Discuss Bipolar
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Self-reported concentration problems predict whether or not bipolar I disorder patients achieve stable employment, the results of a study indicate.
Previous studies have shown that cognitive deficits in bipolar disorder patients are associated with a decline in work performance, employment status, global functioning, and longer clinical course. However, many of these investigations have been hampered by methodological problems.
Andrew Gilbert, from the University of Pittsburgh School of Medicine in Pennsylvania, USA, and colleagues therefore studied 154 bipolar I disorder patients for 15??”43 months, gathering data on demographic characteristics and administering the Mood Spectrum Self-Report (MOOD-SR) questionnaire and Bipolar Disorder Visit Form.
The MOOD-SR was administered at baseline and at study termination, at which points employment was categorized as working ??” full-time, part-time, homemaker, or volunteer ??” or not working ??” leave of absence, disability, unemployed, or no longer volunteering. The patients were categorized clinically as good-stable, improving, worsening, or poor-stable.
In all, 46.6% of the patients were good-stable and employed at baseline and termination, 30.4% were poor-stable and not working at baseline and termination, 14.2% were improving, not working at baseline, and working at termination, and 8.8% were worsening, working at baseline, and not working at termination, the team reports in the Journal of Affective Disorders.
Regression analysis revealed that item 91 on the MOOD-SR, covering problems with concentration, education, and age, was significantly associated with employment.
Self-reported cognitive problems were significantly more common in the poor-stable than good-stable groups, at an odds ratio of 2.51. More well-educated patients were also significantly less likely to belong to the poor-stable than good-stable groups, at an odds ratio of 0.55. Physician-reported measures were not associated with employment.
The team concludes: “The ability to predict employment trajectory using a specific item from the MOOD-SR points to the sensitivity of this measure and may suggest that cognitive problems are more likely to predict employment trajectory if assessed in the context of specific limitations in functioning.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009
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