scholarly journals Meta-analysis of Theory of Mind (ToM) impairment in bipolar disorder

2015 ◽  
Vol 46 (2) ◽  
pp. 253-264 ◽  
Author(s):  
E. Bora ◽  
C. Bartholomeusz ◽  
C. Pantelis

BackgroundTheory of mind (ToM) dysfunction is prominent in a number of psychiatric disorders, in particular, autism and schizophrenia, and can play a significant role in poor functioning. There is now emerging evidence suggesting that ToM abilities are also impaired in bipolar disorder (BP); however, the relationship between ToM deficits and mood state is not clear.MethodWe conducted a meta-analysis of ToM studies in BP. Thirty-four studies comparing 1214 patients with BP and 1097 healthy controls were included. BP groups included remitted (18 samples, 545 BP patients), subsyndromal (12 samples, 510 BP patients), and acute (manic and/or depressed) (10 samples, 159 BP patients) patients.ResultsToM performance was significantly impaired in BP compared to controls. This impairment was evident across different types of ToM tasks (including affective/cognitive and verbal/visual) and was also evident in strictly euthymic patients with BP (d = 0.50). There were no significant differences between remitted and subsyndromal samples. However, ToM deficit was significantly more severe during acute episodes (d = 1.23). ToM impairment was significantly associated with neurocognitive and particularly with manic symptoms.ConclusionSignificant but modest sized ToM dysfunction is evident in remitted and subsyndromal BP. Acute episodes are associated with more robust ToM deficits. Exacerbation of ToM deficits may contribute to the more significant interpersonal problems observed in patients with acute or subsyndromal manic symptoms. There is a need for longitudinal studies comparing the developmental trajectory of ToM deficits across the course of the illness.

2020 ◽  
Vol 34 (6) ◽  
pp. 827-841 ◽  
Author(s):  
Eivind Normann-Eide ◽  
Bj⊘rnar Torske Antonsen ◽  
Elfrida Hartveit Kvarstein ◽  
Geir Pedersen ◽  
Anja Vaskinn ◽  
...  

Impaired theory of mind (ToM) is an assumed feature of borderline personality disorder (BPD). Yet, no studies have compared ToM abilities in patients with BPD, other personality disorders, and healthy controls, or investigated the relationship between ToM and severity of psychopathology and interpersonal problems. In this study, ToM was investigated by the Movie for the Assessment of Social Cognition. No differences were found between the three groups in overall ToM abilities. The BPD group was, however, characterized by more excessive ToM (interpreted as hypermentalization). Yet, when differentiating between BPD and further severity indicators, excessive ToM was not specifically associated with a BPD diagnosis per se. Finally, there was a moderate association between hypermentalization and interpersonal problems in the BPD group. This study suggests that BPD patients tend to hypermentalize when they misinterpret social information, and that this tendency is related to the severity of their psychopathology.


2017 ◽  
Vol 43 ◽  
pp. 81-91 ◽  
Author(s):  
E. Salagre ◽  
A.F. Vizuete ◽  
M. Leite ◽  
D.J. Brownstein ◽  
A. McGuinness ◽  
...  

AbstractBackground:Bipolar disorder (BD) is a psychiatric disorder with an uncertain aetiology. Recently, special attention has been given to homocysteine (Hcy), as it has been suggested that alterations in 1-carbon metabolism might be implicated in diverse psychiatric disorders. However, there is uncertainty regarding possible alterations in peripheral Hcy levels in BD.Methods:This study comprises a meta-analysis comparing serum and plasma Hcy levels in persons with BD and healthy controls. We conducted a systematic search for all eligible English and non-English peer-reviewed articles.Results:Nine cross-sectional studies were included in the meta-analyses, providing data on 1547 participants. Random-effects meta-analysis showed that serum and plasma levels of Hcy were increased in subjects with BD in either mania or euthymia when compared to healthy controls, with a large effect size in the mania group (g= 0.98, 95% CI: 0.8–1.17,P< 0.001,n= 495) and a small effect in the euthymia group (g= 0.3, 95% CI: 0.11–0.48,P= 0.002,n= 1052).Conclusions:Our meta-analysis provides evidence that Hcy levels are elevated in persons with BD during mania and euthymia. Peripheral Hcy could be considered as a potential biomarker in BD, both of trait (since it is increased in euthymia), and also of state (since its increase is more accentuated in mania). Longitudinal studies are needed to clarify the relationship between bipolar disorder and Hcy, as well as the usefulness of peripheral Hcy as both a trait and state biomarker in BD.


2021 ◽  
pp. 1-11
Author(s):  
Emre Bora

Abstract Background It is widely accepted that borderline personality disorder (BPD) is associated with significant impairments in mentalization and theory of mind (ToM) which are considered as closely related concepts by many authors particularly in psychoanalytical circles. However, for understanding interpersonal difficulties in personality disorders, it is important to distinguish neuro-social cognitive impairment from the abnormal meta-social-cognitive style of patients. Methods The current systematic review aimed to conduct separate meta-analyses of ‘mentalization’ [reflective functioning (RF] and different aspects of ToM in BPD. A literature search was conducted to locate relevant articles published between January 1990 to July 2021. Random-effect meta-analyses were conducted in 34 studies involving 1448 individuals with BPD and 2006 healthy controls. Results A very large impairment in RF was evident in BPD [d = 1.68, confidence interval (CI) = 1.17–2.19]. In contrast, ToM impairment was modest (d = 0.36, CI = 0.24–0.48). BPD patients underperformed healthy controls in ToM-reasoning (d = 0.44, CI = 0.32–0.56) but not ToM-decoding. Increased HyperToM (d = 0.60, CI = 0.41–0.79) and faux pas recognition (d = 0.62, CI = 0.35–0.90) errors in BPD compared to healthy controls were most robust ToM findings in this meta-analysis. Conclusions BPD is characterized by very severe deficits in RF and modest and selective abnormalities in ToM. Interpersonal problems and difficulties in processing social information in BPD can be best explained by patients' maldaptive meta-social cognitive style and top-down effects of these abnormalities rather than having a primary neuro-social cognitive deficit.


2021 ◽  
Vol 12 ◽  
Author(s):  
Kaat Hebbrecht ◽  
Katrien Skorobogatov ◽  
Erik J. Giltay ◽  
Violette Coppens ◽  
Livia De Picker ◽  
...  

ObjectiveTryptophan catabolites (TRYCATs) are implicated in the pathophysiology of mood disorders by mediating immune-inflammation and neurodegenerative processes. We performed a meta-analysis of TRYCAT levels in bipolar disorder (BD) patients compared to healthy controls.MethodsA systematic literature search in seven electronic databases (PubMed, Embase, Web of Science, Cochrane, Emcare, PsycINFO, Academic Search Premier) was conducted on TRYCAT levels in cerebrospinal fluid or peripheral blood according to the PRISMA statement. A minimum of three studies per TRYCAT was required for inclusion. Standardized mean differences (SMD) were computed using random effect models. Subgroup analyses were performed for BD patients in a different mood state (depressed, manic). The methodological quality of the studies was rated using the modified Newcastle-Ottawa Quality assessment Scale.ResultsTwenty-one eligible studies were identified. Peripheral levels of tryptophan (SMD = -0.44; p &lt; 0.001), kynurenine (SMD = - 0.3; p = 0.001) and kynurenic acid (SMD = -.45; p = &lt; 0.001) were lower in BD patients versus healthy controls. In the only three eligible studies investigating TRP in cerebrospinal fluid, tryptophan was not significantly different between BD and healthy controls. The methodological quality of the studies was moderate. Subgroup analyses revealed no significant difference in TRP and KYN values between manic and depressed BD patients, but these results were based on a limited number of studies.ConclusionThe TRYCAT pathway appears to be downregulated in BD patients. There is a need for more and high-quality studies of peripheral and central TRYCAT levels, preferably using longitudinal designs.


2018 ◽  
Vol 33 (4) ◽  
pp. 574-584 ◽  
Author(s):  
Anni Rajala

Purpose Relationship learning is viewed as an important factor in enhancing competitiveness and an important determinant of profitability in relationships. Prior studies have acknowledged the positive effects of interorganizational learning on performance, but the performance measures applied have varied. The purpose of this study is to examine the relationship between interorganizational learning and different types of performance. The paper also goes beyond direct effects by investigating the moderating effects of different research designs. Design/methodology/approach This paper applies a meta-analytic approach to systematically analyze 21 independent studies (N = 4,618) to reveal the relationship between interorganizational learning and performance. Findings The findings indicate that interorganizational learning is an important predictor of performance, and that the effects of interorganizational learning on performance differ in magnitude under different research conditions. Research limitations/implications The paper focuses on interorganizational learning, and during the data collection, some related topics were excluded from the data search to retain the focus on learning. Practical implications The study evinces the breadth of the field of interorganizational learning and how different research designs affect research results. Moreover, this meta-analysis indicates the need for greater clarity when defining the concepts used in studies and for definitions of the concepts applied in the field of interorganizational learning to be unified. Originality/value This study is the first to meta-analytically synthesize literature on interorganizational learning. It also illuminates new perspectives for future studies within this field.


2017 ◽  
Vol 47 (14) ◽  
pp. 2401-2413 ◽  
Author(s):  
E. Bora ◽  
B. Binnur Akdede ◽  
K. Alptekin

BackgroundMost studies suggested that patients with deficit schizophrenia have more severe impairment compared with patients with non-deficit schizophrenia. However, it is not clear whether deficit and non-deficit schizophrenia are associated with differential neurocognitive profiles.MethodsThe aim of this meta-analytic review was to compare cognitive performances of deficit and non-deficit patients with each other and with healthy controls. In the current meta-analysis, differences in cognitive abilities between 897 deficit and 1636 non-deficit patients with schizophrenia were examined. Cognitive performances of 899 healthy controls were also compared with 350 patients with deficit and 592 non-deficit schizophrenia.ResultsBoth deficit (d= 1.04–1.53) and non-deficit (d= 0.68–1.19) schizophrenia were associated with significant deficits in all cognitive domains. Deficit patients underperformed non-deficit patients in all cognitive domains (d= 0.24–0.84) and individual tasks (d= 0.39–0.93). The relationship between deficit syndrome and impairment in olfaction, social cognition, verbal fluency, and speed-based cognitive tasks were relatively stronger.ConclusionsOur findings suggest that there is consistent evidence for a significant relationship between deficit syndrome and more severe cognitive impairment in schizophrenia.


2015 ◽  
Vol 45 (10) ◽  
pp. 2031-2043 ◽  
Author(s):  
J. Ventura ◽  
A. Ered ◽  
D. Gretchen-Doorly ◽  
K. L. Subotnik ◽  
W. P. Horan ◽  
...  

BackgroundNumerous studies have reported links between theory of mind (ToM) deficits, neurocognition and negative symptoms with functional outcome in chronic schizophrenia patients. Although the ToM deficit has been observed in first-episode patients, fewer studies have addressed ToM as a possible trait marker, neurocognitive and symptom correlations longitudinally, and associations with later functioning.MethodRecent-onset schizophrenia patients (n = 77) were assessed at baseline after reaching medication stabilization, and again at 6 months (n = 48). Healthy controls (n = 21) were screened, and demographically comparable with the patients. ToM was assessed with a Social Animations Task (SAT), in which the participants’ descriptions of scenes depicting abstract visual stimuli ‘interacting’ in three conditions (ToM, goal directed and random) were rated for degree of intentionality attributed to the figures and for appropriateness. Neurocognition, symptoms and role functioning were also assessed.ResultsOn the SAT, patients had lower scores than controls for both intentionality (p < 0.01) and appropriateness (p < 0.01) during the ToM condition, at baseline and 6 months. The ToM deficit was stable and present even in remitted patients. Analyses at baseline and 6 months indicated that for patients, ToM intentionality and appropriateness were significantly correlated with neurocognition, negative symptoms and role functioning. The relationship between ToM and role functioning was mediated by negative symptoms.ConclusionsThe ToM deficit was found in recent-onset schizophrenia patients and appears to be moderately trait-like. ToM is also moderately correlated with neurocognition, negative and positive symptoms, and role functioning. ToM appears to influence negative symptoms which in turn makes an impact on role functioning.


2012 ◽  
Vol 47 (4) ◽  
pp. 706-742 ◽  
Author(s):  
William Jeynes

This meta-analysis of 51 studies examines the relationship between various kinds of parental involvement programs and the academic achievement of pre-kindergarten-12th-grade school children. Analyses determined the effect sizes for various parental involvement programs overall and subcategories of involvement. Results indicate a significant relationship between parental involvement programs overall and academic achievement, both for younger (preelementary and elementary school) and older (secondary school) students as well as for four types of parental involvement programs. Parental involvement programs, as a whole, were associated with higher academic achievement by .3 of a standard deviation unit. The significance of these results is discussed.


2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Yuling Xing ◽  
Linlin Yang ◽  
Jing Liu ◽  
Huijuan Ma

The relationship between subclinical thyroid dysfunction and uric acid was not well established. This study aimed to determine if subclinical thyroid dysfunction is associated with hyperuricemia risk and to evaluate the levels of uric acid in patients with different forms of subclinical thyroid dysfunction. A systematic search was conducted in 4 databases to obtain relevant studies on subclinical thyroid dysfunction (subclinical hyperthyroidism and subclinical hypothyroidism) and uric acid. The standardized mean difference (SMD) or odds ratio (OR) and 95% confidence interval (95% CI) were used for evaluation, and the sensitivity analysis was conducted. Publication bias was estimated by funnel plot, Egger’s test, and Begg’s test. A total of 73 studies were included in this meta-analysis. The results demonstrated that serum levels of uric acid in patients with subclinical hypothyroidism were significantly higher than those of controls and patients with subclinical hyperthyroidism. Patients with subclinical thyroid dysfunction had a higher prevalence of hyperuricemia compared with normal clinical thyroid function. Subclinical thyroid dysfunction was associated with the prevalence of hyperuricemia. Different types of subclinical thyroid dysfunction had varied effects on serum levels of uric acid.


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