Departamento de Saúde Mental, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. Programa de Pós-Graduação em Neurociências, UFMG, Belo Horizonte, MG, Brazil.
Serviço de Psiquiatria, Instituto da Previdência dos Servidores do Estado de Minas Gerais, Belo Horizonte, MG, Brazil.
Braz J Psychiatry. 2023 May 11;45(2):132-136. doi: 10.47626/1516-4446-2022-2935.
Bipolar disorder type 1 (BD1) and behavioral-variant frontotemporal dementia (bvFTD) share similar behavioral and cognitive symptoms, rendering the differential diagnosis between them a clinical challenge. We investigated the accuracy of social cognition (SC) measures to differentiate bvFTD from BD.
We included three groups of participants: early-onset BD1 (in remission, n=20), bvFTD (n=18), and cognitively healthy controls (HC) (n=40), matched for age, schooling, and sex. All participants underwent cognitive assessment, including the Facial Emotion Recognition (FER) and Modified Faux-Pas (mFP) tests, which assess mentalizing.
Compared to HC, BD1 and bvFTD patients underperformed on both SC measures. BD1 and bvFTD did not differ regarding FER or mFP total scores, although patients with bvFTD had significantly higher difficulties than those in the BD1 group to detect social faux-pas (p < 0.001, d = 1.35).
BD1 and bvFTD share deficits in the core SC functions. These findings should be considered in the development of tasks aiming to improve clinical differentiation between the two disorders.
1 型双相情感障碍（BD1）和行为变异额颞叶痴呆（bvFTD）具有相似的行为和认知症状，使得两者之间的鉴别诊断具有临床挑战性。我们研究了社会认知（SC）测量在区分 bvFTD 和 BD 中的准确性。
我们纳入了三组参与者：缓解期的早发性 BD1（n=20）、bvFTD（n=18）和认知健康对照组（HC）（n=40），匹配年龄、教育程度和性别。所有参与者均接受认知评估，包括面部情绪识别（FER）和改良假性错误（mFP）测试，以评估心理化能力。
与 HC 相比，BD1 和 bvFTD 患者在两个 SC 测量上的表现均较差。BD1 和 bvFTD 在 FER 或 mFP 总分上没有差异，但 bvFTD 患者在检测社交 faux-pas 方面的困难明显高于 BD1 组（p < 0.001，d = 1.35）。
BD1 和 bvFTD 在核心 SC 功能上存在缺陷。这些发现应在开发旨在改善这两种疾病之间临床鉴别任务时加以考虑。
