title: Theory of mind deficit in bipolar disorder: is it related to a previous history of psychotic symptoms?
abstract: It has been hypothesized that a Theory of Mind (ToM) deficit could be a vulnerability marker for psychosis. Recent studies, however, have shown ToM deficits in affective relapses of bipolar disorder as well as in the euthymic phase. This study analyzes the relationship between ToM and a previous history of psychotic symptoms in bipolar disorder. ToM, sustained attention and executive functions were analyzed in 75 bipolar euthymic patients with three or more previous relapses (42 of them had a history of psychotic symptoms and 33 did not) and 48 healthy subjects. ToM was assessed with the Advanced Test by Happé. ToM performance was similar in bipolar patients with or without a history of psychotic symptoms, and in both cases it was significantly reduced as compared with the healthy control group. Similarly, both bipolar groups showed impaired sustained attention and executive functions. This general cognitive deficit partially explains the differences obtained in ToM. The ToM instrument used shows low sensitivity for assessing ToM in bipolar patients and it could partially reflect general cognitive functioning rather than a specific deficit in psychosis. ToM deficit is not a trait marker for psychosis, given that it is present in bipolar disorder regardless of a previous history of psychotic symptoms.
authors.affiliation: Psychiatry Department, Principe de Asturias University Hospital, University of Alcalá, Madrid, Spain. guillermo.lahera@gmail.com
authors.forename: Guillermo
authors.initials: G
authors.lastname: Lahera
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Montes
authors.forename: Adolfo
authors.initials: A
authors.lastname: Benito
authors.forename: María
authors.initials: M
authors.lastname: Valdivia
authors.forename: Elena
authors.initials: E
authors.lastname: Medina
authors.forename: Isabel
authors.initials: I
authors.lastname: Mirapeix
authors.forename: Jerónimo
authors.initials: J
authors.lastname: Sáiz-Ruiz
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001288:Attention; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D018187:Personal Construct Theory; D011340:Problem Solving; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology; D055815:Young Adult