O'Donnell Lisa, Himle Joseph A, Ryan Kelly, Grogan-Kaylor Andrew, McInnis Melvin G, Weintraub Jenna, Kelly Marisa, Deldin Patricia
Postdoctoral fellow at the University of California Los Angeles.
Associate Dean for Research and a professor of social work and psychiatry at the University of Michigan.
J Soc Social Work Res. 2017 Fall;8(3):379-398. doi: 10.1086/693163. Epub 2017 Jul 19.
Bipolar disorder (BD) is characterized by recurrent mood episodes and profound impairments in psychosocial functioning. Occupational disability is one of the most problematic impairments for individuals with BD due to high rates of unemployment and work impairments. Current evidence indicates that social stressors at work-such as social isolation, conflict with others, and stigmas-are common experiences for employed individuals with BD. Yet, few studies have examined the relationship between social stressors at work and overall occupational functioning, instead focusing on individual clinical features of the disorder.
This cross-sectional study employed logistic and linear regressions to determine which demographic variables, mood symptoms, and social aspects of the work environment (exclusion, conflict, social support, stigma) were associated with work status (working vs. not working) and work functioning for individuals with bipolar disorder I and II.
Greater stigma and exclusion at work ( < .05) are associated with unemployment among adult individuals with BD, and higher degrees of depression and conflict at work ( < .05) are associated with work impairments for employed individuals.
By examining two distinct measures of work outcomes (work status and work functioning) within the same group of participants, this study provides a unique insight, revealing that predictors of occupational functioning vary based on the specific measure of work outcomes used. This study also emphasizes the need for treatments that address the clinical features of BD and intervene in the work environment to improve functioning and prevent unemployment among individuals with BD.
双相情感障碍（BD）的特征是反复出现情绪发作以及心理社会功能严重受损。职业残疾是BD患者最棘手的损害之一，因为其失业率和工作障碍发生率很高。目前的证据表明，工作中的社会压力源，如社会隔离、与他人的冲突和耻辱感，是BD在职患者的常见经历。然而，很少有研究探讨工作中的社会压力源与整体职业功能之间的关系，而是侧重于该疾病的个体临床特征。
这项横断面研究采用逻辑回归和线性回归，以确定哪些人口统计学变量、情绪症状以及工作环境的社会方面（排斥、冲突、社会支持、耻辱感）与I型和II型双相情感障碍患者的工作状态（工作与否）和工作功能相关。
工作中更大的耻辱感和排斥感（<.05）与成年BD患者的失业有关，而工作中更高程度的抑郁和冲突（<.05）与在职患者的工作障碍有关。
通过在同一组参与者中考察两种不同的工作结果衡量指标（工作状态和工作功能），本研究提供了独特的见解，揭示了职业功能的预测因素因所使用的工作结果具体衡量指标而异。本研究还强调需要针对BD的临床特征进行治疗，并干预工作环境，以改善BD患者的功能并预防失业。
