Level of functioning, perceived work ability, and work status among psychiatric patients with major mental disorders

Karpov, Boris; Joffe, Grigori; Aaltonen, Kari; Suvisaari, Jaana; Baryshnikov, Ilya; Näätänen, Petri; Koivisto, Maaria; Melartin, Tarja; Oksanen, Jorma; Suominen, Kirsi; Heikkinen, Martti; Isometsä, Erkki

doi:10.1016/j.eurpsy.2017.03.010

Cited by 23 publications

(18 citation statements)

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“…The lower functional impairment, more unemployment and increased depressive symptoms among the affected twins with previous affective episodes than high-risk and low-risk are consistent with prior studies ( 30 – 32 ). We have previously found that subclinical depressive symptoms were increased in high-risk twins compared with low-risk twins ( 12 ), a finding that was not replicated in the present study, although, the high-risk group numerically had higher scores.…”

Section: Discussionsupporting

confidence: 90%

“…Nevertheless, our prior study did include high-risk twins only and not affected twins. Another study found an association between depressive symptoms and self-rated functional impairment among patients with affective disorders ( 32 ). In the present study, the assessment of functional impairment was interviewer-administered but still relied on the participant's subjective view of their everyday functioning.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Characteristics, Life Adversities and Personality Traits in Monozygotic Twins With, at Risk of and Without Affective Disorders

et al. 2018

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Background: Affective disorders have a long-term impact on psychiatric health and are caused by multiple interacting factors including familial risk, childhood adversity, life events and personality traits.Methods: In this study, monozygotic twins (MZ) at familial risk (indexed by affective disorder in their co-twin; high-risk group), affected MZ twins (indexed by a diagnosis with affective disorder) and MZ twins with no family history of affective disorder (low-risk group) were identified through cross-linking of nation-wide Danish registers. In total, 204 MZ twins were included and psychopathology, personality traits and life adversity were evaluated by semi-structured interviews and questionnaires.Results: Affected MZ twins presented with more subclinical affective symptoms and were functionally impaired as evidenced by higher unemployment rates and reduced functional status. The affected and the high-risk groups reported more childhood adversity and had experienced more stressful life events than the low-risk group. A direct comparison within the discordant twin pairs showed that the high-risk twins presented fewer affective symptoms, better functional status, more extraversion and lower neuroticism scores than their affected co-twins although they had equal levels of life adversity as their affected co-twins.Conclusion: These findings add to the evidence indicating that patients experience higher neuroticism, persistent subclinical symptoms and reduced socio-occupational function after affective episodes. Additionally, neuroticism and extraversion seem capable of moderating the sensitivity to exposure from the environment.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics, Life Adversities and Personality Traits in Monozygotic Twins With, at Risk of and Without Affective Disorders

et al. 2018

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“…Variability in cognitive performance is partly explained by genetic risk in schizophrenia (Blokland et al, 2016), although at least some of these genetic risk factors are likely to influence also cognitive function in other psychotic disorders (Van Assche et al, 2017; Parellada et al, 2017; Ranlund et al, 2018). Secondary environmental factors, such a low occupational level and social isolation, have also been associated with cognitive performance in chronic schizophrenia and, to a lesser extent, in bipolar disorder (Karpov et al, 2017). Above and beyond the relationships between these genetic and environmental factors on cognition, these factors may also be important for the degree to which individuals can compensate for the deleterious outcomes of CT.…”

Section: Discussionmentioning

confidence: 99%

The role of childhood trauma in cognitive performance in schizophrenia and bipolar disorder – A systematic review

Dauvermann

Donohoe

2019

Schizophrenia Research: Cognition

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Childhood trauma (CT) has repeatedly been associated with cognitive deficits in patients with psychosis but many inconsistencies have been reported so that the nature of the relationship remains unclear. The purpose of this review was to better characterize the contribution of CT to cognitive deficits by considering the type, severity and frequency of childhood traumatic events and their relationships with psychosis at all stages.Relevant studies were identified via electronic and manual literature searches and included original studies that investigated the relationship between CT and higher cognitive performance or social cognitive performance in patients with schizophrenia, bipolar disorder and psychosis at all stages of the illness stages (i.e. ultra-high risk, first episode or chronic phase).Overall, a majority of studies reported that patients who experienced CT displayed deficits in general cognitive ability compared to patients with psychosis without such a history. Associations between CT and other cognitive function were more mixed. When comparing patient groups, the association between CT and cognitive function was more inconsistent in patients with chronic schizophrenia than in healthy participants, ultra-high risk individuals, first-episode patients and patients with chronic bipolar disorder.In understanding the variability in the reported relationships between CT and cognition across study populations, we highlight the variety of questionnaires used and discuss the likelihood of there being differences in cognitive function based on specific stressors, severity and frequency. Finally, we consider future research steps that may shed light on psychobiological mechanisms underlying CT and cognitive performance in patients with psychosis.

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“…Moreover, subjects with schizophrenia are typically more severely cognitively impaired than are subjects with major depressive or bipolar disorder (Keefe and Fenton, 2007). Accordingly, educational and occupational attainment in individuals with schizophrenia is lower than healthy (Keefe and Fenton, 2007; Rajji et al ., 2014; Green, 2016) and psychiatrically-ill (Vreeker et al ., 2016; Karpov et al ., 2017) subjects. Although comparisons to healthy subjects from the general population identifies approximately 80% of individuals with schizophrenia as cognitively impaired (Keefe and Fenton, 2007), both the presence and severity of cognitive impairments in any given individual with schizophrenia appears to be more accurately identified by the deviation from the cognitive aptitude of their parents (Keefe et al ., 2005; Keefe and Fenton, 2007).…”

Section: Introductionmentioning

confidence: 99%

Proxy measures of premortem cognitive aptitude in postmortem subjects with schizophrenia

et al. 2019

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BackgroundPostmortem human brain studies provide the molecular, cellular, and circuitry levels of resolution essential for the development of mechanistically-novel interventions for cognitive deficits in schizophrenia. However, the absence of measures of premortem cognitive aptitude in postmortem subjects has presented a major challenge to interpreting the relationship between the severity of neural alterations and cognitive deficits within the same subjects.MethodsTo begin addressing this challenge, proxy measures of cognitive aptitude were evaluated in postmortem subjects (N = 507) meeting criteria for schizophrenia, major depressive or bipolar disorder, and unaffected comparison subjects. Specifically, highest levels of educational and occupational attainment of the decedent and their parents were obtained during postmortem psychological autopsies.ResultsConsistent with prior findings in living subjects, subjects with schizophrenia had the lowest educational and occupational attainment relative to all other subject groups, and they also failed to show the generational improvement in attainment observed in all other subject groups.ConclusionsEducational and occupational attainment data obtained during postmortem psychological autopsies can be used as proxy measures of premortem cognitive function to interrogate the neural substrate of cognitive dysfunction in schizophrenia.

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Level of functioning, perceived work ability, and work status among psychiatric patients with major mental disorders

Cited by 23 publications

References 61 publications

Clinical Characteristics, Life Adversities and Personality Traits in Monozygotic Twins With, at Risk of and Without Affective Disorders

Clinical Characteristics, Life Adversities and Personality Traits in Monozygotic Twins With, at Risk of and Without Affective Disorders

The role of childhood trauma in cognitive performance in schizophrenia and bipolar disorder – A systematic review

Proxy measures of premortem cognitive aptitude in postmortem subjects with schizophrenia

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