Social cue recognition and attributional bias in remitted bipolar disorder: Impact on social functioning.

The role of social cue recognition and attributional bias on social functioning has been sparsely studied in remitted bipolar disorder (BD). In view of this, we evaluated thirty subjects with BD (without a history of psychotic symptoms) who were in remission and thirty age and, gender-matched healthy controls for social cue recognition [using SoCueReTI (Social Cue Recognition Test- Indian Setting)], and attributional bias (using an Attributional style questionnaire). Social functioning was assessed in subjects with BD using the Functional assessment short test (FAST) - Interpersonal relationships. Subjects with BD had significant deficits in recognizing social cues in low-intensity and high-intensity vignettes when compared to healthy controls. Deficits in recognizing social cues in low-intensity vignettes were significantly correlated with the FAST scores, even after controlling for the number of episodes and duration of illness. Further replication studies are needed to ascertain the association between social cue recognition deficits and social functioning in BD.

Theory of Mind Deficits and Their Influence on Functional Impairment in Remitted Phase of Bipolar Disorder.

BACKGROUND: Functional impairment has been convincingly established in the euthymic/ remitted phase of bipolar disorder (BD). Though deficits in social cognition, especially theory of mind (ToM), predict functional impairment, the association has not been consistently proven. METHODS: Thirty remitted subjects with BD (as per DSM 5) and 30 age- and gender-matched healthy controls were screened for eligibility and the sociodemographic details and ToM scores, that is, first-order ToM, second-order ToM, and Faux pas, were collected. In subjects with BD, functioning was assessed using Functioning Assessment Short Test (FAST) and illness variables were collected. RESULTS: No significant difference was found in occupation or education between the groups. Remitted subjects with BD had statistically significant deficits in all domains of ToM, that is, first-order ToM (r = 0.65), second-order ToM (r = 0.69), and Faux pas (r = 0.75). Significant correlations existed between first-order ToM and FAST total score, as well as second-order ToM and FAST total score, but the correlations dropped after controlling for duration of illness and number of depressive episodes. Quantile regression analysis showed that the only factors which predicted global functional impairment was a higher number of episodes (ßτ= -0.45, SE = 3.51, t = 0.13, P = 0.04), while all other illness variables and ToM failed to predict the global functioning. CONCLUSION: Though there seems to be an association between ToM and functioning, only illness variables predicted functional impairment in subjects with BD. We need prospective studies to delineate the contributors to functional impairment.