Impaired social cognition in patients with bipolar disorder: a place in a number of other mental disorders and the negative social motivation

Abstract

The aim of the study was to test two hypotheses: 1) the existence of a continuum of mental pathology (the spectrum model) on the material of impaired social cognition in the form of capacity for mentalization in patients with bipolar disorder (BD) compared with patients with schizophrenia, schizoaffective disorder (SZD) and a group of healthy individuals; 2) the hypothesis that violations of social cognition in patients with BD negative social motivation and psychopathology. Materials and methods. The study included 92 patients (men – 45, women – 47, mean age – 33,15 ± 9,09 years) with a diagnosis of Bipolar disorder (22 patients), Schizophrenia (39 patients), Schizoaffective disorder (31 patients) and 41 healthy subjects (men – 21, women – 20, mean age – 31,73 ± 7,48 years). To assess the ability to mentalization used test of Reading the mind in the Eyes (BaronCCohen S.). The following methods are used: to assess the social motivation – Revised Social Anhedonia Scale (RSAS); to assess the severity of clinical symptoms – Symptom checklist-90-Revised (SCLC90CR) and The Hospital Anxiety and Depression Scale (HADS). Results and Conclusions. It is shown that the capacity for mentalization in patients with BD is better preserved than that of patients with schizophrenia did not differ from patients with SZD and reduced as compared to healthy subjects, indicating that the hypothesis of the spectrum of mental pathology. It is also shown that the impaired ability to mentalization in patients with BD correlated with the severity of the negative social motivation in the form of symptoms of anhedonia, as well as with the severity of clinical symptoms of irritability and hostility. Conclusions about the importance of social anhedonia and a high level of hostility for psychotherapeutic work with patients with BD in an integrated treatment, as well as the need for continued research and expansion of clinical samples in order to obtain more reliable results.