title: Occupational outcome in bipolar disorder is not predicted by premorbid functioning and intelligence.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Moodnet Research Group, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway. hsc@sus.no
authors.forename: Helle K
authors.initials: HK
authors.lastname: Schoeyen
authors.forename: Ingrid
authors.initials: I
authors.lastname: Melle
authors.forename: Kjetil
authors.initials: K
authors.lastname: Sundet
authors.forename: Sofie R
authors.initials: SR
authors.lastname: Aminoff
authors.forename: Tone
authors.initials: T
authors.lastname: Hellvin
authors.forename: Bjoern H
authors.initials: BH
authors.lastname: Auestad
authors.forename: Gunnar
authors.initials: G
authors.lastname: Morken
authors.forename: Ole A
authors.initials: OA
authors.lastname: Andreassen
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology; D003710:Demography; D004651:Employment; D005260:Female; D006801:Humans; D007360:Intelligence; D007361:Intelligence Tests; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D011932:Reading; D012189:Retrospective Studies