Self-reported cognitive problems predict employment trajectory in patients with bipolar I disorder

• Published in: Journal of affective disorders 2010-08, Vol.124 (3), p.324-328
• Main Authors: Gilbert, A.M, Olino, T.M, Houck, P, Fagiolini, A, Kupfer, D.J, Frank, E
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Attention; Biological and medical sciences; Bipolar affective disorder; Bipolar disorder; Bipolar Disorder - diagnosis; Bipolar Disorder - psychology; Bipolar Disorder - rehabilitation; Bipolar disorders; Brief Psychiatric Rating Scale - statistics & numerical data; Cognition Disorders - diagnosis; Cognition Disorders - psychology; Cognition Disorders - rehabilitation; Cognitive function; Concentration; Disability Evaluation; Employment; Employment status; Female; Functional impairment; Functional outcome; Humans; Male; Medical sciences; Memory Disorders - diagnosis; Memory Disorders - psychology; Memory Disorders - rehabilitation; Mood disorders; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychometrics; Psychopathology. Psychiatry; Rehabilitation, Vocational; Self Disclosure; Statistics as Topic; Surveys and Questionnaires; Temperament; Termination; Young Adult
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2009.11.012

Abstract Background Cognitive impairment in bipolar disorder has been associated with poor functional outcomes. We examined the relation of self-reported cognitive problems to employment trajectory in patients diagnosed with bipolar I disorder. Methods 154 bipolar I disorder patients were followed for 15–43 months at the Bipolar Disorders Center for Pennsylvanians. Using a multinomial logistic regression we examined predictors of employment group including self-reported cognitive problems, mood symptoms, education and age. Cognitive functioning was measured via 4 self-report items assessing memory/concentration at baseline and termination. Employment status was recorded at baseline and termination. Employment was categorized as working (full-time, part-time, homemaker, volunteer) or not working (leave of absence, disability, unemployed, no longer volunteering) at each time point. Patients were categorized as good stable, improving, worsening and poor stable. Results Baseline self-reported concentration problems and years of education significantly predicted employment trajectory. Limitations Post-hoc analyses of existing clinical data. Conclusions Self-reported concentration problems assessed in the context of specific areas of functioning may serve as a sensitive predictor of functional outcome in patients diagnosed with bipolar I disorder.