Depression and executive functioning deficits predict poor occupational functioning in a large longitudinal sample with bipolar disorder

Abstract Background Bipolar Disorder (BD) is characterized by impairments in psychosocial functioning with occupational disability being one of the most significant. Depression and neurocognitive deficits are features of BD most commonly associated with poor occupational functioning (OF). Few studie...

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Bibliographic Details
Published in:Journal of affective disorders 2017-06, Vol.215, p.135-142
Main Authors: O’Donnell, Lisa A, Deldin, Patricia J, Grogan-Kaylor, Andrew, McInnis, Melvin G, Weintraub, Jenna, Ryan, Kelly A, Himle, Joseph A
Format: Article
Language:English
Subjects:
Absenteeism
Adult
Aged
Aged, 80 and over
Bipolar Disorder - complications
Bipolar Disorder - psychology
Cognition Disorders - complications
Cognition Disorders - psychology
Executive Function
Female
Humans
Interpersonal Relations
Job Satisfaction
Longitudinal Studies
Male
Middle Aged
Models, Psychological
Neuropsychological Tests
Psychiatry
Work Performance
Young Adult
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Summary:Abstract Background Bipolar Disorder (BD) is characterized by impairments in psychosocial functioning with occupational disability being one of the most significant. Depression and neurocognitive deficits are features of BD most commonly associated with poor occupational functioning (OF). Few studies have examined these features over an extended period of time focusing on distinct aspects of work functioning. Methods This longitudinal study included 273 adults with bipolar I disorder (N=173), bipolar II disorder (N=69), and bipolar not otherwise specified (N=31). The participants underwent an annual clinical assessment, neuropsychological testing, and work functioning measures over 5 years. We employed multilevel modeling (MLM) to determine which demographic, clinical, and neurocognitive characteristics influence 4 aspects of work functioning (work attendance, conflict, enjoyment, performance) over this 5-year period. Limitations Work functioning was measured using a self-report measure, which may be confounded by responder bias and is not tailored for distinct occupations. Due to insufficient power, medication use was not accounted for and our sample may not generalize to the broader BD population. Results Using MLM, those with higher levels of depression and greater cognitive flexibility deficits were more likely to experience poorer work attendance ( p
ISSN:0165-0327
1573-2517
DOI:10.1016/j.jad.2017.03.015