Cognitive and affective theory-of-mind impairment in people with early-stage bipolar disorder
Abstract Background Literature suggests impaired theory-of-mind (ToM) in people with bipolar-disorder (BD). However, prior research primarily examined patients at chronic stage (stage 3c–4) and was constrained by clinical heterogeneity. Deficits in ToM modalities remain to be clarified. We aimed to...
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2025-05-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-025-06808-1 |
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| author | Jacob Man Tik Chan Heidi Ka Ying Lo Anson Kai Chun Chau Aerin Sum Yin Mok Co Co Ho Yi Tong Candice Tze Kwan Kam Catherine Zhiqian Fang Wing Chung Chang |
| author_facet | Jacob Man Tik Chan Heidi Ka Ying Lo Anson Kai Chun Chau Aerin Sum Yin Mok Co Co Ho Yi Tong Candice Tze Kwan Kam Catherine Zhiqian Fang Wing Chung Chang |
| author_sort | Jacob Man Tik Chan |
| collection | DOAJ |
| description | Abstract Background Literature suggests impaired theory-of-mind (ToM) in people with bipolar-disorder (BD). However, prior research primarily examined patients at chronic stage (stage 3c–4) and was constrained by clinical heterogeneity. Deficits in ToM modalities remain to be clarified. We aimed to assess cognitive and affective ToM performance in euthymic people with early-stage BD. Methods Cognitive and affective ToM were examined in 41 euthymic early-stage (stage 2–3b) BD patients aged 16 - 40 years who were treated within three-years from first-episode mania and 40 demographically-matched healthy controls, using Faux-pas task (FPT) and Reading the Mind in the Eyes test (RMET). Relationships of ToM performance with symptom severity, cognitive functions, history of psychosis and depressive episode were assessed. Results Participants displayed significantly lower scores than controls in both cognitive and affective ToM components in FPT. The two groups showed comparable performance in RMET. No significant correlations were observed between ToM measures and variables of symptom dimensions, cognitive functions and treatment variables in BD patients. Additional analyses revealed no significant differences in ToM performance in FPT and RMET between BD patients with versus without a history of psychosis, and between BD patients with versus without a history of depressive episode. Conclusion This study extends previous findings of ToM deficits in later-stage BD to euthymic people with early-stage BD who exhibit cognitive and affect ToM impairment. Further research is needed to clarify potential differential trajectories of cognitive and affective ToM deficits and their relationships with psychosis, polarity of mood episodes, and functional outcomes in early-stage BD. |
| format | Article |
| id | doaj-art-917885fe542e4fe39f6d4a971b4fb1e7 |
| institution | Kabale University |
| issn | 1471-244X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj-art-917885fe542e4fe39f6d4a971b4fb1e72025-08-20T03:48:18ZengBMCBMC Psychiatry1471-244X2025-05-012511910.1186/s12888-025-06808-1Cognitive and affective theory-of-mind impairment in people with early-stage bipolar disorderJacob Man Tik Chan0Heidi Ka Ying Lo1Anson Kai Chun Chau2Aerin Sum Yin Mok3Co Co Ho Yi Tong4Candice Tze Kwan Kam5Catherine Zhiqian Fang6Wing Chung Chang7Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Psychology, College of Arts and Sciences, Cornell UniversityDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Psychiatry, Queen Mary Hospital, Hospital AuthorityDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongAbstract Background Literature suggests impaired theory-of-mind (ToM) in people with bipolar-disorder (BD). However, prior research primarily examined patients at chronic stage (stage 3c–4) and was constrained by clinical heterogeneity. Deficits in ToM modalities remain to be clarified. We aimed to assess cognitive and affective ToM performance in euthymic people with early-stage BD. Methods Cognitive and affective ToM were examined in 41 euthymic early-stage (stage 2–3b) BD patients aged 16 - 40 years who were treated within three-years from first-episode mania and 40 demographically-matched healthy controls, using Faux-pas task (FPT) and Reading the Mind in the Eyes test (RMET). Relationships of ToM performance with symptom severity, cognitive functions, history of psychosis and depressive episode were assessed. Results Participants displayed significantly lower scores than controls in both cognitive and affective ToM components in FPT. The two groups showed comparable performance in RMET. No significant correlations were observed between ToM measures and variables of symptom dimensions, cognitive functions and treatment variables in BD patients. Additional analyses revealed no significant differences in ToM performance in FPT and RMET between BD patients with versus without a history of psychosis, and between BD patients with versus without a history of depressive episode. Conclusion This study extends previous findings of ToM deficits in later-stage BD to euthymic people with early-stage BD who exhibit cognitive and affect ToM impairment. Further research is needed to clarify potential differential trajectories of cognitive and affective ToM deficits and their relationships with psychosis, polarity of mood episodes, and functional outcomes in early-stage BD.https://doi.org/10.1186/s12888-025-06808-1Theory of mindBipolar disorderPsychosisFaux pas taskRMETFirst-episode mania |
| spellingShingle | Jacob Man Tik Chan Heidi Ka Ying Lo Anson Kai Chun Chau Aerin Sum Yin Mok Co Co Ho Yi Tong Candice Tze Kwan Kam Catherine Zhiqian Fang Wing Chung Chang Cognitive and affective theory-of-mind impairment in people with early-stage bipolar disorder BMC Psychiatry Theory of mind Bipolar disorder Psychosis Faux pas task RMET First-episode mania |
| title | Cognitive and affective theory-of-mind impairment in people with early-stage bipolar disorder |
| title_full | Cognitive and affective theory-of-mind impairment in people with early-stage bipolar disorder |
| title_fullStr | Cognitive and affective theory-of-mind impairment in people with early-stage bipolar disorder |
| title_full_unstemmed | Cognitive and affective theory-of-mind impairment in people with early-stage bipolar disorder |
| title_short | Cognitive and affective theory-of-mind impairment in people with early-stage bipolar disorder |
| title_sort | cognitive and affective theory of mind impairment in people with early stage bipolar disorder |
| topic | Theory of mind Bipolar disorder Psychosis Faux pas task RMET First-episode mania |
| url | https://doi.org/10.1186/s12888-025-06808-1 |
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