Bonnín C M, Torrent C, Goikolea J M, Reinares M, Solé B, Valentí M, Sánchez-Moreno J, Hidalgo D, Tabarés-Seisdedos R, Martínez-Arán A, Vieta E
Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Villarroel 170, 08036, Barcelona, Catalonia, Spain.
Eur Arch Psychiatry Clin Neurosci. 2014 Apr;264(3):247-54. doi: 10.1007/s00406-013-0431-2. Epub 2013 Aug 3.
The aim of this study was to study the clinical and neurocognitive variables that best explain poor work adjustment in a sample of bipolar I euthymic patients. Eighty-five euthymic patients at the Hospital Clinic of Barcelona were assessed for this study by means of a comprehensive neuropsychological battery and a work-focused interview to determine work adjustment. Clinical and sociodemographic variables were also collected. Direct logistic regression was performed to assess the impact of demographic, clinical and neuropsychological variables on the likelihood of presenting poor work adjustment. The model that best fitted contained five variables (Hamilton Depression Rating scores, number of manic episodes, number of perseverative errors in the Wisconsin Card Sorting Test (WCST), number of depressive episodes and Trail Making Test-part B). However, only two out of these variables made a unique statistically significant contribution to the model, which were number of manic episodes (OR 1.401; CI 1.05-1.86; p = 0.021) and number of perseverative errors in the WCST (OR 1.062; CI 1.00-1.12; p = 0.044). The model explained up to 36 % of the variance in work adjustment. This study highlights the role of manic relapses and neurocognitive impairment, specifically the role of executive function, in work adjustment.
本研究的目的是探讨在一组双相 I 型心境正常的患者样本中，哪些临床和神经认知变量最能解释工作适应不良的情况。巴塞罗那医院诊所的 85 名心境正常的患者参与了本研究，通过一套全面的神经心理测试和一次以工作为重点的访谈来评估工作适应情况。同时还收集了临床和社会人口统计学变量。采用直接逻辑回归分析来评估人口统计学、临床和神经心理学变量对出现工作适应不良可能性的影响。拟合效果最佳的模型包含五个变量（汉密尔顿抑郁量表评分、躁狂发作次数、威斯康星卡片分类测验（WCST）中的持续性错误次数、抑郁发作次数和连线测验 B 部分）。然而，这些变量中只有两个对模型有独特的统计学显著贡献，即躁狂发作次数（OR 1.401；CI 1.05 - 1.86；p = 0.021）和 WCST 中的持续性错误次数（OR 1.062；CI 1.00 - 1.12；p = 0.044）。该模型解释了工作适应差异的 36%。本研究强调了躁狂复发和神经认知损害，特别是执行功能在工作适应中的作用。
