There is emerging evidence of social cognitive impairments in bipolar disorders (BD). Less evident is the question if social cognitive impairments are predictive of psychosocial functioning, independently of neurocognitive impairment. The aims of the study were to investigate if patients with BD-I showed impairments in facial emotion recognition and alterations in affective empathy, in relation to healthy controls, and if these impairments would predict psychosocial functioning, after accounting for neurocognitive impairments. Thirty-seven patients diagnosed with BD-I, in an euthymic state, and 37 matched healthy controls underwent an assessment including a facial recognition test (ERT) and a self-report scale of affective empathy (BEES). Patients additionally underwent an extensive neuropsychological assessment consisting of traditional tests. Patients with BD-I were significantly less able to recognize the emotion fear compared to healthy controls. However, the lower ability to recognize fear did not predict psychosocial functioning. In addition, it was not related to any of the other neuropsychological variables. The degree of self-reported empathy did not differ between patients and healthy controls. The results add to the evidence of a specific deficit in recognizing fear in BD-I
however, a link with psychosocial functioning was lacking. It is possible that the ability to recognize fear is related to a more narrow concept of interpersonal functioning than to the broad concept of psychosocial functioning. Future research should be directed towards aspects of social functioning in relation to social cognitive impairments, while taking account of subgroups of social cognitive functioning.