Filiz KULACAOĞLU, Hasan ÜNVER, Yusuf Ezel YILDIRIM, Gamze ERZİN

Bipolar I bozukluk tanılı hastalarda zihin kuramının, metabolik parametreler ve işlevsellik ile ilişkisi

Amaç: Bu çalışmada bipolar bozukluk-1 (BB-1) tanılı hastaların remisyon dönemlerindeki zihin kuramı becerileri ile, işlevsellik ve metabolik değişimleri arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntem: Bu kesitsel çalışma, remisyonda BB-1 tanılı 68 hasta ve 45 sağlıklı kontrolden oluşmaktadır. Katılımcılara sosyodemografik form, Gözlerden Zihin Okuma Testi, Bipolar Bozukluk İşlevsellik Anketi uygulandı. Katılımcıların beden kitle indeksi (BKİ), bel çevresi (BÇ), açlık plazma glukozu (PG), yüksek yoğunluklu lipoprotein kolesterol (HDL), düşük yoğunluklu lipoprotein kolesterol (LDL), toplam kolesterol, trigliserit (TG) seviyeleri kaydedildi. Bulgular: Hasta grubu ile sağlıklı kontrol grubu arasında BÇ, BKİ, HDL, LDL, TG düzeyleri açısından anlamlı farklılıklar vardı. Bağımsız örnekler t-testi sonuçlarına göre kontrol grubunda hasta grubuna göre Gözlerden Zihin Okuma Testi’nde istatistiki olarak anlamlı daha yüksek skorlar elde edilmiştir. Sonuç: Remisyon döneminde BB-1 tanılı hastalar, sağlıklı kontrollere göre zihin kuramı becerilerinde daha düşük performansa ve metabolik parametrelerde daha fazla değişikliğe sahiptir. Metabolik değişiklik ve zihin bozukluğu teorisi, BD için potansiyel tedavi hedefi olmalıdır.

Anahtar Kelimeler:

Zihin kuramı, bipolar bozukluk, metabolik disfonksiyon, Theory of mind, bipolar disorder, metabolic dysfunction

Relationship between theory of mind and metabolic parameters and functioning in patients with bipolar I disorder

Purpose: We aimed to investigate the relationship theory of mind abilities with functionality and metabolic alteration in patients with bipolar disorder-1 (BD-1) during the remission period. Materials and Methods: This cross-sectional study is consisted of 68 patients with bipolar disorder-1 and 45 healthy controls. Sociodemographic form, Reading the Mind in the Eyes Test (RMET), Bipolar Disorder Functioning Questionnaire (BDFQ) were administered to the participants. Body mass index (BMI), waist circumference (WC), fasting plasma glucose (FG), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), total cholesterol (TC), triglyceride (TG) levels were recorded. Results: There were significant differences between the patient group and healthy control group in terms of WC, BMI, HDL, LDL, TG. The results of independent samples t-test indicated a statistically significant difference in RMET score between the two groups with control group significantly higher than patient group. Conclusion: Patients with BD-1 during the remission period have lower performance on theory of mind abilities and more alteration in metabolic parameters than healthy controls. Metabolic alteration and theory of mind impairment should be potential treatment target for BD

Keywords:

Theory of mind, bipolar disorder, metabolic dysfunction,

PDF

___

1. Vieta E, de Arce R, Jiménez-Arriero MA, Rodriguez A, Balanzá V, Cobaleda S. Detection of subclinical depression in bipolar disorder: a cross-sectional, 4-month prospective follow-up study at community mental health services (SIN-DEPRES). J Clin Psychiatry. 2010;71:4291.
2. Sanchez-Moreno J, Martinez-Aran A, Tabarés-Seisdedos R, Torrent C, Vieta E, Ayuso-Mateos JL. Functioning and disability in bipolar disorder: an extensive review. Psychother Psychosom. 2009;78:285–97. 3. Kurtz MM, Gerraty RT. A meta-analytic investigation of neurocognitive deficits in bipolar illness: profile and effects of clinical state. Neuropsychology. 2009;23:551.
4. Cullen B, Ward J, Graham NA, Deary IJ, Pell JP, Smith DJ, et al. Prevalence and correlates of cognitive impairment in euthymic adults with bipolar disorder: a systematic review. J Affect Disord. 2016;205:165–81.
5. Fiske ST, Taylor SE. Social cognition. Mcgraw-Hill Book Company; 1991.
6. Green MF, Horan WP, Lee J. Social cognition in schizophrenia. Nat Rev Neurosci. 2015;16:620–31.
7. Green MF, Leitman DI. Social cognition in schizophrenia. Schizophr Bull. 2008;34:670–2.
8. Pinkham AE, Penn DL, Perkins DO, Lieberman J. Implications for the neural basis of social cognition for the study of schizophrenia. Am J Psychiatry. 2003;160(5):815–24.
9. Brüne M. Social cognition and psychopathology in an evolutionary perspective. Psychopathology. 2001;34:85–94.
10. Samamé C, Martino DJ, Strejilevich SA. Social cognition in euthymic bipolar disorder: Systematic review and meta-analytic approach. Acta Psychiatr Scand. 2012;125:266–80.
11. Samamé C, Martino DJ, Strejilevich SA. An individual task meta-analysis of social cognition in euthymic bipolar disorders. J Affect Disord. 2015;173:146–53.
12. Bora E, Bartholomeusz C, Pantelis C. Meta-analysis of Theory of Mind (ToM) impairment in bipolar disorder. Psychol Med. 2016;46:253–64.
13. van Neerven T, Bos DJ, van Haren NE. Deficiencies in Theory of Mind in patients with schizophrenia, bipolar disorder, and major depressive disorder: A systematic review of secondary literature. Neurosci Biobehav Rev. 2021;120:249–61.
14. Baron-Cohen S, Wheelwright S, Hill J, Raste Y, Plumb I. The “Reading the Mind in the Eyes” Test revised version: a study with normal adults, and adults with Asperger syndrome or high-functioning autism. J Child Psychol Psychiatry. 2001;42:241–51.
15. Ibanez A, Cetkovich M, Petroni A, Urquina H, Baez S, Gonzalez-Gadea ML, et al. The neural basis of decision-making and reward processing in adults with euthymic bipolar disorder or attention-deficit/hyperactivity disorder (ADHD). PloS One. 2012;7:e37306.
16. Cusi AM, Nazarov A, Holshausen K, MacQueen GM, McKinnon MC. Systematic review of the neural basis of social cognition in patients with mood disorders. J Psychiatry Neurosci. 2012;37:154–69.
17. Martino DJ, Strejilevich SA, Fassi G, Marengo E, Igoa A. Theory of mind and facial emotion recognition in euthymic bipolar I and bipolar II disorders. Psychiatry Res. 2011;18:379–84.
18. Barrera Á, Vázquez G, Tannenhaus L, Lolich M, Herbst L. Theory of mind and functionality in bipolar patients with symptomatic remission. Rev Psiquiatr Salud Ment Engl Ed. 2013;6:67–74.
19. Espinós U, Fernández-Abascal EG, Ovejero M. What your eyes tell me: Theory of mind in bipolar disorder. Psychiatry Res. 2018;262:536–41.
20. Depp CA, Mausbach BT, Harmell AL, Savla GN, Bowie CR, Harvey PD, et al. Meta-analysis of the association between cognitive abilities and everyday functioning in bipolar disorder. Bipolar Disord. 2012;14:217–26.
21. Goswami U, Sharma A, Khastigir U, Ferrier IN, Young AH, Gallagher P, et al. Neuropsychological dysfunction, soft neurological signs and social disability in euthymic patients with bipolar disorder. Br J Psychiatry. 2006;188:366–73.
22. Vancampfort D, Vansteelandt K, Correll CU, Mitchell AJ, De Herdt A, Sienaert P, et al. Metabolic syndrome and metabolic abnormalities in bipolar disorder: a meta-analysis of prevalence rates and moderators. Am J Psychiatry. 2013;170:265–74.
23. Cook R, Cheng HL, O’Dwyer N, Raymond J, Rooney K, Steinbeck K, et al. The relationship between overweight, obesity and cognitive function in adults: A systematic review and meta-analysis. Obes Res Clin Pract. 2014;8:21.
24. Yang Y, Shields GS, Guo C, Liu Y. Executive function performance in obesity and overweight individuals: A meta-analysis and review. Neurosci Biobehav Rev. 2018;84:225–44.
25. Bora E, McIntyre RS, Ozerdem A. Neurococognitive and neuroimaging correlates of obesity and components of metabolic syndrome in bipolar disorder: a systematic review. Psychol Med. 2019;49:738–49.
26. Hamilton M. Hamilton anxiety scale. Group. 1959;1:4.
27. Akdemir A, Türkçapar MH, Örsel SD, Demirergi N, Dag I, Özbay MH. Reliability and validity of the Turkish version of the Hamilton Depression Rating Scale. Compr Psychiatry. 2001;42:161–5.
28. Karadağ F, Oral ET, Aran Yalçın F, Erten E. Young mani derecelendirme ölçeğinin Türkiye’de geçerlik ve güvenilirliği. Türk Psikiyatri Derg. 2001;13:107–14. 29. Baron-Cohen S, Jolliffe T, Mortimore C, Robertson M. Another advanced test of theory of mind: Evidence from very high functioning adults with autism or Asperger syndrome. J Child Psychol Psychiatry. 1997;38:813–22.
30. Yildirim EA, Kasar M, Güdük M, Ateş E, Küçükparlak I, ÖZALMETE EO. Investigation of the reliability of the" reading the mind in the eyes test" in a Turkish population. Turk J Psychiatry. 2011;22(3).
31. Aydemır Ö, Eren İ, Savaş H, Kalkan Oğuzhanoğlu N, Koçal N, Devrımcı Özgüven H, et al. Bipolar Bozuklukta Işlevsellik Ölçeğinin Geliştirilmesi, Güvenilirlik ve Geçerliliği. Turk Psikiyatri Derg. 2007;18:344-52
32. Bora E, Vahip S, Gonul AS, Akdeniz F, Alkan M, Ogut M, et al. Evidence for theory of mind deficits in euthymic patients with bipolar disorder. Acta Psychiatr Scand. 2005;112:110–6.
33. Rubinsztein JS, Fletcher PC, Rogers RD, Ho LW, Aigbirhio FI, Paykel ES, et al. Decision-making in mania: a PET study. Brain. 2001;124:2550–63.
34. Berecz H, Tényi T. Social cognitive functioning in first-degree relatives of patients with bipolar disorder. A review of the literature. Psychiatr Hung Magy Pszichiatriai Tarsasag Tudomanyos Folyoirata. 2016;31:376–81.
35. Rosa AR, Bonnin CM, Mazzarini L, Amann B, Kapczinski FP, Vieta E. Predictores clínicos del funcionamiento interpersonal en pacientes bipolares. Rev Psiquiatr Salud Ment. 2009;2:83–8.
36. de Louw EJ, Paans NP, Sonnenberg CM, Konz H, Meesters PD, van Grootheest D, et al. Metabolic syndrome rates in older patients with severe mental illness after five years of follow-up and the association with mortality. Int J Geriatr Psychiatry. 2019;34:333–6.
37. Yokum S, Ng J, Stice E. Relation of regional gray and white matter volumes to current BMI and future increases in BMI: a prospective MRI study. Int J Obes. 2012;36:656–64.
38. Bora E, Akdede BB, Alptekin K. The relationship between cognitive impairment in schizophrenia and metabolic syndrome: a systematic review and meta-analysis. Psychol Med. 2017;47:1030–40.
39. Anjum S, Bathla M. A comparative study of prevalence and predictors of metabolic syndrome in various psychiatric disorders in state of Haryana: More than 30 years Vs. less than 30 years. Diabetes Metab Syndr Clin Res Rev. 2019;13:510–6.
40. Cigliobianco M, Paoli RA, Caletti E, Mansur R, Zugno E, Prunas C, et al. Possible association between social cognition and metabolic dysfunctions in bipolar disorder and schizophrenia: preliminary results. J Affect Disord. 2019;246:828–35.