Neural basis of social cognition in bipolar disorder

Abstract

This article review studies social and interpersonal functioning in patients with bipolar disorder (BD), and reports on the neurobiological underpinnings of the dysfunctions in emotion recognition, i.e. one of the main domains of social cognition. A bibliographical research of controlled studies from 1967 to 2015 was completed in PubMed and PsycINFO using the keywords: "fMRI", "emotion comprehension", "emotion perception", "affect comprehension", "affect perception", "facial expression", "prosody", "theory of mind", "mentalizing", "attributional style", "social perception", "empathy" and "bipolar disorder" or "unipolar depression". Limbic hyperactivity, with a lack of appropriate cortical control, has been reported in subjects with BD during social interactions. This is particularly evident during the acute affective episodes but may persist during the euthymic phases. Deficits in emotion regulation, including neural systems implicated both in voluntary and automatic emotion regulatory subprocesses, are present in DB, particularly for what pertains to social interactions and interpersonal functioning. Patients with bipolar disorder may present a dysfunction in the cortical ability to modulate the limbic system, which may show hyperactivity during social interactions. More studies are needed, including studies to evaluate treatment implications.