Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 2/2014

01-02-2014 | Original Paper

Occupational functioning and work impairment in association with personality disorder trait-scores

Authors: Michael P. Hengartner, Mario Müller, Stephanie Rodgers, Wulf Rössler, Vladeta Ajdacic-Gross

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 2/2014

Login to get access

Abstract

Purpose

According to the DSM, functional impairment is a main criterion for the general definition of personality disorders (PDs), but research suggests that some PDs might not be related to impaired functioning. Occupational functioning has rarely been examined in all ten DSM PDs.

Methods

We analysed 511 adults aged 20–41 years from the general population of the canton of Zurich, Switzerland, using data from the Epidemiology Survey of the Zurich Programme for Sustainable Development of Mental Health Services. All PDs were assessed with dimensional trait-scores and associations with indicators of occupational functioning were analysed with generalised linear models.

Results

Each PD revealed at least a weak association with some form of occupational impairment. Most PDs, especially from cluster A and B, were significantly related to occupational dysfunction, in particular low education level, conflicts in the workplace, dismissal or demotion, and unemployment. In contrast, obsessive–compulsive PD was mostly unrelated to occupational functioning. A total personality pathology dose–response relationship was observed for low education level, conflicts in the workplace, dismissal or demotion, and unemployment.

Conclusions

Impairment in occupational functioning is an important aspect particularly of cluster A and B PDs. Assuming that functional impairment is a predictor of illness severity, we advocate that clinicians should carefully explore indicators of occupational functioning in the diagnosis, prognosis, and treatment of PDs. The findings discussed herein have implications for general treatment, interventions in the work environment, or re-integration of patients into the labour force.
Literature
1.
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders DSM-5. American Psychiatric Association, Washington
2.
American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders DSM-IV-TR. American Psychiatric Association, Washington
3.
Hengartner MP, Müller M, Rodgers S, Rössler W, Ajdacic-Gross V (2013) Interpersonal functioning deficits in association with DSM-IV personality disorder dimensions. Soc Psychiatry Psychiatr Epidemiol. doi:10.​1007/​s00127-013-0707-x
4.
Coid J, Yang M, Tyrer P, Roberts A, Ullrich S (2006) Prevalence and correlates of personality disorder in Great Britain. Br J Psychiatry 188:423–431PubMedCrossRef
5.
Johnson JG, First MB, Cohen P, Skodol AE, Kasen S, Brook JS (2005) Adverse outcomes associated with personality disorder not otherwise specified in a community sample. Am J Psychiatry 162:1926–1932PubMedCrossRef
6.
Oltmanns TF, Melley AH, Turkheimer E (2002) Impaired social functioning and symptoms of personality disorders assessed by peer and self-report in a nonclinical population. J Pers Disord 16:437–452PubMedCrossRef
7.
Torgersen S, Kringlen E, Cramer V (2001) The prevalence of personality disorders in a community sample. Arch Gen Psychiatry 58:590–596PubMedCrossRef
8.
Crawford MJ, Koldobsky N, Mulder R, Tyrer P (2011) Classifying personality disorder according to severity. J Pers Disord 25:321–330PubMedCrossRef
9.
Cramer V, Torgersen S, Kringlen E (2006) Personality disorders and quality of life. A population study. Compr Psychiatry 47:178–184PubMedCrossRef
10.
Skodol AE, Gunderson JG, McGlashan TH, Dyck IR, Stout RL, Bender DS, Grilo CM et al (2002) Functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder. Am J Psychiatry 159:276–283PubMedCrossRef
11.
Hardt J, Egle UT, Kappis B, Hessel A, Brähler E (2004) Symptom Checklist SCL-27: results of a representative German survey. Psychother Psych Med 54:214–223CrossRef
12.
Angst J, Gamma A, Neuenschwander M, Ajdacic-Gross V, Eich D, Rössler W, Merikangas KR (2005) Prevalence of mental disorders in the Zurich cohort study: a twenty year prospective study. Epidemiol Psichiatr Soc 14:68–76PubMedCrossRef
13.
Dunn G, Pickles A, Tansella M, Vazquez-Barquero JL (1999) Two-phase epidemiological surveys in psychiatric research. Br J Psychiatry 174:95–100PubMedCrossRef
14.
Schotte CKW, de Doncker D (1994) ADP-IV Questionnaire. University Hospital Antwerp, Antwerp
15.
Doering S, Renn D, Hofer S, Rumpold G, Smrekar U, Janecke N, Schatz DS et al (2007) Validation of the German version of the assessment of DSM-IV personality disorders (ADP-IV) questionnaire. Z Psychosom Med Psychother 53:111–128PubMed
16.
Schotte CKW, de Doncker D, Vankerckhoven C, Vertommen H, Cosyns P (1998) Self-report assessment of the DSM-IV personality disorders. Measurement of trait and distress characteristics: the ADP-IV. Psychol Med 28:1179–1188PubMedCrossRef
17.
Schotte CKW, de Doncker DA, Dmitruk D, Van Mulders I, D’Haenen H, Cosyns P (2004) The ADP-IV questionnaire: differential validity and concordance with the semi-structured interview. J Pers Disord 18:405–419PubMed
18.
Schafer JL, Graham JW (2002) Missing data: our view of the state of the art. Psychol Methods 7:147–177PubMedCrossRef
19.
Hengartner MP, Ajdacic-Gross V, Rodgers S, Müller M, Rössler W (2013) Childhood adversity in association with personality disorder dimensions: new findings in an old debate. Eur Psychiatry. doi:10.​1016/​j.​eurpsy.​2013.​04.​004
20.
21.
Davidson G, Devaney J, Spratt T (2010) The impact of adversity in childhood on outcomes in adulthood: research lessons and limitations. J Soc Work 10:369–390CrossRef
22.
Gilbert R, Widom CS, Browne K, Fergusson D, Webb E, Janson S (2009) Burden and consequences of child maltreatment in high-income countries. Lancet 373:68–81PubMedCrossRef
23.
Haigler ED, Widiger TA (2001) Experimental manipulation of NEO-PI-R items. J Pers Assess 77:339–358PubMedCrossRef
24.
25.
Barrick MR, Mount MK, Judge TA (2001) Personality and performance at the beginning of the new millennium: what do we know and where do we go next? Int J Select Assess 9:9–30CrossRef
26.
Busato VV, Prins FJ, Elshout JJ, Hamaker C (2000) Intellectual ability, learning style, personality, achievement motivation and academic success of psychology students in higher education. Pers Individ Dif 29:1057–1068CrossRef
27.
De Fruyt F, Mervielde I (1998) Personality and interests as predictors of educational streaming and achievement. Eur J Pers 10:405–425CrossRef
28.
29.
Saulsman LM, Page AC (2004) The five-factor model and personality disorder empirical literature: a meta-analytic review. Clin Psychol Rev 23:1055–1085PubMedCrossRef
30.
Judge TA, Ilies R (2002) Relationship of personality to performance motivation: a meta-analytic review. J Appl Psychol 87:797–807PubMedCrossRef
31.
Michon HW, ten Have M, Kroon H, van Weeghel J, de Graaf R, Schene AH (2008) Mental disorders and personality traits as determinants of impaired work functioning. Psychol Med 38:1627–1637PubMedCrossRef
32.
Goodwin RD, Hoven CW, Lyons JS, Stein MB (2002) Mental health service utilization in the United States. The role of personality factors. Soc Psychiatry Psychiatr Epidemiol 37:561–566PubMedCrossRef
33.
ten Have M, Oldehinkel A, Vollebergh W, Ormel J (2005) Does neuroticism explain variations in care service use for mental health problems in the general population? Results from the Netherlands mental health survey and incidence study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol 40:425–431PubMedCrossRef
34.
Bassett SS, Chase GA, Folstein MF, Regier DA (1998) Disability and psychiatric disorders in an urban community: measurement, prevalence and outcomes. Psychol Med 28:509–517PubMedCrossRef
35.
ten Have H, Vollebergh W, Bijl R, Ormel J (2002) Combined effect of mental disorder and low social support on care service use for mental health problems in the Dutch general population. Psychol Med 32:311–323CrossRef
36.
37.
Miller JD, Pilkonis PA, Mulvey EP (2006) Treatment utilization and satisfaction: examining the contributions of axis II psychopathology and the five-factor model of personality. J Pers Disord 20:369–387PubMedCrossRef
38.
Rymaszewska J, Jarosz-Nowak J, Kiejna A, Kallert T, Schutzwohl M, Priebe S, Wright D et al (2007) Social disability in different mental disorders. Eur Psychiatry 22:160–166PubMedCrossRef
39.
Skodol AE, Pagano ME, Bender DS, Shea MT, Gunderson JG, Yen S, Stout RL et al (2005) Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder over two years. Psychol Med 35:443–451PubMedCentralPubMedCrossRef
Metadata
Title
Occupational functioning and work impairment in association with personality disorder trait-scores
Authors
Michael P. Hengartner
Mario Müller
Stephanie Rodgers
Wulf Rössler
Vladeta Ajdacic-Gross
Publication date
01-02-2014
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 2/2014
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-013-0739-2

Other articles of this Issue 2/2014

Social Psychiatry and Psychiatric Epidemiology 2/2014 Go to the issue

Original Paper

Attitudes and stigma in relation to help-seeking intentions for psychological problems in low and high suicide rate regions

Original Paper

Parental socio-economic position during childhood as a determinant of self-harm in adolescence

Original Paper

Stressful psychosocial school environment and suicidal ideation in Chinese adolescents

Original Paper

Feasibility of internet-delivered mental health treatments for rural populations

Original Paper

Gender differences in the relationship between school problems, school class context and psychological distress: results from the Young-HUNT 3 study

Original Paper

A prediction model for the incidence of civil detention for crisis patients with psychiatric illnesses; the Amsterdam study of acute psychiatry VII