaired social cognition in bipolar disorder: A meta-analysis of Theory of Mind in euthymic patients

Rotenberg

Beraldi

Belizário

et al. 2020

Aust N Z J Psychiatry

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“…Patients consistently showed impairment across cognitive ToM (i.e., interpreting the thoughts of others) but emotion ToM (i.e., interpreting the feelings of others) results compared with HCs. Specifically, patients showed difficulties with inferring the mental states of others, for which they frequently attached a positive mental state to the presented neutral stimulus unlike HCs 30,33,39 . They also displayed marked impairment on verbal ToM (i.e., tasks testing the ability to infer intentions behind indirect speech utterances) but not nonverbal ToM (i.e., tasks testing the ability to infer mental states from eye gaze) 37 .…”

Section: Resultsmentioning

confidence: 99%

Deficits of social cognition in bipolar disorder: Systematic review and meta‐analysis

et al. 2021

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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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“…This task has been utilized very widely in many fMRI studies (310, 311, 319–324) and as an outcome measure in clinical experimental trials (227, 325–334). Atypical performance can be detected in association with childhood adverse experiences (335, 336) and patient groups with schizophrenia (210, 337–342), Parkinson’s disease (343), bipolar disorder and depression (344, 345), methamphetamine users with psychosis (346), frontotemporal dementia (347), ASD (348, 349), epilepsy (350), Huntington’s disease (183, 184, 351, 352), Tourette syndrome (100), attention deficit-hyperactivity disorder (353), and cerebellar tumor (354). However, some clinical samples demonstrate no impairment [bipolar disorder: Ref.…”

Section: Resultsmentioning

confidence: 99%

What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations

Eddy

2019

Front. Psychiatry

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Social interaction is closely associated with both functional capacity and well-being. Previous research has not only revealed evidence of social dysfunction in individuals with a wide range of psychiatric and neurological disorders but also generated an abundance of potential measures for assessing social cognition. This review explores the most popular measures used within neuropsychiatric populations to investigate the ability to recognize or reason about the mental states of others. Measures are also critically analyzed in terms of strengths and limitations to aid task selection in future clinical studies. The most frequently applied assessment tools use verbal, visual or audiovisual forms of presentation and assess recognition of mental states from facial features, self-rated empathy, the understanding of other’s cognitive mental states such as beliefs and intentions, or the ability to combine knowledge of other’s thoughts and emotions in order to understand subtle communications or socially inappropriate behavior. Key weaknesses of previous research include limited investigation of relationships with clinical symptoms, and underutilization of measures of everyday social functioning that offer a useful counterpart to traditional “lab” tasks. Future studies should aim to carefully select measures not only based on the range of skills to be assessed but also taking into account potential difficulties with interpretation and the need to gain insight into the application of social cognitive skills as well as ability per se . Some of the best measures include those with well-matched control trials (e.g., Yoni Task) or those that restrict the influence of verbal deficits (e.g., intentions comic strip task), elicit spontaneous mentalizing (e.g., Animations Task), and possess greater ecological validity (e.g., Movie for the Assessment of Social Cognition). Social cognitive research within psychiatric populations will be further enhanced through the development of more closely matched control tasks, and the exploration of relationships between task performance, medication, strategy use, and broader emotional and motor functions.

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What your eyes tell me: Theory of mind in bipolar disorder

Cited by 10 publications

References 38 publications

Impaired social cognition in bipolar disorder: A meta-analysis of Theory of Mind in euthymic patients

Impaired social cognition in bipolar disorder: A meta-analysis of Theory of Mind in euthymic patients

Deficits of social cognition in bipolar disorder: Systematic review and meta‐analysis

What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations

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