How psychosis shapes the impact of childhood trauma on social cognition in bipolar disorder: the role of Theory of Mind.

The correlations between psychotic symptoms and childhood maltreatment as well as sex differences in adolescents with major depressive disorder.

Theory of mind in adults with pediatric onset multiple sclerosis: neuropsychological, emotional, and quality of life correlates.

BACKGROUND Social cognition may be impaired in Multiple Sclerosis (MS) including the Theory of Mind (ToM), the capacity to understand others' mental states across cognitive and affective components and first- and second-order attributions. Its relationship with neuropsychological functioning in Pediatric Onset Multiple Sclerosis (POMS) remains unclear. OBJECTIVE To investigate associations between neuropsychological functions and ToM in POMS. METHODS Thirty adults with POMS (mean age 25.90 ± 4.87 years; females 60%; disease duration 10.60 ± 5.83; median EDSS 2) completed the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), Modified Fatigue Impact Scale (MFIS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), 36-Item Health Survey Short Form (SF-36) and 48-Yoni Task. Spearman correlations examined relationships between clinical, cognitive and quality-of-life measures and ToM performance. RESULTS Mean accuracy was 0.80 ± 0.11, and 23.3% showed low ToM performance. Higher BAI correlated with longer cognitive ToM responses and reduced efficiency. Slower ToM responses were associated with reduced physical functioning, general and mental health. CONCLUSIONS Anxiety correlates with slower ToM performance. Slower ToM responses relate to poorer quality of life. ToM response times may capture relevant aspects of functioning in adults with POMS.

Cognitive impairment in bipolar disorder: How close to dementia?

Bipolar disorder (BD) is a severe mental illness associated with cognitive and functional impairment. This cross-sectional study evaluated the heterogeneity of cognitive and psychosocial functioning in BD, compared cognitive performance between BD and dementia groups, and identified factors associated with cognitive dysfunction. The study included 108 individuals with BD, of whom 32 were euthymic, while the remainder were symptomatic and 39 with major neurocognitive disorder. Sociodemographic data and mood symptoms were collected through structured interviews. Cognitive and functional status were assessed using the Mini-Mental State Examination, Montreal Cognitive Assessment (MoCA), neuropsychological tests, and the Functioning Assessment Short Test (FAST). BD participants were classified into three cognitive-functional profiles: Dementia-like (BD-DL; N = 69), Mild (BD-M; N = 22), and Preserved (BD-P; N = 17), based on MoCA and FAST scores. A multivariate analysis of covariance, adjusted for age and years of education (Pillai's Trace = 0.65, F = 6.14, p < 0.001; Wilks' Lambda = 0.39, F = 7.96, p < 0.001) showed significant group differences in neuropsychological tests. BD-P showed the highest performance in semantic and phonemic fluency, immediate verbal memory (RAVLT A1), and delayed verbal memory (RAVLT A7) while a pronounced impairment was observed in BD-DL and Dementia. Multinomial logistic regression analyses indicated that younger age, lower rates of hypertension, and fewer depressive symptoms were associated with greater odds of belonging to the BD-P and BD-M groups compared with the Dementia. Our findings support distinct cognitive-functional subgroups and indicate that cognitive deficits in BD may approximate the severity observed in dementia.

A comprehensive investigation of social cognition across different stages of psychosis: A staging model comparison including familial high-risk, ultra high-risk, first episode and chronic patients.

BACKGROUND Social cognition (SC) is central to functioning in schizophrenia spectrum disorders, yet most studies examine single disease stages or domains. It therefore remains unclear whether five SC domains (Theory of Mind [ToM], Social Perception [SP], Social Knowledge [SK], Emotion Recognition [ER], Attributional Bias [AB]) show homogenous impairments and follow a stage-like patterns across the psychosis spectrum. METHODS A total of 359 participants (schizophrenia [SCH] = 59; first-episode psychosis [FEP] = 75; ultra-high risk [UHR-P] = 84; familial high-risk [FHR-P] = 55; healthy controls = 86) were administered a comprehensive SC battery and clinical scales. Group differences and linear trends (stage-ordered differences; stepwise gradients from FHR-P to SCH) were analyzed by ANCOVAs controlling for age and education. Associations with clinical variables were assessed using Spearman correlation. RESULTS ANCOVA revealed a significant group difference only in ToM domain (p = .025), with lower performance in patients compared to asymptomatic FHRP. Linear trend analysis indicated small, but significant staging pattern in ToM (p = .023) and SK (p = .015). No significant staging was observed in SP, ER or AB. Better ToM and SK performance correlated with better functioning, fewer negative symptoms, and later age of onset. CONCLUSIONS SC impairment in psychosis is heterogeneous. ToM, and to a lesser extent SK, shows stage-ordered differences and significant clinical links, whereas SP, ER, and AB exhibit relatively flatter stage profiles across the psychosis spectrum. Given the cross-sectional design and modest effect sizes, conclusions about within-person change are not warranted.

Demographic moderators of the relationship between psychiatric diagnosis and functional capacity in people with serious mental illness.

The UCSD Performance-based Skills Assessment-Brief (UPSA-B) is widely used to evaluate functional capacity in people with serious mental illness (SMI; schizophrenia/schizoaffective disorder [SZ], bipolar disorder [BD], major depressive disorder [MDD]). Previous research has not addressed diagnostic group differences on UPSA-B performance using demographically normed T-scores, nor has it probed whether this relationship is moderated by demographic factors (age, sex, racial/ethnic minority status, education). Participants were 153 outpatients with SMI (SZ n = 58; BD n = 37; MDD n = 58). We analyzed relationships among UPSA-B T-score, diagnostic group, demographic variables, and diagnostic group by demographic variable interactions. The model revealed a significant main effect of age, with younger participants outperforming older participants (F[1144]=12.26, p=.0006). There was a significant effect of diagnosis, with SZ participants performing significantly worse than those with BD and MDD (F[2144]=17.72, p<.0001). There was also a significant diagnosis by sex interaction (F[1144] = 9.10, p=.006) such that within MDD participants, women outperformed men. The diagnostic effect (lower scores in SZ compared with BD/MDD) is consistent with prior research. The age and sex effects were above and beyond the UPSA-B normative corrections generated in a non-psychiatric sample, suggesting an accelerated aging effect in a transdiagnostic SMI sample and a distinct functional disadvantage for men with MDD. When developing and implementing interventions for this population, particular attention should be paid to those living with schizophrenia and schizoaffective disorder, older adults with SMI, and men with MDD.

Childhood trauma, specifically emotional abuse, is associated with psychiatric symptom severity in drug‑naïve first‑episode patients with schizophrenia

Schizophrenia (SCZ) is a highly heterogeneous disorder. Childhood trauma (CT) is a well‑established risk factor, although the contribution of specific CT dimensions remains incompletely understood. This study systematically investigated which CT dimensions were most strongly associated with symptom severity in drug‑naïve first‑episode SCZ patients. In a cross‑sectional design, 284 patients were classified into a SCZ‑ct group (n = 234) and a SCZ‑nct group (n = 50) based on Childhood Trauma Questionnaire. Symptom severity was assessed using the Positive and Negative Syndrome Scale. Hierarchical regression analyses adjusted for demographic and clinical covariates were performed, with rater effects examined via a linear mixed‑effects model. The SCZ‑ct group exhibited significantly higher total and positive symptom scores, whereas negative symptom scores did not differ. Higher total CTQ scores were associated with greater overall symptom severity. Emotional abuse was independently associated with total PANSS scores after adjustment for other CT dimensions and covariates, and this association remained robust after additionally accounting for rater effects. These findings support the potential value of addressing childhood trauma, particularly emotional abuse, in both clinical practice and public health strategies.