Social cognition

What is social cognition in bipolar disorder?

Social cognition describes the ability to understand the actions and intentions of other people. These include 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, including 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 bipolar disorder?

High quality evidence finds a small reduction in social cognition ability in people with bipolar disorder compared to people without the disorder. There is also a small reduction in this ability in first-degree relatives of people with bipolar disorder. In patients, there is reduced emotional intelligence, and reduced recognition of surprise, fear and disgust emotions. There were no differences in recognition of anger, happiness or sadness between patients and controls.

Moderate to high quality evidence finds a medium-sized decrease in theory of mind ability in people with bipolar disorder. This effect was largest in verbal tasks, in people with bipolar II disorder, and in acute patients.

High quality evidence finds a medium to large reduction in emotion recognition ability in children with bipolar disorder compared to age-matched controls. Unmedicated children showed longer response times in emotion recognition than medicated children. Caucasian children with bipolar disorder showed longer response time and poorer accuracy in emotion recognition than non-Caucasian children. Moderate quality evidence also finds a large effect of decreased theory of mind ability in children with bipolar disorder.

Moderate to high quality evidence finds a medium-sized increase in social cognition ability in people with bipolar disorder compared to people with schizophrenia. This was found on Theory of Mind and negative facial emotion recognition tasks, and particularly in male patients. There were no differences on positive (happy) facial emotion recognition tasks between bipolar disorder and schizophrenia.

Moderate to low quality evidence finds a weak relationship between decreased emotion processing ability and poorer general functioning, particularly with severe depressive symptoms.

October 2021

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Last updated at: 11:24 pm, 10th October 2021
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