Investigation of the relationship between cognitive flexibility, theory of mind and creative thinking in patients with bipolar disorder

May 6, 2025BMC psychiatry

How flexible thinking, understanding others, and creativity are related in people with bipolar disorder

AI simplified

Circadian Biology on OpenScience ↗PubMed ↗DOI ↗OA ↗

Abstract

Patients with bipolar disorder (BD) made significantly more perseverative errors, with a mean difference indicating a p < .001 compared to healthy controls (HCs).

No significant difference was found in between BD patients and HCs, t(98)=-0.99, p =.323.
BD patients performed worse on tasks, including a higher number of perseverative errors, t(98) = 4.84, p <.001.
BD patients completed fewer categories in cognitive tasks, z=-4.38, p <.001, and scored lower on assessments, t(98)=-3.51, p <.001.
Correlations in BD patients indicated a relationship between innovation search and irony scores (r(48) = 0.44, p =.001).
In HCs, associations were observed between cognitive flexibility measures and various aspects of creative thinking, including innovation search and perseverative errors.
The model variables explained 44% of the MCTDS score in HCs at a statistically significant level.

AI simplified

BACKGROUND: This study aimed to analyse the differences in between patients with bipolar disorder (BD) and healthy controls (HCs) and to examine the potential role of (CF) and (ToM) as mediators of this relationship.

METHODS: Fifty patients diagnosed with BD in remission and fifty HCs participated in the study. The participants completed the Wisconsin Card Sorting Test (WCST), the Reading the Mind in the Eyes Test (RMET), the Dokuz Eylul Theory of Mind Index (DEToMI) and the Marmara Creative Thinking Dispositions Scale (MCTDS).

RESULTS: There was no significant difference between the groups in terms of creative thinking dispositions, t(98)=-0.99, p =.323. However, patients performed worse in several areas, such as the number of perseverative errors (PEs) t(98) = 4.84, p <.001, number of completed categories (z=-4.38, p <.001), DEToMI total score t(98)=-3.51, p <.001, and RMET score t(98)=-2.77, p <.007, than HCs. In the patient group, correlations were found between innovation search and irony scores (r (48) = 0.44, p =.001) and between innovation search and the DEToMI total score (r [(48) = 0.44, p =.002). In the HC group, associations were found between PEs and innovation search, r (48)=-0.33, p =.019; PEs and inquisitive, r (48)=-0.29, p =.044; SOFB and inquisitive, r (48) = - 0.30, p =.034; doubt and irony, r (48) = 0.29, p =.043; and the RMET score and courage, r (48)=-0.31, p =.027. In the HC group, 44% of the MCTDS score was explained by the model variables at a statistically significant level.

LIMITATIONS: Not all factors affecting creative thinking dispositions and cognitive functions were examined.

CONCLUSIONS: The relationship between creativity and BD varies depending on the research approach; however, consistent with the current literature, our study found no significant differences in creative thinking dispositions between the groups. While CF and ToM predicted creative thinking in healthy individuals, they do not predict these dispositions in BD patients. Therefore, focusing on other cognitive factors related to creativity in individuals with BD may help clarify this issue. Our study contributes to the limited literature by investigating the effects of CF and ToM on creative thinking dispositions in BD patients.

Key numbers

27.62

Perseverative Errors

Average number of perseverative errors on the Wisconsin Card Sorting Test for BD patients.

Completed Categories

Average number of completed categories on the Wisconsin Card Sorting Test for BD patients.

1.82

DEToMI Total Score

Average total score on the Dokuz Eylul Index for BD patients.

Full Text

We can’t show the full text here under this license. Use the link below to read it at the source.

View full text (PDF) ↗View full text (HTML) ↗

Investigation of the relationship between cognitive flexibility, theory of mind and creative thinking in patients with bipolar disorder

Abstract

Key numbers

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief