Abstract

This study assesses the empathy level, cognitive performance and emotion recognition skills of remitted patients with schizophrenia, schizoaffective disorder and bipolar disorder, and also explores the relationship between impairments in the mentioned domains. The study was performed on 77 subjects divided into two groups: PAT sample (N = 37) included remitted patients with either schizophrenia, schizoaffective or bipolar disorder who were compared with healthy control subjects from the HC sample (N = 40). Along with sociodemographic and clinical data, empathy levels (using EQ (Empathy Quotient) scale), the ability to recognize another person’s emotional state (using RMET (Reading the Mind in the Eyes Test)), and cognitive performance (using MoCA (Montreal Cognitive Assessment) Scale) were investigated. The intensity of the psychiatric symptoms was measured with BPRS-E (Brief Psychiatric Rating Scale—Expanded). The remitted patients had lower EQ (p = 0.02) and RMET (p < 0.0001) scores than the healthy subjects. In the PAT group, RMET scores were positively correlated with MoCA total scores. Both EQ and RMET scores were negatively correlated with BPRS-E total scores. Psychiatric disorder was a significant predictor for deficits in emotion recognition. There were no significant differences in RMET, EQ and MoCA scores between patients with respect to diagnosis, the type of antipsychotic or the associated medication. In both samples, females had higher empathy levels (p = 0.04) and better emotion recognition abilities (p = 0.04) than males. Patients with schizophrenia, schizoaffective or bipolar disorder, currently in remission, displayed lower empathy levels and poorer emotion recognition skills than healthy subjects. Poor emotion recognition skills were associated with symptom severity and impairments in global cognition.

Highlights

  • The ability to make inferences about one’s own as well as others’ mental status is critical for effective social functioning

  • The study is cross-sectional and included 37 outpatients (PAT sample) with either schizophrenia, schizoaffective disorder or bipolar disorder diagnosed by psychiatrists, currently in remission, according to ICD-10 diagnostic criteria; and 40 healthy subjects (HC sample, which showed normal values for BPRS-E and MOCA), matched for age and gender

  • We found no significant differences in EQ, RMET, MoCA and BPRS-E scores between patients with respect to the type of the psychiatric disorder, the type of antipsychotic, or the associated medication

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Summary

Introduction

The ability to make inferences about one’s own as well as others’ mental status is critical for effective social functioning. This is referred to as social cognition or the Theory of Mind (ToM)/mentalizing, which includes a cognitive aspect, when assuming others’. Beliefs, thoughts or intentions, and an affective aspect, when inferring others’ emotions and feelings. Being capable to adopt another’s perspective refers to cognitive empathy and is the equivalent of the affective aspect of ToM. In this regard, affective ToM requires the integration of cognitive ToM with empathy [1]

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