Theory of mind and facial emotion recognition in euthymic bipolar I and bipolar II disorders

Martino, Diego Javier; Strejilevich, Sergio; Fassi, Guillermo; Marengo, Eliana; Igoa, Ana

doi:10.1016/j.psychres.2011.04.033

Cited by 155 publications

(181 citation statements)

References 44 publications

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“…Of the~30% of variation explained by the variables considered here, 25% was explained by variation in symptom severity, only~5% was explained by neuropsychological function, and performance on social cognition failed to explain any further variance in GAF scores. These findings are consisted with a recent study in 87 patients with bipolar disorder (Martino et al, 2011).…”

Section: Discussionsupporting

confidence: 68%

Social dysfunction in schizophrenia: An investigation of the GAF scale's sensitivity to deficits in social cognition

Robertson

Hargreaves

Kelleher

et al. 2013

Schizophrenia Research

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Background: Schizophrenia is accompanied by significant impairment in psychosocial functioning, which is only partially explained by clinical symptom severity. Recently, these impairments have been strongly associated with deficits in neurocognition and social cognition. Although the Global Assessment of Function (GAF) scale remains the most widely used measure of psychosocial function in clinical practice, it is unclear whether this instrument is sensitive to changes in cognition, or merely provides a snapshot of symptom severity. To investigate this, we assessed whether variation in GAF score was explained by performance on measures of neurocognitive and social cognition, particularly after variation associated with symptom severity had been accounted for. Methods: 216 patients with schizophrenia were assessed using the GAF scale, two theory of mind tasks (the 'Hinting' task and 'Reading the Eyes in the Mind' task), and a neuropsychological battery sensitive to the areas of deficit typically seen in schizophrenia -IQ, episodic memory, working memory and attentional control. Results: Using linear regression analysis, symptom severity explained 24% of the variance in GAF scores (F(3, 188) = 21.14, p b .001). While neuropsychological performance explained a further 4.7% of variation (r 2 change = .047, F change (1, 187) = 12.63, p b .001), social cognition did not explain any further variance in functioning (r 2 change =.006, F change (1, 186)=1.63, p=.20). Conclusion: These data indicate that GAF scores are primarily sensitive to variation in clinical symptoms severity and not at all sensitive to variation in social cognition, an important determinant of real world outcome. Doing so highlights the need to supplement the measurement of psychosocial function using the GAF in clinical practice with functional measures that are more sensitive to deficits in social cognition.

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Section: Discussionsupporting

confidence: 68%

Social dysfunction in schizophrenia: An investigation of the GAF scale's sensitivity to deficits in social cognition

Robertson

Hargreaves

Kelleher

et al. 2013

Schizophrenia Research

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“…However, it has several limitations that should be taken into account when interpreting its results: 1) the potential interference of psychotropic drugs on the performance of the tests, as all patients were on pharmacological treatment 26 ; 2) a complete neuropsychological assessment was not carried out. In this regard, Martino et al 27 have noted the potential relevance of attentional and executive functions in emotional processing of BD patients; 3) finally, hits and errors were not registered for each particular emotion; instead, an overall score was calculated. This made it impossible to ascertain whether any specific emotion is recognized with higher difficulty.…”

Section: Discussionmentioning

confidence: 99%

Deficits in recognition, identification, and discrimination of facial emotions in patients with bipolar disorder

Benito

Lahera

Herrera

et al. 2013

Rev. Bras. Psiquiatr.

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Objective: To analyze the recognition, identification, and discrimination of facial emotions in a sample of outpatients with bipolar disorder (BD). Methods: Forty-four outpatients with diagnosis of BD and 48 matched control subjects were selected. Both groups were assessed with tests for recognition (Emotion Recognition-40 --ER40), identification (Facial Emotion Identification Test --FEIT), and discrimination (Facial Emotion Discrimination Test --FEDT) of facial emotions, as well as a theory of mind (ToM) verbal test (Hinting Task). Differences between groups were analyzed, controlling the influence of mild depressive and manic symptoms. Results: Patients with BD scored significantly lower than controls on recognition (ER40), identification (FEIT), and discrimination (FEDT) of emotions. Regarding the verbal measure of ToM, a lower score was also observed in patients compared to controls. Patients with mild syndromal depressive symptoms obtained outcomes similar to patients in euthymia. A significant correlation between FEDT scores and global functioning (measured by the Functioning Assessment Short Test, FAST) was found. Conclusions: These results suggest that, even in euthymia, patients with BD experience deficits in recognition, identification, and discrimination of facial emotions, with potential functional implications.

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“…Most studies report the presence of a defi cit concerning ToM and social cognition during all phases of BD (Cusi et al 2010 ;Adida et al 2011 ;Lahera et al 2008 ;Wolf et al 2010 ;Bora et al 2005 ;Donohoe et al 2012 ;Cusi et al 2012 ;Martino et al 2011b ;Inoue et al 2004 ;Scott et al 2000 ). Only a minority of studies is negative (Barrera et al 2012 ;Sarfati and Hardy-Bayle 1999 ).…”

Section: Tommentioning

confidence: 99%

“…Only a minority of studies is negative (Barrera et al 2012 ;Sarfati and Hardy-Bayle 1999 ). One group of authors reported that BD patients do not differ from controls after controlling for medication and other confounding factors (Martino et al 2011b ). One study reported impaired performance on ToM in acute mania and acute bipolar depression even when memory was controlled for but not in remitted patients (Kerr et al 2003 ).…”

Section: Tommentioning

confidence: 99%

Neurocognitive Functioning in Bipolar Disorder: A Comprehensive Review of Recent Data

Fountoulakis

2014

Bipolar Disorder

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Theory of mind and facial emotion recognition in euthymic bipolar I and bipolar II disorders

Cited by 155 publications

References 44 publications

Social dysfunction in schizophrenia: An investigation of the GAF scale's sensitivity to deficits in social cognition

Social dysfunction in schizophrenia: An investigation of the GAF scale's sensitivity to deficits in social cognition

Deficits in recognition, identification, and discrimination of facial emotions in patients with bipolar disorder

Neurocognitive Functioning in Bipolar Disorder: A Comprehensive Review of Recent Data

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