Self-reported cognitive problems predict employment trajectory in patients with bipolar I disorder

Background: Cognitive impairment in bipolar disorder has been associated with poor functional outcomes. We examined the relation of self-reported cognitive problems to employment trajectory in patients diagnosed with bipolar I disorder. Methods: 154 bipolar I disorder patients were followed for 15-43 months at the Bipolar Disorders Center for Pennsylvanians. Using a multinomial logistic regression we examined predictors of employment group including self-reported cognitive problems, mood symptoms, education and age. Cognitive functioning was measured via 4 self-report items assessing memory/concentration at baseline and termination. Employment status was recorded at baseline and termination. Employment was categorized as working (full-time, part-time, homemaker, volunteer) or not working (leave of absence, disability, unemployed, no longer volunteering) at each time point. Patients were categorized as good stable, improving, worsening and poor stable. Results: Baseline self-reported concentration problems and years of education significantly predicted employment trajectory. Limitations: Post-hoc analyses of existing clinical data. Conclusions: Self-reported concentration problems assessed in the context of specific areas of functioning may serve as a sensitive predictor of functional outcome in patients diagnosed with bipolar I disorder. (C) 2009 Elsevier B.V. All rights reserved.