The relations between executive functions and occupational functioning in individuals with bipolar disorder: a scoping review

Abstract

Background Patients with bipolar disorder experience impairments in their occupational functioning, despite remission of symptoms. Previous research has shown that neurocognitive deficits, especially deficits in executive functions, may persist during euthymia and are associated with diminished occupational functioning. Objectives The aim of this scoping review was to identify published studies that report on the relationships between executive functions and occupational functioning in BD to review current knowledge and identify knowledge gaps. In addition to traditional neuropsychological approaches, we aimed to describe executive functioning from a self-regulation perspective, including emotion regulation. Methods We applied the methodological framework as described by Arksey and O’Malley (Int J Soc Res Methodol Theory Pract 8:19–32, 2005) and Levac et al. (Implement Sci 5:1–9, 2010). We searched PubMed and psycINFO for literature up to November 2021, after which we screened papers based on inclusion criteria. Two reviewers independently performed the screening process, data charting process, and synthesis of results. Results The search yielded 1202 references after deduplication, of which 222 remained after initial screening. The screening and inclusion process yielded 82 eligible papers in which relationships between executive functions and occupational functioning are examined. Conclusion Neurocognitive deficits, including in executive functions and self-regulation, are associated with and predictive of diminished occupational functioning. Definitions and measurements for neurocognitive functions and occupational functioning differ greatly between studies, which complicates comparisons. Studies on functional remediation show promising results for improving occupational functioning in patients with BD. In research and clinical practice more attention is needed towards the quality of work functioning and the various contexts in which patients with BD experience deficits.

Demographic and clinical associations to employment status in older‐age bipolar disorder: Analysis from the GAGE‐BD database project

“…38 In BD, cognitive impairment is observed even during remission 39 ; people with BD who have lower cognitive reserve also have worse performance on cognitive measures 40 and experience greater cognitive decline after illness onset. 41 Since cognitive deficits have been found to be predictive of diminished occupational functioning in BD 42 and OABD, 43,44 it is possible that those with higher education would have greater cognitive reserve and less decline in cognitive performance, making it easier to maintain employment.…”

Structural and Functional Characteristics of the Dorsolateral Prefrontal Cortex in Schizophrenia Spectrum Disorders and Their Associations with Onset Age

“…ДЛПФК играет критическую роль в реализации регуляторных функций (executive functions), благодаря которым становятся возможными планирование, контроль и регуляция собственного поведения [6]. Сохранность регуляторных функций важна для успешного выполнения повседневных задач [7], профессионального [8] и социального [9] функционирования.…”

Slow-wave brain connectivity predicts executive functioning and group belonging in socially vulnerable individuals

“…Executive function encompasses a set of cognitive skills crucial for the control of behaviour, including focusing attention, planning, remembering relevant recent information, thinking flexibly, and inhibiting impulses (Diamond, 2013;Ferguson et al, 2021). Multiple studies have found that, to different extents, impairments in executive function are present in various neuropsychiatric conditions such as schizophrenia (Haugen et al, 2021;Raffard et al, 2009;Wobrock et al, 2009), bipolar disorder (Cotrena et al, 2020;Koene et al, 2022), substance abuse (Hester & Garavan, 2004;Kim-Spoon et al, 2017), traumatic brain injury (McDonald et al, 2002), and personality disorders (Gvirts et al, 2012;Koudys & Ruocco, 2022). Importantly, poor executive function performance typically correlates with symptom severity and social maladaptation (Drakopoulos et al, 2020;Simon et al, 2003).…”