Picture sequencing task performance indicates theory of mind deficit in bipolar disorder

J Affect Disord. 2013 Dec;151(3):1132-4. doi: 10.1016/j.jad.2013.07.009. Epub 2013 Jul 31.


Background: This paper reports the performance of DSM-IV-TR diagnosed bipolar disorder (BD) patients on a well-recognised measure of theory of mind (ToM) that commonly elicits group-related differences in schizophrenia research.

Methods: Forty-nine BD patients and 49 age and gender matched controls completed Langdon and Coltheart (1999)Picture Sequencing Task.

Results: Relative to controls, patients with BD performed significantly worse on the ToM relevant false-belief stories of the picture sequencing task, but not on the control stories requiring social script knowledge, executive control or an understanding of causal connexions. There were no differences in the ToM performance of symptomatic versus euthymic patients or those categorised as having BD I or BD II.

Limitations: As sub group sizes were small, data suggesting a trait-like deficit in ToM should be interpreted with caution.

Conclusions: The results support previous evidence of ToM impairment in BD and indicate a potential endophenotypic overlap in the phenomenology of both schizophrenia and BD.

Keywords: Bipolar disorder; Endophenotypes; Picture sequencing; Social cognition; Theory of mind.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bipolar Disorder / psychology*
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Schizophrenic Psychology
  • Theory of Mind*
  • Young Adult