Top

European Archives of Psychiatry and Clinical Neuroscience

Published in:

01-04-2014 | Original Paper

The impact of repeated manic episodes and executive dysfunction on work adjustment in bipolar disorder

Authors: C. M. Bonnín, C. Torrent, J. M. Goikolea, M. Reinares, B. Solé, M. Valentí, J. Sánchez-Moreno, D. Hidalgo, R. Tabarés-Seisdedos, A. Martínez-Arán, E. Vieta

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 3/2014

Abstract

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.

Haro JM, Reed C, Gonzalez-Pinto A, Novick D, Bertsch J, Vieta E (2011) 2-Year course of bipolar disorder type I patients in outpatient care: factors associated with remission and functional recovery. Eur Neuropsychopharmacol 21:287–293PubMedCrossRef

Wingo AP, Baldessarini RJ, Holtzheimer PE, Harvey PD (2010) Factors associated with functional recovery in bipolar disorder patients. Bipolar Disord 12:319–326PubMedCentralPubMedCrossRef

de Jong A, Giel R, Slooff CJ, Wiersma D (1985) Social disability and outcome in schizophrenic patients. Br J Psychiatry 147:631–636PubMedCrossRef

Michalak EE, Yatham LN, Maxwell V, Hale S, Lam RW (2007) The impact of bipolar disorder upon work functioning: a qualitative analysis. Bipolar Disord 9:126–143PubMedCrossRef

Gutierrez-Rojas L, Jurado D, Gurpegui M (2011) Factors associated with work, social life and family life disability in bipolar disorder patients. Psychiatry Res 186:254–260PubMedCrossRef

Dickerson FB, Boronow JJ, Stallings CR, Origoni AE, Cole S, Yolken RH (2004) Association between cognitive functioning and employment status of persons with bipolar disorder. Psychiatr Serv 55:54–58PubMedCrossRef

Zimmerman M, Galione JN, Chelminski I, Young D, Dalrymple K, Ruggero CJ (2010) Sustained unemployment in psychiatric outpatients with bipolar disorder: frequency and association with demographic variables and comorbid disorders. Bipolar Disord 12:720–726PubMedCrossRef

Altamura AC, Serati M, Albano A, Paoli RA, Glick ID, Dell’Osso B (2011) An epidemiologic and clinical overview of medical and psychopathological comorbidities in major psychoses. Eur Arch Psychiatry Clin Neurosci 261:489–508PubMedCrossRef

Grande I, Goikolea JM, de DC, Gonzalez-Pinto A, Montes JM, Saiz-Ruiz J, Prieto E, Vieta E (2013) Occupational disability in bipolar disorder: analysis of predictors of being on severe disablement benefit (PREBIS study data). Acta Psychiatr Scand 127(5):403–411

10.

Martino DJ, Marengo E, Igoa A, Scapola M, Ais ED, Perinot L, Strejilevich SA (2009) Neurocognitive and symptomatic predictors of functional outcome in bipolar disorders: a prospective 1 year follow-up study. J Affect Disord 116:37–42PubMedCrossRef

11.

Bonnin CM, Sanchez-Moreno J, Martinez-Aran A, Sole B, Reinares M, Rosa AR, Goikolea JM, Benabarre A, Ayuso-Mateos JL, Ferrer M, Vieta E, Torrent C (2012) Subthreshold symptoms in bipolar disorder: impact on neurocognition, quality of life and disability. J Affect Disord 136:650–659PubMedCrossRef

12.

Goetz I, Tohen M, Reed C, Lorenzo M, Vieta E (2007) Functional impairment in patients with mania: baseline results of the EMBLEM study. Bipolar Disord 9:45–52PubMedCrossRef

13.

Bearden CE, Shih VH, Green MF, Gitlin M, Sokolski KN, Levander E, Marusak S, Hammen C, Sugar CA, Altshuler LL (2011) The impact of neurocognitive impairment on occupational recovery of clinically stable patients with bipolar disorder: a prospective study. Bipolar Disord 13:323–333PubMedCentralPubMedCrossRef

14.

Vieta E (2013) Pros and cons of specialised care in bipolar disorder: an international perspective. Br J Psychiatry 202(3):170–171

15.

Vieta E (2011) Bipolar units and programmes: are they really needed? World Psychiatry 10:152PubMedCentralPubMed

16.

Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62PubMedCentralPubMedCrossRef

17.

Ramos-Brieva JA, Cordero VA (1986) Validation of the castillian version of the Hamilton Rating Scale for depression. Actas Luso Esp Neurol Psiquiatr Cienc Afines 14:324–334PubMed

18.

Young RC, Biggs JT, Ziegler VE, Meyer DA (1978) A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 133:429–435PubMedCrossRef

19.

Colom F, Vieta E, Martinez-Aran A, Garcia-Garcia M, Reinares M, Torrent C, Goikolea JM, Banus S, Salamero M (2002) Spanish version of a scale for the assessment of mania: validity and reliability of the Young Mania Rating Scale. Med Clin (Barc) 119:366–371CrossRef

20.

American Psychiatric Association (APA) (2000) Diagnostic and statistical manual of mental disorders, text revision (DSM-IV-TR), 4th edn. American Psychiatric Press, ArlingtonCrossRef

21.

Reed C, Goetz I, Vieta E, Bassi M, Haro JM (2010) Work impairment in bipolar disorder patients–results from a 2-year observational study (EMBLEM). Eur Psychiatry 25:338–344PubMedCrossRef

22.

Weschler D (1997) The Wechsler adult intelligence scale -III (WAIS-III) (Spanish version) Madrid, Spain: TEA ediciones

23.

Heaton RK (1981) Wisconsin card sorting test manual. Psychological Assessment Resources, Odessa

24.

Golden CJ (1978) Stroop colour and word test. Stoelting, Chicago

25.

Benton AL, Hamsher K (1976) Multilingual aphasia examination. University of Iowa, Iowa City

26.

Reitan RM (1958) Validity of the trail making test as a indication of organic brain damage. Percept Mot Skills 8:271–276CrossRef

27.

Delis DC, Kramer JH, Kaplan E, Ober B (1987) California verbal learning test. Psychological Corporation, New York

28.

MacQueen GM, Young LT, Robb JC, Marriott M, Cooke RG, Joffe RT (2000) Effect of number of episodes on wellbeing and functioning of patients with bipolar disorder. Acta Psychiatr Scand 101:374–381PubMedCrossRef

29.

Gitlin MJ, Mintz J, Sokolski K, Hammen C, Altshuler LL (2011) Subsyndromal depressive symptoms after symptomatic recovery from mania are associated with delayed functional recovery. J Clin Psychiatry 72:692–697PubMedCrossRef

30.

Bonnin CM, Martinez-Aran A, Torrent C, Pacchiarotti I, Rosa AR, Franco C, Murru A, Sanchez-Moreno J, Vieta E (2010) Clinical and neurocognitive predictors of functional outcome in bipolar euthymic patients: a long-term, follow-up study. J Affect Disord 121:156–160PubMedCrossRef

31.

Lopez-Jaramillo C, Lopera-Vasquez J, Gallo A, Ospina-Duque J, Bell V, Torrent C, Martinez-Aran A, Vieta E (2010) Effects of recurrence on the cognitive performance of patients with bipolar I disorder: implications for relapse prevention and treatment adherence. Bipolar Disord 12:557–567PubMedCrossRef

32.

Vieta E, de Arce AR, Jimenez-Arriero MA, Rodriguez A, Balanza V, Cobaleda S (2010) Detection of subclinical depression in bipolar disorder: a cross-sectional, 4-month prospective follow-up study at community mental health services (SIN-DEPRES). J Clin Psychiatry 71:1465–1474PubMedCrossRef

33.

Martinez-Aran A, Vieta E, Torrent C, Sanchez-Moreno J, Goikolea JM, Salamero M, Malhi GS, Gonzalez-Pinto A, Daban C, varez-Grandi S, Fountoulakis K, Kaprinis G, Tabares-Seisdedos R, Ayuso-Mateos JL (2007) Functional outcome in bipolar disorder: the role of clinical and cognitive factors. Bipolar Disord 9:103–113PubMedCrossRef

34.

Torrent C, Martinez-Aran A, Bonnin CM, Reinares M, Daban C, Sole B, Rosa AR, Tabares-Seisdedos R, Popovic D, Salamero M, Vieta E (2012) Long-term outcome of cognitive impairment in bipolar disorder. J Clin Psychiatry 73:e899–e905PubMedCrossRef

35.

Mora E, Portella MJ, Forcada I, Vieta E, Mur M (2012) Persistence of cognitive impairment and its negative impact on psychosocial functioning in lithium-treated, euthymic bipolar patients: a 6-year follow-up study. Psychol Med 1:1–10

36.

Mur M, Portella MJ, Martinez-Aran A, Pifarre J, Vieta E (2008) Long-term stability of cognitive impairment in bipolar disorder: a 2-year follow-up study of lithium-treated euthymic bipolar patients. J Clin Psychiatry 69:712–719PubMedCrossRef

37.

O’Shea R, Poz R, Michael A, Berrios GE, Evans JJ, Rubinsztein JS (2010) Ecologically valid cognitive tests and everyday functioning in euthymic bipolar disorder patients. J Affect Disord 125:336–340PubMedCrossRef

38.

Reichenberg A, Weiser M, Rabinowitz J, Caspi A, Schmeidler J, Mark M, Kaplan Z, Davidson M (2002) A population-based cohort study of premorbid intellectual, language, and behavioral functioning in patients with schizophrenia, schizoaffective disorder, and nonpsychotic bipolar disorder. Am J Psychiatry 159:2027–2035PubMedCrossRef

39.

Lewandowski KE, Eack SM, Hogarty SS, Greenwald DP, Keshavan MS (2011) Is cognitive enhancement therapy equally effective for patients with schizophrenia and schizoaffective disorder? Schizophr Res 125:291–294PubMedCrossRef

40.

MacCabe JH, Lambe MP, Cnattingius S, Sham PC, David AS, Reichenberg A, Murray RM, Hultman CM (2010) Excellent school performance at age 16 and risk of adult bipolar disorder: national cohort study. Br J Psychiatry 196:109–115PubMedCrossRef

41.

Andreazza AC, Kapczinski F, Kauer-Sant’Anna M, Walz JC, Bond DJ, Goncalves CA, Young LT, Yatham LN (2009) 3-Nitrotyrosine and glutathione antioxidant system in patients in the early and late stages of bipolar disorder. J Psychiatry Neurosci 34:263–271PubMedCentralPubMed

42.

Kauer-Sant’Anna M, Kapczinski F, Andreazza AC, Bond DJ, Lam RW, Young LT, Yatham LN (2009) Brain-derived neurotrophic factor and inflammatory markers in patients with early- versus late-stage bipolar disorder. Int J Neuropsychopharmacol 12:447–458PubMedCrossRef

43.

Thompson JM, Gallagher P, Hughes JH, Watson S, Gray JM, Ferrier IN, Young AH (2005) Neurocognitive impairment in euthymic patients with bipolar affective disorder. Br J Psychiatry 186:32–40PubMedCrossRef

44.

Elshahawi HH, Essawi H, Rabie MA, Mansour M, Beshry ZA, Mansour AN (2011) Cognitive functions among euthymic bipolar I patients after a single manic episode versus recurrent episodes. J Affect Disord 130:180–191PubMedCrossRef

45.

Kapczinski F, Vieta E, Andreazza AC, Frey BN, Gomes FA, Tramontina J, Kauer-Sant’Anna M, Grassi-Oliveira R, Post RM (2008) Allostatic load in bipolar disorder: implications for pathophysiology and treatment. Neurosci Biobehav Rev 32:675–692PubMedCrossRef

46.

Reinares M, Papachristou E, Harvey P, Mar BC, Sanchez-Moreno J, Torrent C, Ayuso-Mateos JL, Ploubidis GB, Vieta E, Frangou S (2013) Towards a clinical staging for bipolar disorder: defining patient subtypes based on functional outcome. J Affect Disord 144:65–71PubMedCrossRef

47.

Rosa AR, Reinares M, Franco C, Comes M, Torrent C, Sanchez-Moreno J, Martinez-Aran A, Salamero M, Kapczinski F, Vieta E (2009) Clinical predictors of functional outcome of bipolar patients in remission. Bipolar Disord 11:401–409PubMedCrossRef

48.

da Silva SA, Scazufca M, Menezes PR (2013) Population impact of depression on functional disability in elderly: results from “Sao Paulo Ageing and Health Study” (SPAH). Eur Arch Psychiatry Clin Neurosci 263:153–158PubMedCrossRef

49.

Vieta E (2011) Tertiarism in psychiatry: the Barcelona clinic bipolar disorders programme. Rev Psiquiatr Salud Ment 4:1–4PubMedCrossRef

50.

Martinez-Aran A, Torrent C, Sole B, Bonnin CM, Rosa AR, Sanchez-Moreno J, Vieta E (2011) Functional remediation for bipolar disorder. Clin Pract Epidemiol Ment Health 7:112–116PubMedCentralPubMedCrossRef

51.

Torrent C, Del Mar BC, Martinez-Aran A, Valle J, Amann BL, Gonzalez-Pinto A, Crespo JM, Ibanez A, Garcia-Portilla MP, Tabares-Seisdedos R, Arango C, Colom F, Sole B, Pacchiarotti I, Rosa AR, Ayuso-Mateos JL, Anaya C, Fernandez P, Landin-Romero R, Alonso-Lana S, Ortiz-Gil J, Segura B, Barbeito S, Vega P, Fernandez M, Ugarte A, Subira M, Cerrillo E, Custal N, Menchon JM, Saiz-Ruiz J, Rodao JM, Isella S, Alegria A, Al-Halabi S, Bobes J, Galvan G, Saiz PA, Balanza-Martinez V, Selva G, Fuentes-Dura I, Correa P, Mayoral M, Chiclana G, Merchan-Naranjo J, Rapado-Castro M, Salamero M, Vieta E (2013) Efficacy of functional remediation in bipolar disorder: a multicenter randomized controlled study. Am J Psychiatry 20:10. doi:10.1176/appi.ajp.2012.12070971

Title: The impact of repeated manic episodes and executive dysfunction on work adjustment in bipolar disorder
Authors: C. M. Bonnín
C. Torrent
J. M. Goikolea
M. Reinares
B. Solé
M. Valentí
J. Sánchez-Moreno
D. Hidalgo
R. Tabarés-Seisdedos
A. Martínez-Arán
E. Vieta
Publication date: 01-04-2014
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Psychiatry and Clinical Neuroscience / Issue 3/2014
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI: https://doi.org/10.1007/s00406-013-0431-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The impact of repeated manic episodes and executive dysfunction on work adjustment in bipolar disorder

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2014

Impact of the anesthetic agents ketamine, etomidate, thiopental, and propofol on seizure parameters and seizure quality in electroconvulsive therapy: a retrospective study

Depression and anxiety in Swedish primary health care: prevalence, incidence, and risk factors

Brain structural imaging correlates of olfactory dysfunction in obsessive–compulsive disorder

An fMRI study of reward circuitry in patients with minimal or extensive history of major depression

Vagus somatosensory evoked potentials are delayed in Alzheimer’s disease, but not in major depression

Pretreatment anterior cingulate activity predicts antidepressant treatment response in major depressive episodes