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Identifying social cognition subgroups in euthymic patients with bipolar disorder: a cluster analytical approach

Published online by Cambridge University Press:  17 June 2020

C. Varo ,
B. Solé ,
E. Jiménez ,
C. M. Bonnín ,
C. Torrent Open the ORCID record for C. Torrent [Opens in a new window] ,
E. Valls ,
G. Lahera Open the ORCID record for G. Lahera [Opens in a new window] ,
A. Martínez-Arán Open the ORCID record for A. Martínez-Arán [Opens in a new window] ,
A. F. Carvalho  and
K. W. Miskowiak Open the ORCID record for K. W. Miskowiak [Opens in a new window]
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C. Varo
Affiliation:
Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
B. Solé
Affiliation:
Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
E. Jiménez
Affiliation:
Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
C. M. Bonnín
Affiliation:
Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
C. Torrent
Affiliation:
Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
E. Valls
Affiliation:
Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
G. Lahera
Affiliation:
Faculty of Medicine, University of Alcalá, IRyCIS, CIBERSAM, Madrid, Spain
A. Martínez-Arán*
Affiliation:
Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
A. F. Carvalho
Affiliation:
Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada Department of Psychiatry, University of Toronto, Toronto, ON, Canada
K. W. Miskowiak
Affiliation:
Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark Department of Psychology, University of Copenhagen, Copenhagen, Denmark
E. Vieta*
Affiliation:
Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
M. Reinares
Affiliation:
Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
*
Author for correspondence: A. Martínez-Arán, E-mail: amartiar@clinic.cat; E. Vieta, E-mail: evieta@clinic.cat
Author for correspondence: A. Martínez-Arán, E-mail: amartiar@clinic.cat; E. Vieta, E-mail: evieta@clinic.cat
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Abstract

Background

Bipolar disorder (BD) is associated with social cognition (SC) impairments even during remission periods although a large heterogeneity has been described. Our aim was to explore the existence of different profiles on SC in euthymic patients with BD, and further explore the potential impact of distinct variables on SC.

Methods

Hierarchical cluster analysis was conducted using three SC domains [Theory of Mind (ToM), Emotional Intelligence (EI) and Attributional Bias (AB)]. The sample comprised of 131 individuals, 71 patients with BD and 60 healthy control subjects who were compared in terms of SC performance, demographic, clinical, and neurocognitive variables. A logistic regression model was used to estimate the effect of SC-associated risk factors.

Results

A two-cluster solution was identified with an adjusted-performance group (N = 48, 67.6%) and a low-performance group (N = 23, 32.4%) with mild deficits in ToM and AB domains and with moderate difficulties in EI. Patients with low SC performance were mostly males, showed lower estimated IQ, higher subthreshold depressive symptoms, longer illness duration, and poorer visual memory and attention. Low estimated IQ (OR 0.920, 95% CI 0.863–0.981), male gender (OR 5.661, 95% CI 1.473–21.762), and longer illness duration (OR 1.085, 95% CI 1.006–1.171) contributed the most to the patients clustering. The model explained up to 35% of the variance in SC performance.

Conclusions

Our results confirmed the existence of two discrete profiles of SC among BD. Nearly two-thirds of patients exhibited adjusted social cognitive abilities. Longer illness duration, male gender, and lower estimated IQ were associated with low SC performance.

Keywords

Attributional biasbipolar disorderscluster analysisemotional intelligencesocial cognitiontheory of mind
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 1 , January 2022 , pp. 159 - 168
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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