Social cognition

What is social cognition and how is it measured?

Social cognition describes the ability to understand the actions and intentions of other people; the cognitive processes underlying social interactions that are used to guide behaviour. Aspects of social cognition may be altered in people with bipolar disorder, including processes such as Theory of Mind, social perception, and emotion processing. Theory of Mind refers to the ability to infer the mental states of other people. Social perception is an awareness of social cues and norms that dictate social interactions. Emotion processing is the ability to perceive emotional cues, such as the emotional content of facial expressions or vocal inflections (prosody). Social cognition is crucial for effective communication and relates to social competence and may predict work functioning.

What is the evidence regarding social cognition in people with bipolar disorder?

High quality evidence suggests a small effect of poorer overall social cognition in people with bipolar disorder compared to people without bipolar disorder (controls). There is poorer emotional intelligence, recognition of surprise, fear and disgust, but no differences in recognition of anger, happiness or sadness. High quality evidence also suggests small effects of poorer overall social cognition in first-degree relatives of people with bipolar disorder compared to people with no first-degree relative with the disorder.

Moderate to high quality evidence suggests a medium-sized effect of poorer theory of mind in people with bipolar disorder compared to controls. The effect size was similar across tasks, but was larger in acute patients than in patients with subclinicial symptoms, or remitted patients.

Moderate to high quality evidence also suggests a medium-sized effect of better social cognition in people with bipolar disorder than in people with schizophrenia on Theory of Mind and negative facial emotion recognition tasks, particularly in male patients. There were no differences between people with bipolar disorder or schizophrenia on positive (happy) facial emotion recognition tasks.

Moderate to low quality evidence suggests a small relationship between poor emotion processing (identification and regulation) and poor general functioning, particularly in people with more severe depressive symptoms.

March 2019

Last updated at: 5:27 am, 31st March 2019
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