Metacognition is described as the set of human abilities that allows us to recognize and think about own and other people's mental states. We use these skills in order to overcome psychological and interpersonal issues and to cope emotional, cognitive and behavioral suffering. Studies that focusing on metacognition in bipolar disorder (BD) are still limited and data are controversial. Our purpose is investigating the difference between BD patients and BD patients with alcohol addiction (BD+A), in terms of metacognitive functions. In addition, we want to assess among BD+A whether the increase in metacognitive functions mediates the relationship between symptoms at T0 and T1.

Forty patients were recruited for this study. A set of tests was performed on each patient to formulate a metacognitive and clinical evaluation. A single measurement was performed on 20 BD patients. Two measurements (T0–T1) were carried out on the 20 BD+A patients, after an integrated treatment.

Data shown significant differences between these two groups. As regards the treatment of BD+A patients, differences were found between T0 and T1. Among the BD+A patients, reduction in the Beck Cognitive Insight Scale (BCIS-SC, P 0. 042) scores between T0 and T1, leads to the prediction of symptom improvement.

Our results confirm the existence of a specific profile of metacognitive functioning in these patients. Our results reveal that the metacognitive functions appear to be predictors of the improvement in the remission of symptoms.