title: Associations between sleep disturbance, cognitive functioning and work disability in Bipolar Disorder.
abstract: Bipolar Disorder (BD) is associated with impairment in a number of areas including poor work functioning, often despite the remission of mood symptoms. The present study aimed to examine the role of sleep disturbance and cognitive functioning in occupational impairment in BD. Twenty-four euthymic BD participants and 24 healthy control participants completed a week of prospective assessment of sleep disruption via self-report and actigraphy, a battery of neuropsychological tests of executive functioning, working memory, and verbal learning, and assessments of work functioning. BD participants experienced significantly poorer cognitive functioning as well as greater months of unemployment and greater incidence of being fired than controls. Moderation analyses revealed that both poor sleep and cognitive functioning were associated with poor work performance in BD participants, but not control participants. Sleep and cognitive functioning may be impaired in euthymic BD and are associated with poor work functioning in this population. More research should be conducted to better understand how sleep and cognitive functioning may interact in BD.
authors.affiliation: Mental Illness Research Education and Clinical Centers, Corporal Michael J. Crescenz Veterans Affairs Medical Center and the University of Pennsylvania School of Medicine Behavioral Health Service and Department of Psychiatry, Philadelphia, PA, USA. Electronic address: bolande@mail.med.upenn.edu.
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Boland
authors.affiliation: Temple University Department of Psychology, Philadelphia, PA, USA.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Stange
authors.affiliation: Temple University Department of Psychology, Philadelphia, PA, USA.
authors.forename: Ashleigh
authors.initials: A
authors.lastname: Molz Adams
authors.affiliation: Temple University Department of Psychology, Philadelphia, PA, USA.
authors.forename: Denise R
authors.initials: DR
authors.lastname: LaBelle
authors.affiliation: University of North Carolina, Chapel Hill Department of Psychology, Chapel Hill, NC, USA.
authors.forename: Mian-Li
authors.initials: ML
authors.lastname: Ong
authors.affiliation: Temple University Department of Psychology, Philadelphia, PA, USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Hamilton
authors.affiliation: Temple University Department of Psychology, Philadelphia, PA, USA.
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Connolly
authors.affiliation: Temple University Department of Psychology, Philadelphia, PA, USA.
authors.forename: Chelsea L
authors.initials: CL
authors.lastname: Black
authors.affiliation: Temple University Department of Psychology, Philadelphia, PA, USA.
authors.forename: Angelo B
authors.initials: AB
authors.lastname: Cedeño
authors.affiliation: Temple University Department of Psychology, Philadelphia, PA, USA.
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Alloy
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000503:physiopathology*; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology*; D006233:Persons with Disabilities / Q000523:psychology*; D004651:Employment / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology / Q000503:physiopathology*
keywords: Bipolar Disorder; Cognitive functioning; Functional outcomes; Sleep