Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T07:49:55.015Z Has data issue: false hasContentIssue false
  • English
  • Français

Level of functioning, perceived work ability, and work status among psychiatric patients with major mental disorders

Published online by Cambridge University Press:  23 March 2020

B. Karpov ,
G. Joffe ,
K. Aaltonen ,
J. Suvisaari ,
I. Baryshnikov ,
P. Näätänen ,
M. Koivisto ,
T. Melartin ,
J. Oksanen  and
K. Suominen
...Show all authors
B. Karpov
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
G. Joffe
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
K. Aaltonen
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
J. Suvisaari
Affiliation:
National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166, 00271Helsinki, Finland
I. Baryshnikov
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
P. Näätänen
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
M. Koivisto
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
T. Melartin
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
J. Oksanen
Affiliation:
National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166, 00271Helsinki, Finland
K. Suominen
Affiliation:
Department of Social Services and Health Care, Nordenskiöldinkatu 20, 15-7, 00250Helsinki, Finland
M. Heikkinen
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
E. Isometsä*
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166, 00271Helsinki, Finland
*
* Corresponding author at. Department of Psychiatry, P.O. Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland. Fax: +358 9 471 63735. E-mail address:erkki.isometsa@hus.fi (E. Isometsä).
Get access

Abstract

Background:

Major mental disorders are highly disabling conditions that result in substantial socioeconomic burden. Subjective and objective measures of functioning or ability to work, their concordance, or risk factors for them may differ between disorders.

Methods:

Self-reported level of functioning, perceived work ability, and current work status were evaluated among psychiatric care patients with schizophrenia or schizoaffective disorder (SSA, n = 113), bipolar disorder (BD, n = 99), or depressive disorder (DD, n = 188) within the Helsinki University Psychiatric Consortium Study. Correlates of functional impairment, subjective work disability, and occupational status were investigated using regression analysis.

Results:

DD patients reported the highest and SSA patients the lowest perceived functional impairment. Depressive symptoms in all diagnostic groups and anxiety in SSA and BD groups were significantly associated with disability. Only 5.3% of SSA patients versus 29.3% or 33.0% of BD or DD patients, respectively, were currently working. About half of all patients reported subjective work disability. Objective work status and perceived disability correlated strongly among BD and DD patients, but not among SSA patients. Work status was associated with number of hospitalizations, and perceived work disability with current depressive symptoms.

Conclusions:

Psychiatric care patients commonly end up outside the labour force. However, while among patients with mood disorders objective and subjective indicators of ability to work are largely concordant, among those with schizophrenia or schizoaffective disorder they are commonly contradictory. Among all groups, perceived functional impairment and work disability are coloured by current depressive symptoms, but objective work status reflects illness course, particularly preceding psychiatric hospitalizations.

Keywords

Functional impairmentDisabilityWork statusPsychiatric care
Type
Original article
Information
European Psychiatry , Volume 44 , July 2017 , pp. 83 - 89
Copyright
Copyright © European Psychiatric Association 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

Fax: +358 9 471 63735.

References

Vos, TAllen, CArora, MBarber, RMBhutta, ZABrown, A, et al.GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388(10053): 1545–1602.CrossRefGoogle Scholar
Vos, TFlaxman, ADNaghavi, MLozano, RMichaud, CEzzati, M, et al.Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380(9859): 2163–2196.CrossRefGoogle ScholarPubMed
Whiteford, HAFerrari, AJDegenhardt, LFeigin, VVos, TThe global burden of mental, neurological and substance use disorders: an analysis from the Global Burden of Disease Study 2010. PLoS One 2015;10(2):e0116820.CrossRefGoogle ScholarPubMed
Mojtabai, RStuart, EAHwang, ISusukida, REaton, WWSampson, N, et al.Long-term effects of mental disorders on employment in the National Comorbidity Survey ten-year follow-up. Soc Psychiatry Psychiatr Epidemiol 2015; 50(11): 1657–1668.CrossRefGoogle ScholarPubMed
Murray, CJVos, TLozano, RNaghavi, MFlaxman, ADMichaud, C, et al.Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380(9859): 2197–2223.CrossRefGoogle ScholarPubMed
Laaksonen, MGould, RReturn to work after temporary disability pension in Finland. J Occup Rehabil 2015; 25(3): 471–480.10.1007/s10926-014-9554-1CrossRefGoogle ScholarPubMed
Ekberg, KWahlin, CPersson, JBernfort, LOberg, BEarly and late return to work after sick leave: predictors in a cohort of sick-listed individuals with common mental disorders. J Occup Rehabil 2015; 25(3): 627–637.CrossRefGoogle Scholar
Netterstrom, BEller, NHBorritz, M Prognostic factors of returning to work after sick leave due to work-related common mental disorders: a one- and three-year follow-up study. Biomed Res Int 2015;596572. http://dx.doi.org/10.1155/2015/596572 [Epub 2015 Oct 18].CrossRefGoogle Scholar
Lahelma, EPietilainen, ORahkonen, OLallukka, TCommon mental disorders and cause-specific disability retirement. Occup Environ Med 2015; 72(3): 181–187.CrossRefGoogle ScholarPubMed
Kaila-Kangas, LHaukka, EMiranda, HKivekas, TAhola, KLuukkonen, R, et al.Common mental and musculoskeletal disorders as predictors of disability retirement among Finns. J Affect Disord 2014; 165: 38–44.CrossRefGoogle ScholarPubMed
Lopez, ADMathers, CDEzzati, MJamison, DTMurray, CJGlobal and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 2006; 367(9524): 1747–1757.CrossRefGoogle ScholarPubMed
Chen, FPSamet, SGorroochurn, PO’Hara, KMCharacterizing factors of employment status in persons with major depressive disorder. Eval Health Prof 2016; 39(3): 263–281.CrossRefGoogle ScholarPubMed
Marwaha, SDurrani, ASingh, SEmployment outcomes in people with bipolar disorder: a systematic review. Acta Psychiatr Scand 2013; 128(3): 179–193.CrossRefGoogle ScholarPubMed
Goldberg, JFHarrow, MA 15-year prospective follow-up of bipolar affective disorders: comparisons with unipolar nonpsychotic depression. Bipolar Disord 2011;13(2):155–63.CrossRefGoogle ScholarPubMed
Miettunen, JLauronen, EVeijola, JKoponen, HSaarento, OTaanila, A, et al.Socio-demographic and clinical predictors of occupational status in schizophrenic psychoses – follow-up within the Northern Finland 1966 Birth Cohort. Psychiatry Res 2007; 150(3): 217–225.CrossRefGoogle ScholarPubMed
Marwaha, SJohnson, SSchizophrenia and employment – a review. Soc Psychiatry Psychiatr Epidemiol 2004; 39(5): 337–349.CrossRefGoogle ScholarPubMed
Rosenheck, RLeslie, DKeefe, RMcEvoy, JSwartz, MPerkins, D, et al.Barriers to employment for people with schizophrenia. Am J Psychiatry 2006; 163(3): 411–417.CrossRefGoogle ScholarPubMed
Pranjic, NMales-Bilic, LWork ability index, absenteeism and depression among patients with burnout syndrome. Mater Sociomed 2014; 26(4): 249–252.CrossRefGoogle ScholarPubMed
Zimmerman, MMartinez, JAAttiullah, NFriedman, MToba, CBoerescu, DA, et al.Why do some depressed outpatients who are in remission according to the Hamilton Depression Rating Scale not consider themselves to be in remission?. J Clin Psychiatry 2012; 73(6): 790–795 [Physicians Postgraduate Press, Inc.].CrossRefGoogle Scholar
Fagiolini, AKupfer, DJMasalehdan, AScott, JAHouck, PRFrank, EFunctional impairment in the remission phase of bipolar disorder. Bipolar Disord 2005; 7(3): 281–285.CrossRefGoogle ScholarPubMed
Oorschot, MLataster, TThewissen, VLardinois, Mvan Os, JDelespaul, PA, et al.Symptomatic remission in psychosis and real-life functioning. Br J Psychiatry 2012; 201(3): 215–220.CrossRefGoogle ScholarPubMed
Huppert, JDWeiss, KALim, RPratt, SSmith, TEQuality of life in schizophrenia: contributions of anxiety and depression. Schizophr Res 2001; 51(2–3): 171–180.CrossRefGoogle ScholarPubMed
Holma, IAHolma, KMMelartin, TKRytsala, HJIsometsa, ETA 5-year prospective study of predictors for disability pension among patients with major depressive disorder. Acta Psychiatr Scand 2012; 125(4): 325–334.CrossRefGoogle ScholarPubMed
Arvilommi, PSuominen, KMantere, OValtonen, HLeppamaki, SIsometsa, EPredictors of long-term work disability among patients with type I and II bipolar disorder: a prospective 18-month follow-up study. Bipolar Disord 2015; 17(8): 821–835.CrossRefGoogle ScholarPubMed
Tsang, HWLeung, AYChung, RCBell, MCheung, WMReview on vocational predictors: a systematic review of predictors of vocational outcomes among individuals with schizophrenia: an update since 1998. Aust N Z J Psychiatry 2010; 44(6): 495–504.Google ScholarPubMed
Gutierrez-Rojas, LJurado, DGurpegui, MFactors associated with work, social life and family life disability in bipolar disorder patients. Psychiatry Res 2011; 186(2–3): 254–260.CrossRefGoogle ScholarPubMed
Rytsälä, HJMelartin, TKLeskela, USSokero, TPLestela-Mielonen, PSIsometsa, ETPredictors of long-term work disability in Major Depressive Disorder: a prospective study. Acta Psychiatr Scand 2007; 115(3): 206–213.CrossRefGoogle ScholarPubMed
Braga, RJMendlowicz, MVMarrocos, RPFigueira, ILAnxiety disorders in outpatients with schizophrenia: prevalence and impact on the subjective quality of life. J Psychiatr Res 2005; 39(4): 409–414.CrossRefGoogle ScholarPubMed
Lee, RSHermens, DFNaismith, SLLagopoulos, JJones, AScott, J, et al.Neuropsychological and functional outcomes in recent-onset major depression, bipolar disorder and schizophrenia spectrum disorders: a longitudinal cohort study. Transl Psychiatry 2015;5:e555.CrossRefGoogle ScholarPubMed
Bowie, CRDepp, CMcGrath, JAWolyniec, PMausbach, BTThornquist, MH, et al.Prediction of real-world functional disability in chronic mental disorders: a comparison of schizophrenia and bipolar disorder. Am J Psychiatry 2010; 167(9): 1116–1124.CrossRefGoogle ScholarPubMed
Lee, RSHermens, DFRedoblado-Hodge, MANaismith, SLPorter, MAKaur, M, et al.Neuropsychological and socio-occupational functioning in young psychiatric outpatients: a longitudinal investigation. PLoS One 2013;8(3):e58176.CrossRefGoogle ScholarPubMed
Bahorik, ALEack, SMExamining the course and outcome of individuals diagnosed with schizophrenia and comorbid borderline personality disorder. Schizophr Res 2010; 124(1–3): 29–35.CrossRefGoogle ScholarPubMed
Zimmerman, MMartinez, JHYoung, DChelminski, IDalrymple, KSustained unemployment in psychiatric outpatients with bipolar depression compared to major depressive disorder with comorbid borderline personality disorder. Bipolar Disord 2012; 14(8): 856–862.CrossRefGoogle ScholarPubMed
Cardenas, VAbel, SBowie, CRTiznado, DDepp, CAPatterson, TL, et al.When functional capacity and real-world functioning converge: the role of self-efficacy. Schizophr Bull 2013; 39(4): 908–916.CrossRefGoogle ScholarPubMed
Norman, SBCissell, SHMeans-Christensen, AJStein, MBDevelopment and validation of an Overall Anxiety Severity and Impairment Scale (OASIS). Depress Anxiety 2006; 23(4): 245–249.CrossRefGoogle Scholar
Baryshnikov, IAaltonen, KKoivisto, MNäätänen, PKarpov, BMelartin, T, et al.Differences and overlap in self-reported symptoms of bipolar disorder and borderline personality disorder. Eur Psychiatry 2015; 30(8): 914–919.CrossRefGoogle ScholarPubMed
Aaltonen, KNäätänen, PHeikkinen, MKoivisto, MBaryshnikov, IKarpov, B, et al.Differences and similarities of risk factors for suicidal ideation and attempts among patients with depressive or bipolar disorders. J Affect Disord 2016; 193: 318–330.CrossRefGoogle ScholarPubMed
Karpov, BJoffe, GAaltonen, KSuvisaari, JBaryshnikov, INäätänen, P, et al.Anxiety symptoms in a major mood and schizophrenia spectrum disorders. Eur Psychiatry 2016; 37: 1–7.CrossRefGoogle Scholar
World Health Organization, International classification of disease, 10th ed., Geneva: WHO; 1992.Google Scholar
Sheehan, DVThe anxiety disease New York, NY, USA: Charles Scribners Sons; 1983Google Scholar
Sheehan, DVHarnett-Sheehan, KRaj, BAThe measurement of disability. Int Clin Psychopharmacol 1996;11(Suppl. 3):89–95.10.1097/00004850-199606003-00015CrossRefGoogle ScholarPubMed
Beck, ATWard, CHMendelson, MMock, JErbaugh, JAn inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561–571.CrossRefGoogle ScholarPubMed
Schwarzer, RJerusalem, MGeneralized Self-Efficacy Scale. In: Weinman, JWright, SJohnston, M (eds.). Measures in health psychology: a user's portfolio. Causal and control beliefs. Windsor, UK:NFER-NELSON; 1995. p. 35–37.Google Scholar
Zanarini, MCVujanovic, AAParachini, EABoulanger, JLFrankenburg, FRHennen, JA screening measure for BPD: the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD). J Pers Disord 2003; 17(6): 568–573.10.1521/pedi.17.6.568.25355CrossRefGoogle Scholar
IBM SPSS Statistics for Windows, Version 22.0. Released 2013. Armonk, NY: IBM Corp; 2005.Google Scholar
van der Voort, TYSeldenrijk, Avan Meijel, BGoossens, PJBeekman, ATPenninx, BW, et al.Functional versus syndromal recovery in patients with major depressive disorder and bipolar disorder. J Clin Psychiatry 2015;76(6):e809–e814 [Physicians Postgraduate Press, Inc, United State].CrossRefGoogle ScholarPubMed
Simonsen, CSundet, KVaskinn, AUeland, TRomm, KLHellvin, T, et al.Psychosocial function in schizophrenia and bipolar disorder: relationship to neurocognition and clinical symptoms. J Int Neuropsychol Soc 2010; 16(5): 771–783 [England].CrossRefGoogle ScholarPubMed
Hendriks, SMSpijker, JLicht, CMHardeveld, Fde Graaf, RBatelaan, NM, et al.Long-term work disability and absenteeism in anxiety and depressive disorders. J Affect Disord 2015; 178: 121–130.CrossRefGoogle ScholarPubMed
Rosa, ARFranco, CMartinez-Aran, ASanchez-Moreno, JReinares, MSalamero, M, et al.Functional impairment in patients with remitted bipolar disorder. Psychother Psychosom 2008; 77(6): 390–392.CrossRefGoogle ScholarPubMed
Goldberg, JFHarrow, MA 15-year prospective follow-up of bipolar affective disorders: comparisons with unipolar nonpsychotic depression. Bipolar Disord 2011; 13(29): 155–163.CrossRefGoogle ScholarPubMed
Disner, SGBeevers, CGHaigh, EABeck, ATNeural mechanisms of the cognitive model of depression. Nat Rev Neurosci 2011; 12(8): 467–477.CrossRefGoogle Scholar
Sönmez, NRossberg, JIEvensen, JBarder, HEHaahr, UTen Velden Hegelstad, W, et al.Depressive symptoms in first-episode psychosis: a 10-year follow-up study. Early Interv Psychiatry 2016; 10(3): 227–233.CrossRefGoogle ScholarPubMed
Johnson, SSathyaseelan, MCharles, HJacob, KSPredictors of disability: a 5-year cohort study of first-episode schizophrenia. Asian J Psychiatr 2014; 9: 45–50.CrossRefGoogle ScholarPubMed
Harvey, PDDisability in schizophrenia: contributing factors and validated assessments. J Clin Psychiatry 2014;75(Suppl. 1):15–20.CrossRefGoogle ScholarPubMed
Braga, RJReynolds, GPSiris, SGAnxiety comorbidity in schizophrenia. Psychiatry Res 2013; 210(1): 1–7.CrossRefGoogle Scholar
Alptekin, KErkoc, SGogus, AKKultur, SMete, LUcok, A, et al.Disability in schizophrenia: clinical correlates and prediction over 1-year follow-up. Psychiatry Res 2005; 135(2): 103–111.CrossRefGoogle ScholarPubMed
Razzano, LACook, JABurke-Miller, JKMueser, KTPickett-Schenk, SAGrey, DD, et al.Clinical factors associated with employment among people with severe mental illness: findings from the employment intervention demonstration program. J Nerv Ment Dis 2005; 193(11): 705–713.CrossRefGoogle ScholarPubMed
Catty, JLissouba, PWhite, SBecker, TDrake, REFioritti, A, et al.Predictors of employment for people with severe mental illness: results of an international six-centre randomised controlled trial. Br J Psychiatry 2008; 192(3): 224–231.CrossRefGoogle ScholarPubMed
Depp, CAMausbach, BTBowie, CWolyniec, PThornquist, MHLuke, JR, et al.Determinants of occupational and residential functioning in bipolar disorder. J Affect Disord 2012; 136(3): 812–818.CrossRefGoogle ScholarPubMed
Hayhurst, KPMassie, JADunn, GLewis, SWDrake, RJValidity of subjective versus objective quality of life assessment in people with schizophrenia. BMC Psychiatry 2014;14 [365-014-0365-x].CrossRefGoogle Scholar
Bengtsson-Tops, AHansson, LSandlund, MBjarnason, OKorkeila, JMerinder, L, et al.Subjective versus interviewer assessment of global quality of life among persons with schizophrenia living in the community: a Nordic multicentre study. Qual Life Res 2005; 14(1): 221–229.CrossRefGoogle ScholarPubMed
Harvey, PDAssessing disability in schizophrenia: tools and contributors. J Clin Psychiatry 2014;75(10):e27.CrossRefGoogle ScholarPubMed
Mantere, OSuominen, KLeppämäki, SValtonen, HArvilommi, PIsometsä, EThe clinical characteristics of DSM-IV bipolar I and II disorders: baseline findings from the Jorvi Bipolar Study (JoBS). Bipolar Disord 2004; 6(5): 395–405.CrossRefGoogle Scholar
Melartin, TKRytsala, HJLeskela, USLestela-Mielonen, PSSokero, TPIsometsa, ETCurrent comorbidity of psychiatric disorders among DSM-IV major depressive disorder patients in psychiatric care in the Vantaa Depression Study. J Clin Psychiatry 2002; 63(2): 126–134.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.