title: The impact of repeated manic episodes and executive dysfunction on work adjustment in bipolar disorder.
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.
authors.affiliation: Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Villarroel 170, 08036, Barcelona, Catalonia, Spain.
authors.forename: C M
authors.initials: CM
authors.lastname: Bonnín
authors.forename: C
authors.initials: C
authors.lastname: Torrent
authors.forename: J M
authors.initials: JM
authors.lastname: Goikolea
authors.forename: M
authors.initials: M
authors.lastname: Reinares
authors.forename: B
authors.initials: B
authors.lastname: Solé
authors.forename: M
authors.initials: M
authors.lastname: Valentí
authors.forename: J
authors.initials: J
authors.lastname: Sánchez-Moreno
authors.forename: D
authors.initials: D
authors.lastname: Hidalgo
authors.forename: R
authors.initials: R
authors.lastname: Tabarés-Seisdedos
authors.forename: A
authors.initials: A
authors.lastname: Martínez-Arán
authors.forename: E
authors.initials: E
authors.lastname: Vieta
mesh_terms: D000275:Adjustment Disorders / Q000209:etiology*; D000328:Adult; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000150:complications* / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D014937:Work
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