Zyto Susan, Jabben Nienke, Nugter Annet, Schulte Peter F J, Kupka Ralph W, Schouws Sigfried
Department of Medical Psychology, Dijklander Hospital, Hoorn, The Netherlands.
Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands.
J Neuropsychol. 2025 Sep;19(3):486-498. doi: 10.1111/jnp.12417. Epub 2025 Feb 17.
There is emerging evidence of social cognitive impairments in bipolar disorders (BD). Less evident is the question if social cognitive impairments are predictive of psychosocial functioning, independently of neurocognitive impairment. The aims of the study were to investigate if patients with BD-I showed impairments in facial emotion recognition and alterations in affective empathy, in relation to healthy controls, and if these impairments would predict psychosocial functioning, after accounting for neurocognitive impairments. Thirty-seven patients diagnosed with BD-I, in an euthymic state, and 37 matched healthy controls underwent an assessment including a facial recognition test (ERT) and a self-report scale of affective empathy (BEES). Patients additionally underwent an extensive neuropsychological assessment consisting of traditional tests. Patients with BD-I were significantly less able to recognize the emotion fear compared to healthy controls. However, the lower ability to recognize fear did not predict psychosocial functioning. In addition, it was not related to any of the other neuropsychological variables. The degree of self-reported empathy did not differ between patients and healthy controls. The results add to the evidence of a specific deficit in recognizing fear in BD-I; however, a link with psychosocial functioning was lacking. It is possible that the ability to recognize fear is related to a more narrow concept of interpersonal functioning than to the broad concept of psychosocial functioning. Future research should be directed towards aspects of social functioning in relation to social cognitive impairments, while taking account of subgroups of social cognitive functioning.
有新证据表明双相情感障碍（BD）存在社会认知障碍。社会认知障碍是否能独立于神经认知障碍预测心理社会功能，这一问题尚不明确。本研究的目的是调查与健康对照组相比，I型双相情感障碍患者在面部表情识别和情感共情方面是否存在障碍，以及在考虑神经认知障碍后，这些障碍是否能预测心理社会功能。37名诊断为I型双相情感障碍且处于心境正常状态的患者和37名匹配的健康对照者接受了包括面部识别测试（ERT）和情感共情自我报告量表（BEES）在内的评估。患者还接受了由传统测试组成的广泛神经心理学评估。与健康对照组相比，I型双相情感障碍患者识别恐惧情绪的能力明显较低。然而，识别恐惧能力较低并不能预测心理社会功能。此外，它与任何其他神经心理学变量均无关联。患者和健康对照组在自我报告的共情程度上没有差异。这些结果进一步证明了I型双相情感障碍在识别恐惧方面存在特定缺陷；然而，与心理社会功能之间缺乏联系。识别恐惧的能力可能与人际功能的更狭义概念有关，而非与心理社会功能的广义概念有关。未来的研究应针对与社会认知障碍相关的社会功能方面，同时考虑社会认知功能的亚组。
