Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-13T05:48:06.770Z Has data issue: false hasContentIssue false
  • English
  • Français

Work impairment in bipolar disorder patients – results from a two-year observational study (EMBLEM)

Published online by Cambridge University Press:  16 April 2020

C. Reed ,
I. Goetz ,
E. Vieta ,
M. Bassi ,
J.M. Haro  and
the EMBLEM Advisory Board
C. Reed*
Affiliation:
Eli Lilly and Company Limited, Lilly Research Centre, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, WindleshamGU20 6PH, UK
I. Goetz
Affiliation:
Eli Lilly and Company Limited, Lilly Research Centre, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, WindleshamGU20 6PH, UK
E. Vieta
Affiliation:
Bipolar Disorders Programme, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
M. Bassi
Affiliation:
Dipartimento di Salute Mentale Azienda Ospedaliera Niguarda Cà Granda Milano, Milano, Italy
J.M. Haro
Affiliation:
Sant Joan De Deu-SSM, Fundació Sant Joan de Déu, CIBER en Salud Mental (ISCIII), Barcelona, Spain
*
*Corresponding author. Tel.: +44 0 1276 483243; fax: +44 0 1276 483192. E-mail address: reed_catherine@lilly.com (C. Reed).
Get access

Abstract

Objectives

To explore factors associated with work impairment at 2 years following an acute episode.

Methods

European Mania in Bipolar disorder Longitudinal Evaluation of Medication (EMBLEM) is a prospective, observational study on the outcomes of patients with a manic/mixed episode. Work impairment was measured using a Longitudinal Interval Follow-up Evaluation (slice of LIFE) item and patients were categorised with either low or high work impairment at each observation. Baseline factors associated with work impairment at 2 years were assessed using multivariate modelling.

Results

At baseline (n = 2289), 69% of patients had high work impairment. At 2 years (n = 1393), high impairment reduced to 41%. Modelling identified rapid cycling as the strongest disease-related factor associated with high work impairment at 2 years, although high work impairment at baseline had the strongest association overall. Lower levels of education, recent admissions, CGI-BP overall severity in the 12 months prior to baseline and CGI-BP mania at baseline all predicted higher work impairment. Living together in a relationship and independent housing were both significantly associated with having low work impairment at 2 years.

Conclusions

Work impairment in bipolar disorder is maintained over long periods, and is strongly associated with relationship status, living conditions and various disease-related factors.

Keywords

Bipolar disorderLongitudinal studyManiaWork impairmentFunctional outcomes
Type
Bipolar Disorder
Information
European Psychiatry , Volume 25 , Issue 6 , October 2010 , pp. 338 - 344
Copyright
Copyright © Elsevier Masson SAS 2010

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.)

References

Bauer, MS, Kirk, GF, Gavin, C, Williford, WODeterminants of functional outcome and healthcare costs in bipolar disorder: a high intensity follow-up study. J Affect Disord 2001;65:231–241.CrossRefGoogle ScholarPubMed
Berk, M, Ng, F, Wang, WV, Calabrese, JR, Mitchell, PBet al.The empirical redefinition of the psychometric criteria for remission in bipolar disorder. J Affect Disord 2008;106:153–158.CrossRefGoogle ScholarPubMed
Coryell, W, Schetner, W, Keller, M, Endicott, J, Maser, J, Klerman, GLThe enduring psychosocial consequences of mania and depression. Am J Psychiatry 1993;150:720–727.Google ScholarPubMed
Cruz, N, Vieta, E, Comes, M, Haro, JM, Reed, C, Bertsch, Jet al.Rapid-cycling bipolar I disorder: Course and treatment outcome of a large sample across Europe. J Psychiatr Res 2008;42:1068–1075.CrossRefGoogle ScholarPubMed
Dickerson, FB, Boronow, JJ, Stallings, CR, Origoni, AE, Cole, A, Yolken, RHAssociation between cognitive functioning and employment status of persons with bipolar disorder. Psychiatr Serv 2004;5:54–58.CrossRefGoogle Scholar
Dion, GL, Tohen, M, Anthony, WA, Waternaux, CSPatients with bipolar disorder six months after hospitalization. Hosp Com Psychiatry 1988;39:652–657.Google ScholarPubMed
Gitlin, MJ, Swendsen, J, Heller, TL, Hammen, CRelapse and impairment in bipolar disorder. Am J Psychiatry 1995;152:1635–1640.Google ScholarPubMed
Goetz, I, Tohen, M, Reed, C, Lorenzo, M, Vieta, E, the EMBLEM Advisory Board. Functional impairment in patients with mania: baseline results of the EMBLEM study. Bipolar Disord 2007;9:45–52.CrossRefGoogle ScholarPubMed
Gonzalez-Pinto, A, Ballesteros, J, Aldama, A, Perez de Heredia, JL, Gutierrez, M, Mosquera, Fet al.Principal components of mania. J Affect Disord 2003;76:95–102.CrossRefGoogle ScholarPubMed
Gonzalez-Pinto, A, Mosquera, F, Reed, C, Novick, D, Barbieto, S, Vega, P, et al.Validity and reliability of the Hamilton Depression Rating Scale (5 items) for manic and mixed bipolar disorders. J Nerve Ment Dis 2009;197:682–86.CrossRefGoogle ScholarPubMed
Goodwin, FK, Jamison, KManic-depressive illness. New York: Oxford University Press; 1990.Google Scholar
Hammen, C, Gitlin, M, Altshuler, LPredictors of work adjustment in bipolar I patients: a naturalistic longitudinal follow up. J Consult Clin Psychol 2000;68:220–225.CrossRefGoogle ScholarPubMed
Haro, JM, van Os, J, Vieta, E, Reed, C, Lorenzo, M, Goetz, Iet al.Evidence for three distinct classes of ‘typical’, ‘psychotic’ and ‘dual’ mania: results from the EMBLEM study. Acta Psychiatr Scand 2006;113:112–120.CrossRefGoogle ScholarPubMed
Huxley, N, Baldessarini, RJDisability and its treatment in bipolar disorder patients. Bipolar Disord 2007;9:183–196.CrossRefGoogle ScholarPubMed
Keck, PE, McElroy, SL, Strakowski, SM, West, S, Sax, KW, Hawkins, JMet al.12-month outcome of patients with bipolar disorder following hospitalization for a manic or mixed episode. Am J Psychiatry 1998;155:646–652.CrossRefGoogle ScholarPubMed
Keller, MB, Lavori, PW, Friedman, B, Nielson, E, Endicott, J, McDonald-Scott, Pet al.The Longitudinal Interval Follow-up Evaluation. A comprehensive method for assessing outcome in prospective longitudinal studies. Arch Gen Psychiatry 1987;44:540–548.CrossRefGoogle ScholarPubMed
Kessler, RC, McGonagle, KA, Zhao, S, Nelson, CB, Hughes, M, Eshleman, Set al.Lifetime and 12-month prevalence of DSM-III-R psychiatric disorder in the United States. Arch Gen Psychiatry 1994;51:8–19.CrossRefGoogle ScholarPubMed
Kupfer, DJ, Frank, E, Grochocinski, VJ, Cluss, PA, Houck, PR, Stapf, DADemographic and clinical characteristics of individuals in a bipolar case registry. J Clin Psychiatry 2002;63:120–125.CrossRefGoogle Scholar
Maj, M, Pirozzi, R, Magliano, L, Bartoli, LLong-term outcome of lithium prophylaxis in bipolar disorder: a 5-year prospective study of 402 patients at a lithium clinic. Am J Psychiatry 1998;155:30–35.CrossRefGoogle Scholar
Martinez-Aran, A, Vieta, E, Torrent, C, Sanchez-Moreno, J, Goikolea, JM, Salamero, Met al.Functional outcome in bipolar disorder: the role of clinical and cognitive factors. Bipolar Disord 2007;9:103–113.CrossRefGoogle ScholarPubMed
McQueen, GM, Young, LT, Joffe, RTA review of psychosocial outcome in patients with bipolar disorder. Acta Psychiatr Scand 2001;103:163–170.CrossRefGoogle Scholar
Merikangas, KR, Akiskal, HS, Angst, J, Greenberg, PE, Hirschfeld, RM, Petrukhova, Met al.Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2007;64:543–552.CrossRefGoogle ScholarPubMed
Murray, CJL, Lopez, ADThe Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries. and Risk Factors in 1990 and Projected to 2020 Cambridge, MA: Harvard University Press; 1996.Google Scholar
O’Connell, RA, Mayo, JA, Eng, LK, Jones, JS, Gabel, RHSocial support and long-term lithium outcome. Br J Psychiatry 1985;147:272–285.CrossRefGoogle ScholarPubMed
Pini, S, de Queiroz, V, Pagnin, D, Pezawas, L, Angst, J, Cassano, GBet al.Prevalence and burden of bipolar disorders in European countries. Eur Neuropsychopharmacol 2005;15:425–434.CrossRefGoogle ScholarPubMed
Ruggero, CJ, Chelminski, I, Young, D, Zimmerman, MPsychosocial impairment associated with bipolar II disorder. J Affect Disord 2007;104:53–60.CrossRefGoogle ScholarPubMed
Spearing, MK, Post, RM, Leverich, GS, Brandt, D, Nolen, WModification of the Clinical Global Impressions (CGI) scale for use in bipolar illness (BP): the CGI-BP. Psychiatry Res 1997;73:159–171.CrossRefGoogle ScholarPubMed
Tohen, M, Stoll, AL, Strakowski, SM, Faedda, GL, Mayer, PV, Goodwin, DCet al.The McLean first-episode psychosis project: six-month recovery and recurrence outcome. Schizophr Bull 1992;18:273–281.CrossRefGoogle ScholarPubMed
Tohen, M, Waternaux, CM, Tsuang, MTA 4-year prospective follow-up of 75 patients utilizing survival analysis. Arch Gen Psychiatry 1990;47:1106–1111.CrossRefGoogle ScholarPubMed
Tohen, M, Waternaux, CM, Tsuang, MT, Hunt, ATFour-year follow-up of twenty-four first-episode manic patients. J Affect Disord 1990;19:79–86.CrossRefGoogle ScholarPubMed
Tohen, M, Zarate, CA Jr., Hennen, J, Khalsa, H.-M., Strakowski, SM, Gebre-Medhin, Pet al.The McLean-Harvard First-Episode Mania Study: prediction of recovery and first recurrence. Am J Psychiatry 2003;160:2099–2107.CrossRefGoogle ScholarPubMed
Vieta, E, Calabrese, JR, Hennen, J, Colom, F, Martinez-Aran, A, Sanchez-Moreno, Jet al.Comparison of rapid-cycling and non-rapid-cycling bipolar I manic patients during treatment with olanzapine: analysis of pooled data. J Clin Psychiatry 2004;65:1420–1428.CrossRefGoogle ScholarPubMed
Vieta, E, Torrent, C, Martinez-Aran, A, Colom, VF, Reinares, GM, Benabarre, HAet al.A user-friendly scale for the short and long term outcome of bipolar disorder: the CGI-BP-M. [Spanish]. Actas Esp Psiquiatr 2002;30:301–304.Google Scholar
Waraich, P, Goldner, EM, Somers, JM, Hsu, LPrevalence and incidence studies of mood disorders: a systematic review of the literature. Can J Psychiatry 2004;49:124–138.CrossRefGoogle ScholarPubMed
Wehr, TA, Sack, DA, Rosenthal, NE, Cowdry, RWRapid cycling affective disorder: contributing factors and treatment responses in 51 patients. Am J Psychiatry 1988;145:179–184.Google ScholarPubMed
Young, RC, Biggs, JT, Ziegler, VE, Meyer, DAA rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 1978;133:429–435.CrossRefGoogle ScholarPubMed
Zarate, CA Jr., Tohen, M, Land, M, Cavanagh, SFunctional impairment and cognition in bipolar disorder. Psychiatric Q 2000;71:309–329.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.