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

Area of Science:

• Psychiatry
• Neuroscience
• Clinical Psychology

Background:

• Bipolar disorder (BD) has varied long-term outcomes, necessitating research into preventive factors and predictors of disability.
• Studies on the impact of intellectual function (IQ) and premorbid functioning on occupational outcomes in BD are limited.

Purpose of the Study:

• To investigate the role of premorbid functioning, intelligence, illness course, and sociodemographics on occupational outcomes in bipolar disorder.
• To identify predictors of disability benefit receipt in BD patients.

Main Methods:

• Consecutive recruitment of 226 bipolar disorder patients from Oslo psychiatric units (BD-I, BD-II, BD-NOS).
• Assessment of premorbid functioning (Premorbid Adjustment Scale - PAS), premorbid and current IQ (National Adult Reading Test - NART).
• Logistic regression analyses to examine associations between clinical, sociodemographic factors, IQ, PAS, and disability benefit receipt.

Main Results:

• Increased hospitalizations for depressive episodes and longer illness duration were linked to higher disability benefit risk.
• Premorbid Adjustment Scale (PAS), premorbid IQ, current IQ, and IQ decline did not predict disability benefit receipt.
• A severe clinical course of BD was associated with receiving disability benefits.

Conclusions:

• Occupational outcome in bipolar disorder is determined by the persistence of severe clinical symptoms, not global cognitive functioning.
• Premorbid functioning and IQ measures did not predict occupational outcomes.
• Early and continuous clinical treatment may offer protective benefits for occupational outcomes in BD.