Social cognition in first-degree relatives of bipolar disorder: Theory of Mind and nonverbal sensitivity.

Social cognition might be impaired in first degree relatives (FDR) of BD but existing research shows controversial results about social cognitive impairments in this population. The aim of this study was to assess Theory of Mind (ToM) and nonverbal sensitivity in FDR of BD and compare the results with those of two groups of persons with remitted bipolar disorder (BD), type I and II, and a control group. Social cognitive ability was examined in first degree relatives of BD, with a biological parent, offspring or sibling diagnosed with the disorder. For this study, 37 FDRs of bipolar patients, 37 BD I, 40 BD II and 40 control participants were recruited. Social cognition was explored by means of the Reading the Mind in the Eyes Test and the MiniPONS. Results showed a significant impairment in FDR of BD in the ToM task, but not in nonverbal sensitivity. Performance of FDRs in social cognition is better than that of BDs (either type I or type II) but worse when compared with that of healthy individuals without a family history of psychiatric disorders. Nevertheless, no differences were found between BD I and BD II groups. Males and older participants showed a worse performance in all groups. Group family therapy with FDRs of BD might include training in the recognition of nonverbal cues, which might increase the understanding of their familiars with BD, in order to modify communication abilities.

Theory of mind in remitted bipolar disorder: Interpersonal accuracy in recognition of dynamic nonverbal signals.

A relatively unexplored aspect in bipolar disorder (BD) is the ability to accurately judge other´s nonverbal behavior. To explore this aspect of social cognition in this population is particularly meaningful, as it may have an influence in their social and interpersonal functioning. The aim of this research was to study interpersonal accuracy (IPA) in remitted BDs, that is, the specific skills that fall under the general term Theory of Mind (ToM). Study participants included 119 remitted individuals with BD (70 BD I and 49 BD II), and they were compared with a group of 39 persons diagnosed with unipolar depression (UD) and 119 control participants. The MiniPONS was used to test the whole spectrum of nonverbal cues as facial expressions, body language and voice. Results indicated a superiority of the control group with statistically significant differences both in the performance in the MiniPONS (number of right answers) and in each of the areas evaluated by this test. BD groups, in recognition of the meaning of gestures in face, body and voice intonation, performed significantly worse than controls. ANCOVA analysis controlling the effect of age shows that control group performed significantly better compared to clinical groups, and there were no differences between UD and BD groups. The results indicate a deficit in IPA and suggest that better comprehension of deficiencies in interpersonal accuracy in BD may help to develop new training programs to improve in these patients the understanding of others, which might have a positive impact in their psychosocial functionality, and thus lead to the objective of functional rehabilitation.

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

The aim of this study was to assess social- perceptual Theory of Mind in bipolar disorder (BD). 112 euthymic participants with BD I or BD II (65 with BD I and 47 with BD II) were compared to a group of 112 persons with no psychiatric diagnosis and 43 with unipolar depression (UD). They completed the task of the "Reading the Mind in the Eyes" (RMET). The results show that participants with BD, I and II, as well as the group with UD performed significantly more poorly than the control group. As for the wrong answers, BDs mostly chose positive valence stimuli, while the UD group chose negative valence items. The main limitation of this research is related to the characteristics of the cross-sectional study. It cannot detect at what time of the disorder these differences in emotion processing will appear with more intensity. As for future research, we suggest interventions to improve the deficits in ToM in bipolar persons. The use of the RMET in the first stages of BD II could help to facilitate a correct diagnosis.