Dickerson Faith B, Boronow John J, Stallings Cassie R, Origoni Andrea E, Cole Sara, Yolken Robert H
Sheppard Pratt Stanley Research Center, 6501 North Charles Street, Baltimore, Maryland 21204, USA.
Psychiatr Serv. 2004 Jan;55(1):54-8. doi: 10.1176/appi.ps.55.1.54.
The purpose of this study was to identify variables associated with employment status among persons with bipolar disorder, including cognitive functioning, severity of symptoms, demographic variables, and variables related to course of illness.
The authors assessed the current employment status of 117 persons with bipolar disorder. Study participants' cognitive functioning was evaluated with the Repeatable Battery for the Assessment of Neuropsychological Status, the information and letter-number sequencing subtests of the Wechsler Adult Intelligence Scale III, and part A of the Trail Making Test. Symptoms were rated by using the Brief Psychiatric Rating Scale, the Hamilton Depression Scale, and the Young Mania Rating Scale. A stepwise multivariate logistic regression analysis was used to predict employment status.
Fifty-one percent of the study participants had no current work activity, 21 percent worked part-time or as volunteers, and 27 percent had full-time competitive employment. Current employment status was significantly associated with cognitive performance, especially immediate verbal memory, total symptom severity, history of psychiatric hospitalization, and maternal education. No association was found between employment status and history of psychotic symptoms, number of years of education, or age at onset of illness.
Vocational programs for persons with bipolar disorder would benefit from inclusion of a formal cognitive assessment to better assess work potential and to study the predictors of work-related outcomes.
本研究旨在确定与双相情感障碍患者就业状况相关的变量，包括认知功能、症状严重程度、人口统计学变量以及与病程相关的变量。
作者评估了117名双相情感障碍患者的当前就业状况。使用可重复神经心理状态评估量表、韦氏成人智力量表III的信息及字母数字排序分测验以及连线测验A部分对研究参与者的认知功能进行评估。使用简明精神病评定量表、汉密尔顿抑郁量表和杨氏躁狂量表对症状进行评分。采用逐步多元逻辑回归分析来预测就业状况。
51%的研究参与者目前没有工作，21%从事兼职工作或志愿工作，27%有全职竞争性工作。当前就业状况与认知表现显著相关，尤其是即时言语记忆、总症状严重程度、精神科住院史和母亲受教育程度。未发现就业状况与精神病症状史、受教育年限或发病年龄之间存在关联。
双相情感障碍患者的职业项目若纳入正式的认知评估，将有助于更好地评估工作潜力并研究与工作相关结果的预测因素。
