Deficits in Social Cognition May Affect Bipolar Disorder Functional Outcomes

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Social functioning was generally impaired during acute episodes of bipolar disorder.
Social functioning was generally impaired during acute episodes of bipolar disorder.

In patients with bipolar disorder (BD), deficits in social cognitive processing domains may be associated with functional impairments, according to a review published in European Psychiatry. 

Social cognition is comprised of neuropsychological functioning in the domains of emotion processing, theory of mind, social perception, social knowledge, and attribution bias. 

The study investigators performed a literature search from several databases, focusing on studies published between 2000 and 2017 that examined the relationship between social cognition and functional outcome in patients with BD. 

Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. 

Twenty studies were selected for analysis. Of those studies, 9 were conducted in patients who were euthymic, whereas the remainder included patients who were either symptomatic or subsyndromal. One study compared patients across different mood states. Two studies compared patients with BD I vs BD II. 

Results of the analysis showed significant decreases in functional outcome scores, including social functioning, in patients with BD vs controls. 

Social functioning was generally impaired during acute episodes of BD, although patients having depressive episodes showed functional outcomes across several domains.

Tests of emotion processing, namely facial recognition, identification, and discrimination, showed impairments across patients with BD compared with controls. 

Twelve studies demonstrated connections between emotion processing and functional outcome. Of those studies, 6 demonstrated this relationship in patients with depressive symptoms, whereas no studies showed this connection in patients who had mania. 

Three of 11 studies assessing theory of mind showed its correlation to functional outcome. 

“To the best of our knowledge, the present review is the first to specifically explore the relationship between social cognition and social functioning in patients with BD,” the authors wrote. 

Reference

Vlad M, Raucher-Chéné D, Henry A, Kaladjian A. Functional outcome and social cognition in bipolar disorder: Is there a connection? Eur Psychiatry. 2018;52:116-125.

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