Background: Cognitive impairment in manic patients involves neurocognitive and theory of mind (ToM) impairments. This study aims to investigate cognitive impairment among manic patients and their first-degree relatives (FDRs).

Methods: A total of 31 manic inpatients, 31 unaffected relatives, and 30 healthy controls (HCs) were investigated using the Reading the Mind in Eye Test (RMET) and Hinting Task (HT). The intelligence quotient (IQ), attention, working memory, executive functions, fluency and processing speed were also assessed.

Results: Patients and their relatives scored lower than controls on Theory of Mind reasoning and several neurocognitive measures. Regression analysis of the total sample indicated that a mania diagnosis or a FDR was strongly related to lower ToM reasoning performance. The deficits in ToM among patients were related to years of education.

Conclusions: Due to the comparable performance of ToM between patients and their relatives, the reasoning aspect of ToM may represent a trait marker for bipolar disorder (BD). The deficits in ToM in patients with BD are partly independent of neurocognition.

Keywords: bipolar disorder; mania; neurocognition; relatives; theory of mind.

© 2025 Wiley Periodicals LLC.

背景：躁狂症患者的认知障碍包括神经认知和心智理论（ToM）方面的损伤。本研究旨在调查躁狂患者及其一级亲属（FDRs）的认知障碍。

方法：总共对31名躁狂住院患者、31名未受影响的亲属以及30名健康对照组（HCs）使用“读眼测试”（RMET）和暗示任务（HT）进行了调查。还评估了智商（IQ）、注意力、工作记忆、执行功能、流畅性和处理速度。

结果：患者及其亲属在心智理论推理以及若干神经认知测验中的得分低于对照组。对整个样本的回归分析表明，躁狂诊断或为一级亲属与较低的心智理论推理表现密切相关。患者的ToM缺陷与其受教育年限有关。

结论：由于患者及其亲属在心智理论方面的表现相当，心智理论中的推理方面可能代表双相障碍（BD）的特征标记。患有BD的人在ToM上的缺陷部分独立于神经认知。

关键词：双相障碍；躁狂；神经认知；亲属；心智理论。

© 2025 Wiley Periodicals LLC.