Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep 24;10(19):4349.
doi: 10.3390/jcm10194349.

Exploring Clinical Correlates of Metacognition in Bipolar Disorders Using Moderation Analyses: The Role of Antipsychotics

Paul Roux  1   2   3 , Nathan Faivre  4 , Anne-Sophie Cannavo  2   3 , Eric Brunet-Gouet  1   2   3 , Christine Passerieux  1   2   3
Affiliations

Exploring Clinical Correlates of Metacognition in Bipolar Disorders Using Moderation Analyses: The Role of Antipsychotics

Paul Roux et al. J Clin Med. .

Abstract

The determinants of metacognition are still poorly understood in bipolar disorders (BD). We aimed to examine the clinical determinants of metacognition, defined as the agreement between objective and subjective cognition in individuals with BD. The participants consisted of 281 patients with BD who underwent an extensive neuropsychological battery and clinical evaluation. To assess subjective cognition, participants provided a general rating of their estimated cognitive difficulties. Clinical characteristics of BD were also recorded, along with medication. We studied the potential moderation of the association between cognitive complaints and global objective cognitive performance by several clinical variables with ordinal logistic regressions. Depression and impulsivity were associated with greater cognitive complaints. The only variable that moderated the relationship between objective and subjective cognition in the global model was the prescription of antipsychotics. Patients taking antipsychotics had a poorer association between cognitive complaints and objective neuropsychological performance. This result suggests a role for dopamine in the modulation of metacognitive performance, and calls for the systematic control of antipsychotic medication in future studies documenting metacognitive deficits in severe and persistent mental disorders. Depression and impulsivity should be investigated as potential therapeutic targets for individuals with BD and cognitive complaints, before proposing an extensive neuropsychological evaluation.

Keywords: antipsychotic; bipolar disorders; cognition; cognitive complaints; impulsivity; metacognition.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Distribution of objective cognition according to the level of cognitive complaints in the observed dataset: (a) in individuals with antipsychotic; (b) in individuals without antipsychotic. The width of the boxes is proportional to the sample size in each level of cognitive complaints.
See this image and copyright information in PMC

References

    1. David A.S., Bedford N., Wiffen B., Gilleen J. Failures of Metacognition and Lack of Insight in Neuropsychiatric Disorders. Philos. Trans. R. Soc. Lond. B Biol. Sci. 2012;367:1379–1390. doi: 10.1098/rstb.2012.0002. - DOI - PMC - PubMed
    1. Varga M., Magnusson A., Flekkøy K., Rønneberg U., Opjordsmoen S. Insight, Symptoms and Neurocognition in Bipolar I Patients. J. Affect. Disord. 2006;91:1–9. doi: 10.1016/j.jad.2005.09.002. - DOI - PubMed
    1. Camelo E., Mograbi D.C., de Assis da Silva R., Santana C.M.T., Ferreira do Nascimento R.L., de Oliveira E Silva A.C., Nardi A.E., Cheniaux E. Clinical and Cognitive Correlates of Insight in Bipolar Disorder. Psychiatr. Q. 2019;90:385–394. doi: 10.1007/s11126-019-09627-2. - DOI - PubMed
    1. Favaretto E., Bedani F., Offredi A., Schroffenegger M., Sassaroli S., Ruggiero G., Fagiolini A., Caselli G. Metacognitions and Repetitive Negative Thinking in Bipolar Disorder and Healthy Controls: A Comparative Study. J. Affect. Disord. 2020;276:152–158. doi: 10.1016/j.jad.2020.07.013. - DOI - PubMed
    1. Østefjells T., Melle I., Aminoff S.R., Hellvin T., Hagen R., Lagerberg T.V., Lystad J.U., Røssberg J.I. An Exploration of Metacognitive Beliefs and Thought Control Strategies in Bipolar Disorder. Compr. Psychiatry. 2017;73:84–92. doi: 10.1016/j.comppsych.2016.11.008. - DOI - PubMed

LinkOut - more resources