A case-control study on the theory of mind, insight and quality of life in patients with bipolar I disorder

Objective: Theory of mind (ToM) and insight impairment have been shown to present even in remission period of patients with bipolar I disorder (BP-I) who have low quality of life. This study aimed to evaluate ToM, cognitive insight and quality of life of patients with BP-I, to determine the relation between these three parameters, and to assess the impact of previous psychotic episode on ToM. Methods: One hundred patients in remission period diagnosed with BP-I according to DSM-5 criteria in Erenkoy Psychiatric and Neurologic Disorder Hospital and 40 healthy volunteers were included into the study. Hamilton Depression Rating Scale, Young Mania Rating Scale, Dokuz Eylul Theory of Mind Scale, the Reading the Mind in the Eyes Test, WHOQOL-BREF Quality of Life Scale, Beck Cognitive Insight Scale were applied to all subjects. Results: ToM and quality of life were significantly different between the patient and control groups. However, cognitive insight did not significantly differ between groups. ToM was found to be correlated individually with cognitive insight and quality of life, which did not correlate with each other. Presence of previous psychotic episode had no significant impact on ToM. Conclusion: The findings of the present study suggest that low quality of life in the remission period of BP-I patients is related with ToM.