Zhang Bingren, Chen Xuyu, Qiu Nianhua
Affiliated Hospital (School of Clinical Medicine), Hangzhou Normal University, Hangzhou, 311121, China.
Affiliated Cixi Hospital, Wenzhou Medical University, Ningbo, China.
BMC Psychiatry. 2025 Jan 14;25(1):39. doi: 10.1186/s12888-024-06462-z.
In recent years, there has been a rapid increase in reports upon social-cognition impairments in bipolar disorder. This study aimed to compare the characteristics of social cognition domains in bipolar I (BD I) and II (BD II) based on the findings to date.
A systematic literature search was conducted on Web of Science and PubMed from inception to 28 August 2024. Studies with all-age-group of ICD-10, DSM-IV, DSM-IV-TR, or DSM-5 defined BD (I or II) either in a remitted or symptomatic state were included. The risk of bias was measured using the Newcastle-Ottawa Scale, and the quality of the sources was evaluated using GRADE criteria. Results of the studies were measured by synthesizing Hedge's g effect sizes through a random effects meta-analytic approach.
A total of 20 studies were included, covering three core domains of social cognition (theory of mind (ToM), emotion processing and attributions). There was no significant difference in ToM between BD I and BD II and in emotion processing between non-psychotic patients with BD I and BD II, and history of psychosis negatively predicted performance on emotion processing. Furthermore, BD II performed worse than BD I in attributions, with a low to moderate summary effect size.
BD I and BD II performed similarly on ToM and emotional processing, but BD II had more impaired attributions. Future studies are encouraged to control for the influence of clinical features, to use more neuroscientific techniques, and to explore on other domains of social cognition in bipolar subtypes.
近年来，关于双相情感障碍社会认知损害的报道迅速增加。本研究旨在根据迄今的研究结果，比较双相I型（BD I）和双相II型（BD II）社会认知领域的特征。
在Web of Science和PubMed上进行了一项系统的文献检索，检索时间从数据库建立至2024年8月28日。纳入所有年龄组、采用国际疾病分类第10版（ICD - 10）、《精神疾病诊断与统计手册》第四版（DSM - IV）、《精神疾病诊断与统计手册》第四版修订版（DSM - IV - TR）或《精神疾病诊断与统计手册》第五版（DSM - 5）定义的处于缓解期或症状期的BD（I型或II型）研究。使用纽卡斯尔 - 渥太华量表评估偏倚风险，并使用GRADE标准评估资料来源质量。通过随机效应荟萃分析方法综合Hedge's g效应量来衡量研究结果。
共纳入20项研究，涵盖社会认知的三个核心领域（心理理论（ToM）、情绪加工和归因）。BD I和BD II在ToM方面以及BD I和BD II的非精神病患者在情绪加工方面无显著差异，且精神病病史对情绪加工表现有负向预测作用。此外，BD II在归因方面表现比BD I差，汇总效应量低至中等。
BD I和BD II在ToM和情绪加工方面表现相似，但BD II在归因方面受损更严重。鼓励未来的研究控制临床特征的影响，使用更多神经科学技术，并探索双相情感障碍亚型在社会认知的其他领域。
