Social cognition may moderate the influence of neurocognition on community functioning in patients with bipolar disorder, according to research published in the Journal of Affective Disorders.

Researchers evaluated the neurocognition, social cognition, and community functioning in 200 individuals with bipolar disorder and 49 healthy controls. Neurocognition was assessed using 10 tests across 7 domains, including processing speed, attention and vigilance, working memory, verbal learning, visual learning, reasoning and problem-solving, and social cognition. Social cognition was measured with an emotions management subtest of the neurocognition assessment. Community functioning was evaluated using the World Organization Disability Assessment Schedule, a questionnaire that measures disability severity in several domains, including self-care and participation in society.

Patients with bipolar disorder performed worse in the neurocognitive domains of processing speed (P =.001), attention (P =.001), verbal learning (P =.04), and global neurocognition (P =.03) compared with healthy controls. In addition, bipolar disorder was associated with worse performance on the social cognition composite (P =.05) and community functioning (P <.001). Researchers found no significant predictive influence of neurocognition on functional outcome in the bipolar sample. However, social cognition was found to have moderating effects: in patients with poor social cognition, better neurocognition was associated with improved community functioning (P =.01). The same effect was not observed in patients with good social cognition (P =.13)

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Researchers noted that the small size of the control group and the limited subtype analysis of functioning status limited data generalizability. However, these findings indicate a significant modulating effect of social cognition on neurocognition and community functioning in bipolar disorder, and thus may be relevant in titrating treatment in patients with varying social cognition levels.


Ospina LH, Nitzburg GC, Shanahan M, et al. Social cognition moderates the relationship between neurocognition and community functioning in bipolar disorder. J of Aff Dis. 2018;235:7-14.