Información del artículo
Resumen
Introducción
El trastorno afectivo bipolar (TAP) está asociado con un significativo deterioro en el funcionamiento social, laboral y familiar, incluso en períodos de estabilidad clínica, y ello podría explicarse por un déficit de la cognición social.
ObjetivoRevisar los principales hallazgos sobre la cognición social de los pacientes bipolares, a través de sus principales dimensiones y a través de las distintas fases de la enfermedad.
MétodoBúsqueda en la literatura biomédica en Medline, OVID, Proquest y EMBASE, cruzando los términos MeSH cognición social, teoría de la mente, reconocimiento de emociones, empatía y procesamiento emocional con trastorno bipolar, delimitando los resultados a los estudios clínicos con calidad metodológica media/alta, en español o inglés, y publicados en los últimos 20 años en la población infantil y adulta.
ResultadosSe seleccionaron 83 artículos que se referían al tema, aunque sólo 16 evalúan específicamente la cognición social en población bipolar. La mayoría de estudios muestran un déficit tanto en las fases de descompensación como en estado de eutimia.
DiscusiónDesde una perspectiva neurocognitiva se plantean diversas explicaciones a estas alteraciones cognitivas, asociadas con la existencia de sintomatología subsindrómica afectiva. Finalmente, se revisan las estrategias rehabilitadoras que podrían ser de utilidad para revertir este déficit que conlleva importantes repercusiones funcionales.
Palabras clave:
Trastorno bipolar
adaptación psicosocial
teoría de la mente
rehabilitación
Abstract
Introduction
Bipolar disorder (BD) is associated with significant impairment in social, work, and family functioning, even in euthymic state. This could be explained by a social cognition deficit.
ObjectiveTo review the findings on social cognition in bipolar patients through its main dimensions, and through the various stages of the illness. Method: We searched the biomedical literature on Medline, OVID, Proquest, and EMBASE for articles matching the MeSH terms “social cognition”, “theory of mind”, “emotion recognition”, “empathy”, and “emotional processing” to “bipolar disorder”, limiting the results to clinical studies with medium/high methodological quality, in Spanish or English and published in the last 20 years, in children and adults.
ResultsWe selected 83 items referring to this topic but only 24 specifically assessed social cognition in bipolar population. Most studies showed a deficit in both the phases of relapse as well as in euthymic state. Discussion: From a neurocognitive perspective a number of explanations arise for this cognitive impairment, associated with the existence of subsyndromal affective symptoms. Finally, we review the rehabilitation strategies that could be useful to reverse this deficit that carries important functional implications.
Key words:
Bipolar disorder
psychosocial adjustment
theory of mind
rehabilitation
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Conflictos de interés: G. Lahera es ponente de Lilly España y de Jannsseng España y ha recibido becas de investigación de Pfizer España. Los demás autores no manifiestan ningún conflicto de interés en este artículo. Así mismo, los autores manifiestan que no recibieron ninguna financiación para la realización del artículo.
Copyright © 2011. Asociación Colombiana de Psiquiatría
