The functional impairment of different subtypes and occupational states in euthymic patients with bipolar disorder

Xinyu Liu,Xia Sun,Xiaojuan Ma,Jian Zhang,Wenchen Wang,Xingguang Luo,Yong Zhang

doi:10.1186/s12888-021-03242-x

Xinyu Liu, Xia Sun + Show 5 more

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https://doi.org/10.1186/s12888-021-03242-x

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Abstract

BackgroundThe aim was to explore the associations between clinical symptoms, demographic variables, social and neurocognitive functioning in euthymic patients with bipolar disorder (BD) stratified by subgroups of DSM-IV BD (type I (BD-I) and type II (BD-II)) and occupational status (employed/unemployed), and to highlight the significance of occupational status when assessing social and neurocognitive functioning in euthymic BD patients.MethodsA total of 81 euthymic BD patients were participated in the study. The severity of the depressive and manic/hypomanic symptoms was measured using the 17-item Hamilton Depression Rating Scale (HDRS-17) and the Young Mania Rating Scale (YMRS), respectively. Social functioning and neurocognitive functioning were evaluated by the Functioning Assessment Short Test (FAST) and neurocognitive measures, respectively.ResultsEmployed BD patients displayed greater social functioning (autonomy, occupational functioning, interpersonal relationship domain) and better verbal learning performance and speed of processing than unemployed BD patients. The correlation between neurocognitive functioning and social functioning was stronger in the employed group than in the unemployed group. There were no significant differences in neurocognitive and social functioning between the BD-I and BD-II groups, and the correlation between neurocognitive functioning and social functioning was similar between the BD-I and BD-II groups.ConclusionEmployed BD patients may present greater occupational functioning and interpersonal relationships, as well as better verbal learning performance and speed of processing.

Highlights

The aim was to explore the associations between clinical symptoms, demographic variables, social and neurocognitive functioning in euthymic patients with bipolar disorder (BD) stratified by subgroups of DSM-IV BD (type I (BD-I) and type II (BD-II)) and occupational status, and to highlight the significance of occupational status when assessing social and neurocognitive functioning in euthymic BD patients
We found that Functioning Assessment Short Test (FAST) total scores, interpersonal relationships and occupational functioning were negatively associated with higher scores on the Symbol Digit Modalities Test and Hopkins Verbal Learning Tests-Revised in both BD subtypes
We found that the autonomy domain was negatively related to Stroop Color-Word Test scores and occupational functioning; financial issues was negatively correlated with the Hopkins Verbal Learning TestRevised scores and with interpersonal relationships; and leisure time was correlated with scores on the Symbol Digit Modalities Test and Brief Visuospatial Memory Test-Revised

Summary

Introduction

The aim was to explore the associations between clinical symptoms, demographic variables, social and neurocognitive functioning in euthymic patients with bipolar disorder (BD) stratified by subgroups of DSM-IV BD (type I (BD-I) and type II (BD-II)) and occupational status (employed/unemployed), and to highlight the significance of occupational status when assessing social and neurocognitive functioning in euthymic BD patients. As a recurrent and chronic illness, bipolar disorder (BD) is a complex mental disorder characterized by pathological mood instability [1], that affects 2.4% of the global population [2]. The lifetime prevalence of bipolar disorder was 0.6% according to the China Mental Health Survey in 2012 [3]. Bipolar disorder is reported to be Despite optimal treatment with mood stabilizers and second-generation antipsychotics, social and neurocognitive dysfunction in BD remains a serious problem. It is reported that 60–70% of BD patients have varying degrees of impairment in social and occupational functions [6]. Some findings have indicated that social and neurocognitive functional impairment persists among patients with bipolar disorder, at the acute stage of the illness and in remission [7, 8].

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