Soziale Kognition bei bipolarer Störung

C. Montag; J. Gallinat

doi:10.1055/s-0038-1627817

Nervenheilkunde, Table of Contents

Nervenheilkunde 2011; 30(05): 320-326
DOI: 10.1055/s-0038-1627817

Bipolare Störungen

Schattauer GmbH

Soziale Kognition bei bipolarer Störung

Social cognition in bipolar disorder

Authors

C. Montag

¹Klinik und Poliklinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Campus Mitte
J. Gallinat

¹Klinik und Poliklinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Campus Mitte

Abstract

Zusammenfassung

Sozial-kognitive Funktionen wie Theory of Mind (ToM) und Empathie finden bei der bipolaren affektiven Störung zunehmende Beachtung. Trotz einiger klinischer und neurobiologischer Gemeinsamkeiten mit der Schizophrenie zeigen sich im Hinblick auf die soziale Kognition entscheidende Unterschiede zwischen beiden Erkrankungen. Der Artikel referiert die aktuelle Datenlage zu ToM und Empathie und präsentiert neue empirische Ergebnisse bei euthymen Patienten. Diese Studie zeigt bei bipolaren Patienten ein Defizit in der auf Sprache basierten ToM, wie beispielsweise dem Verständnis von Ironie, welches im Gegensatz zu Defiziten bei kognitiv-kontextuell basierten ToM-Aufgaben unabhängig von allgemeinen kognitiven Funktionen ist. Beim Mentalisieren auf Basis sozialer Perzeption ergab sich kein Unterschied zu Gesunden. Zusammengefasst sind ToM-Defizite bei bipolarer Störung von her-ausgehobenem Interesse, da sie sowohl bei der Entwicklung von psychotischen Symptomen als auch als Belastungsfaktoren in der Interaktion mit anderen diskutiert werden. Vor diesem Hintergrund sind ToM-Defizite schon vor Erkrankungsbeginn beachtenswert und erklären erste Überlegungen, diese Symptomcharakteristik als intermediären Phänotyp im Hinblick auf Assoziationen mit genetischen Varianten zu untersuchen.

Summary

Deficits of theory of mind and empathy have been reported in bipolar disorder and schizophrenia. Despite a range of common characteristics of both disorders, significant differences exist in the field of social cognition. The article reviews current evidence concerning social cognition in bipolar disorder and presents new empirical data on theory of mind and empathy in euthymic bipolar patients. Findings of this study suggest a compromised ability to interpret metaphorical speech in bipolar individuals. In contrast to the deficits of context-dependent cognitive mentalizing, these results were independent from general neurocognitive functioning. Mentalizing based on social perception did not differ between groups. In sum, impairments of theory of mind and empathy are of some interest, as they may contribute to the formation of psychotic symptoms and problems in social interaction. Although social-cognitive deficits should be considered already in the prodromal phase of bipolar disease, further research is required to determine their potential role as an intermediate phenotype.

Schlüsselwörter

ToM - Empathie - soziale Kognition - Mentalisierung - bipolare Störung

Keywords

ToM - empathy - social cognition - mentalizing - bipolar disorder

Full Text

References

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