[Theory of mind in bipolar disorder: a review]. / La teoria della mente nel disturbo bipolare: una rassegna.

AIM: Bipolar disorder (DB) is associated with an impairment in socio-cognitive functioning in both the acute and, to a lesser extent, the euthymic phase. Several neuroimaging and behavioral studies have evaluated social cognition, especially theory of mind (ToM), in people with bipolar disorder, in attempt to identify clinical features, its role and severity. METHODS: A bibliographical research of controlled studies from January 1999 to April 2018 was completed in PubMed and PsycINFO using the keywords "Bipolar Disorder" and "Theory of mind", "Mirror neuron system". RESULTS: During the euthymic phase patients with bipolar disorder show a different pattern in different ToM tasks, compared to healthy controls. Some studies show how these anomalies also involve the mirror neuron system, a network closely connected to the neural structures underlying the ToM. LIMITATIONS: The studies evaluate only one component of social cognition and not all studies include a control group. CONCLUSIONS: Research supports the role of ToM deficits in DB as a relevant clinical element in the complex model of this disorder, especially in interpersonal functioning, offering possibilities for further research and treatment integration.

[The neural bases of social cognition in major depressive disorder: a review]. / La cognizione sociale nel disturbo depressivo maggiore: una rassegna sulle basi neurali.

INTRODUCTION: Major depressive disorder (MDD) is associated with a significant impairment of social and interpersonal functioning. Several neuroimaging studies have evaluated social cognition, i.e. how people with MDD process, store and analyze information about other people and social situations. METHODS: We conducted a focused review and selected manuscript published until August 2016 indexed on PubMed and PsycINFO, searching for the following keywords: "major depressive disorder", "major depression", "unipolar depression", "clinical depression", "fMRI", "emotion comprehension", "emotion perception", "affect comprehension", "affect perception", "facial expression", "prosody", "theory of mind", "mentalizing", "empathy". RESULTS: During depressive episodes, patients with MDD show a difference pattern of neural response during emotion processing, compared to healthy controls. Many studies show that those alterations disappear once the acute episodes remit. However, other studies show that the alterations may persist during remission periods. Limits. The studies evaluate only one component of social cognition and not all studies include a control group. CONCLUSIONS: Neurobiological research supports a role of social cognition deficits in MDD, especially for what pertains interpersonal functioning, this suggesting the need for further research and the possibility for treatment implications.

[Neural basis of social cognition in bipolar disorder]. / Le basi neurali della cognizione sociale nel disturbo bipolare.

AIM: This article review studies social and interpersonal functioning in patients with bipolar disorder (BD), and reports on the neurobiological underpinnings of the dysfunctions in emotion recognition, i.e. one of the main domains of social cognition. METHODS: A bibliographical research of controlled studies from 1967 to 2015 was completed in PubMed and PsycINFO using the keywords: "fMRI", "emotion comprehension", "emotion perception", "affect comprehension", "affect perception", "facial expression", "prosody", "theory of mind", "mentalizing", "attributional style", "social perception", "empathy" and "bipolar disorder" or "unipolar depression". RESULTS: Limbic hyperactivity, with a lack of appropriate cortical control, has been reported in subjects with BD during social interactions. This is particularly evident during the acute affective episodes but may persist during the euthymic phases. DISCUSSION: Deficits in emotion regulation, including neural systems implicated both in voluntary and automatic emotion regulatory subprocesses, are present in DB, particularly for what pertains to social interactions and interpersonal functioning. CONCLUSIONS: Patients with bipolar disorder may present a dysfunction in the cortical ability to modulate the limbic system, which may show hyperactivity during social interactions. More studies are needed, including studies to evaluate treatment implications.