Occupational outcome in bipolar disorder is not predicted by premorbid functioning and intelligence

Abstract

Severe clinical course of BD was associated with receipt of disability benefit. Occupational outcome was unrelated to PAS, premorbid and current IQ, as well as decline in IQ. This suggests that the persistence of severe clinical symptoms, rather than global cognitive functioning, determines occupational outcome in BD and emphasizes the protective potential of early and continuous clinical treatment.

The relationship between neurocognitive functioning and occupational functioning in bipolar disorder: A literature review

“…Schoeyen et al (2013) failed to find a relationship between overall neurocognitive functioning, as measured by IQ, and receipt of a disability benefit.…”

“…Exceptions included Gilbert et al (2010) who used a self-report assessment and a clinical interview to collect information regarding memory and concentration and Altshuler et al (2007) who used a structured interview to assess executive functioning. Schoeyen and colleagues (2013) utilised a neurocognitive test battery to measure participants Full Scale IQ and premorbid intellectual functioning, arguing that the various neurocognitive domains reflect general intellectual ability. O'Shea et al (2010) administered ecologically valid cognitive tests (daily, real-life tasks) to measure their participant’s attention, memory and executive functioning.…”

“…Burdick, Goldberg, and Harrow (2010) measured work disability with the Strauss-Carpenter work functioning rating scale; Bowie et al (2010) examined work skills using the Specific Level of Functioning Scale; Schoeyen et al (2013) used receipt of a disability pension to represent poor occupational outcomes; Bonnín et al (2014) divided work participants into "good" or "poor" work adjustment based on their participation in full- or part-time employment, or otherwise; and Murtagh et al (2010) considered participants work history for the last three years to create two groups - those that had worked for at least six months during that time and those that had not.…”

“…For example, Wingo et al (2010) reported that the relationship between neurocognitive and functional outcomes was reduced after adjusting for education and residual mood symptoms. Similarly, Schoeyen et al (2013) failed to find a correlation between either premorbid or current IQ with receipt of either a full-time or part-time disability benefit (an indicator of poor occupational functioning), though a significant association emerged when clinical variables such as the number of hospitalisations for depressive episodes and illness duration were considered.…”

“…Occupational functioning was also measured using a range of instruments, with one group of researchers measuring occupational adaptation, whilst others considered work disability, work skills, and even participant progress towards engagement in vocational services as measures of occupational functioning. Schoeyen et al (2013) offered a novel perspective by using receipt of a part- or full-time disability benefit as a measure of poor occupational functioning. This method poses some important limitations, for example, some participants may have been working and receiving a (particularly part-time) disability benefit.…”