TY - JOUR
T1 - Associations of independent living and labor force participation with impairment indicators in schizophrenia and bipolar disorder at 20-year follow-up
AU - Strassnig, M.
AU - Kotov, R.
AU - Fochtmann, L.
AU - Kalin, M.
AU - Bromet, E. J.
AU - Harvey, P. D.
N1 - Funding Information:
Over the past 12 months, Dr. Harvey has served as a consultant to: Allergan, Akili, Boehringer-Ingelheim, Lundbeck, Otsuka Digital Health, Sanofi, Takeda. He receives royalties from Neurocog Trials and has research grants from Sunovion, Takeda and the Stanley Medical Research Foundation. Dr. Strassnig is a shareholder of Johnson & Johnson.
Funding Information:
This research was supported by grants from the National Institutes of Health ( MH44801 to EJB and MH094398 to RK), Eli Lilly Corporation (to EJB), The Stanley Medical Research Institute (to EJB) and Stony Brook University's Clinical Research Scholar Award (to RK).
Funding Information:
This research was supported by grants from the National Institutes of Health (MH44801 to EJB and MH094398 to RK), Eli Lilly Corporation (to EJB), The Stanley Medical Research Institute (to EJB) and Stony Brook University's Clinical Research Scholar Award (to RK).
PY - 2018/7
Y1 - 2018/7
N2 - Background: Since the Iowa 500 study, residential and occupational status have been frequently used as indicators of everyday achievements in research on schizophrenia and bipolar disorder. The relationships of residential and occupational status with impairment in multiple domains including physical health indicators across these two diagnoses, however, have rarely been studied. We examined these relationships at the 20-year follow-up assessment of a first-admission sample. Methods: We included 146 participants with schizophrenia and 87 with bipolar disorder with psychosis who participated in the 20-year follow-up of the Suffolk County Mental Health Project. In addition to interviewer-based ratings of employment and residential independence, we examined self-reported impairment derived from the WHODAS, standard measures of current psychopathology, indicators of obesity, as well as performance-based measures of physical and cognitive functioning. Results: Participants with bipolar disorder were more likely to live independently and be gainfully employed; they also performed significantly better on each indicator of impairment apart from balance ability. In both groups, unemployment, but not residential independence, was associated with greater self-reported disability on the WHODAS. Residential independence, gainful employment, and subjective disability were also associated with better physical functioning. Across the two groups, psychiatric symptoms and physical functioning were the major determinants of subjective disability. Discussion: People with psychotic bipolar disorder were more likely to be gainfully employed and living independently than participants with schizophrenia but as a group, much less frequently than population standards. Interventions aimed at physical fitness may have the potential to improve both objective functioning and perceived disability.
AB - Background: Since the Iowa 500 study, residential and occupational status have been frequently used as indicators of everyday achievements in research on schizophrenia and bipolar disorder. The relationships of residential and occupational status with impairment in multiple domains including physical health indicators across these two diagnoses, however, have rarely been studied. We examined these relationships at the 20-year follow-up assessment of a first-admission sample. Methods: We included 146 participants with schizophrenia and 87 with bipolar disorder with psychosis who participated in the 20-year follow-up of the Suffolk County Mental Health Project. In addition to interviewer-based ratings of employment and residential independence, we examined self-reported impairment derived from the WHODAS, standard measures of current psychopathology, indicators of obesity, as well as performance-based measures of physical and cognitive functioning. Results: Participants with bipolar disorder were more likely to live independently and be gainfully employed; they also performed significantly better on each indicator of impairment apart from balance ability. In both groups, unemployment, but not residential independence, was associated with greater self-reported disability on the WHODAS. Residential independence, gainful employment, and subjective disability were also associated with better physical functioning. Across the two groups, psychiatric symptoms and physical functioning were the major determinants of subjective disability. Discussion: People with psychotic bipolar disorder were more likely to be gainfully employed and living independently than participants with schizophrenia but as a group, much less frequently than population standards. Interventions aimed at physical fitness may have the potential to improve both objective functioning and perceived disability.
KW - Cognition
KW - Disability
KW - Obesity
KW - Physical functioning
KW - Schizophrenia
KW - Symptoms
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U2 - 10.1016/j.schres.2018.02.009
DO - 10.1016/j.schres.2018.02.009
M3 - Article
C2 - 29472164
AN - SCOPUS:85042151244
VL - 197
SP - 150
EP - 155
JO - Schizophrenia Research
JF - Schizophrenia Research
SN - 0920-9964
ER -