Moodnet Research Group, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway.
Bipolar Disord. 2013 May;15(3):294-305. doi: 10.1111/bdi.12056. Epub 2013 Mar 26.
Bipolar disorder (BD), over the long term, can manifest a variety of outcomes depending on a number of different conditions. There is a need for further knowledge regarding preventive factors as well as predictors of the disabling course of the disorder. Studies regarding the impact on functional outcome of premorbid and current general intellectual function [intelligence quotient (IQ)] and premorbid functioning in BD patients are sparse. The present study addressed the role of premorbid functioning [assessed with the Premorbid Adjustment Scale (PAS)], intelligence, course of illness, and sociodemographics on occupational outcome in BD.
Bipolar disorder patients were recruited consecutively from psychiatric units (outpatient and inpatient) in four major hospitals in Oslo, Norway [(N = 226: 64.4% bipolar I disorder (BD-I); 30.1% bipolar II disorder (BD-II); 5.5% bipolar disorder not otherwise specified (BD-NOS); 38.6% males]. The associations between current IQ, premorbid IQ [assessed using the National Adult Reading Test (NART)], PAS, clinical and sociodemographic characteristics, and receipt of disability benefit were analysed using descriptive statistics and logistic regression analyses.
The number of hospitalizations for depressive episodes and illness duration was associated with a higher risk of receipt of disability benefit. PAS, premorbid and current IQ, as well as decline in IQ, did not explain the higher risk of receipt of disability benefits.
Severe clinical course of BD was associated with receipt of disability benefit. Occupational outcome was unrelated to PAS, premorbid and current IQ, as well as decline in IQ. This suggests that the persistence of severe clinical symptoms, rather than global cognitive functioning, determines occupational outcome in BD and emphasizes the protective potential of early and continuous clinical treatment.
躁郁症（BD）在长期内可能表现出多种结果，具体取决于多种不同的情况。需要进一步了解预防因素以及疾病致残过程的预测因素。关于躁郁症患者发病前和当前一般智力功能（智商）和发病前功能对功能结果的影响的研究很少。本研究探讨了发病前功能（用发病前调整量表（PAS）评估）、智力、疾病病程和社会人口统计学因素对躁郁症患者职业结局的作用。
从挪威奥斯陆四家主要医院的精神科病房（门诊和住院）连续招募了躁郁症患者[（N=226：64.4%为双相 I 型障碍（BD-I）；30.1%为双相 II 型障碍（BD-II）；5.5%为未特定的双相障碍（BD-NOS）；38.6%为男性]。使用描述性统计和逻辑回归分析，分析当前智商、发病前智商（使用全国成人阅读测验（NART）评估）、PAS、临床和社会人口统计学特征与残疾津贴的关系。
抑郁发作次数和病程与获得残疾津贴的风险增加有关。PAS、发病前和当前智商以及智商下降并不能解释获得残疾津贴的风险增加。
BD 的严重临床病程与获得残疾津贴有关。职业结局与 PAS、发病前和当前智商以及智商下降无关。这表明，严重的临床症状持续存在，而不是整体认知功能，决定了 BD 的职业结局，并强调了早期和持续的临床治疗的保护潜力。
