The impact of neurocognitive impairment on occupational recovery of clinically stable patients with bipolar disorder: A prospective study

Carrie E. Bearden, Vivian H. Shih, Michael F. Green, Michael Gitlin, Kenneth N. Sokolski, Eric Levander, Susan Marusak, Constance Hammen, Catherine A. Sugar, Lori L. Altshuler

Research output: Contribution to journalArticlepeer-review

62 Scopus citations

Abstract

Objective: Many patients with bipolar disorder do not regain their premorbid level of occupational functioning even after mood episodes have resolved. The reasons for this are not well understood. We evaluated the relationship between neurocognition and occupational function in bipolar disorder patients, following symptomatic recovery. Methods: A total of 79 previously employed adults with bipolar I disorder who achieved symptomatic recovery (i.e., at least six weeks clinically euthymic) following a manic episode underwent a neurocognitive evaluation and assessment of occupational functioning. Study participants were evaluated every three months thereafter for up to nine months. Factor analysis was applied to reduce the initial set of neurocognitive variables to five domains: episodic memory, working memory/attention, executive function, visual scanning, and speed of processing. Multiple logistic regression models were used to examine the joint predictive values of these domains for determining occupational recovery. Results: At the time of symptomatic recovery, four of five neurocognitive factors were significant predictors of concomitant occupational recovery and the fifth, executive function, showed a trend in the same direction. For those not occupationally recovered at baseline, longitudinal analyses revealed that changes between baseline and the three-month follow-up timepoint in most cognitive domains were robust and highly significant predictors of occupational recovery at three months. Conclusions: These findings indicate that better neurocognitive function in multiple domains and improvement in these domains over time are strongly predictive of subsequent occupational recovery. Treatments that target cognitive deficit may therefore have potential for improving long-term vocational functioning in bipolar illness.

Original languageEnglish
Pages (from-to)323-333
Number of pages11
JournalBipolar Disorders
Volume13
Issue number4
DOIs
StatePublished - Jun 2011
Externally publishedYes

Funding

FundersFunder number
National Institute on Drug AbuseRL1DA024853

    Keywords

    • Attention
    • Episodic memory
    • Euthymic
    • Executive function
    • Functional outcome
    • Processing speed
    • Recovery
    • Subsyndromal depression
    • Vocational
    • Working memory

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