title: Occupational functioning and work impairment in association with personality disorder trait-scores.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, PO Box 1930, 8021, Zurich, Switzerland, michael.hengartner@dgsp.uzh.ch.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Hengartner
authors.forename: Mario
authors.initials: M
authors.lastname: Müller
authors.forename: Stephanie
authors.initials: S
authors.lastname: Rodgers
authors.forename: Wulf
authors.initials: W
authors.lastname: Rössler
authors.forename: Vladeta
authors.initials: V
authors.lastname: Ajdacic-Gross
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D010552:Personality Assessment / Q000706:statistics & numerical data*; D010554:Personality Disorders / Q000175:diagnosis* / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013557:Switzerland; D014937:Work; D017132:Workplace; D055815:Young Adult