Table_1_The impact of bipolar spectrum disorders on professional functioning: A systematic review.pdf

AimsThe impact of bipolar spectrum (BS) disorders on professional functioning has not been systematically reviewed yet. Since even subsyndromal symptoms may disturb functioning, the determination of the prognostic value of the spectrum of bipolarity for employment seems extremely relevant. The aim of this study was to assess the impact of BS disorders on professional functioning.Materials and methodsA systematic review of the literature (namely, cohort and cross-sectional studies) investigating a link between BS disorders and employment was performed in accordance with PRISMA guidelines. BS was defined based on the concept of two-dimensional BS by Angst. Occupational outcomes and factors affecting employment were evaluated as well.ResultsSeventy-four studies were included. All disorders comprising BS had a negative impact on occupational status, work performance, work costs, and salary, with the greatest unfavorable effect reported by bipolar disorder (BD), followed by borderline personality disorder (BPD), major depressive disorder (MDD), and dysthymia. Employment rates ranged from 40 to 75% (BD), 33 to 67% (BPD), 61 to 88% (MDD), and 86% (dysthymia). The factors affecting employment most included: cognitive impairments, number/severity of symptoms, namely, subsyndromal symptoms (mainly depressive), older age, education, and comorbidity (substance abuse, personality disorders, anxiety, depression, ADHD, PTSD).ConclusionBipolar spectrum symptoms exert a negative impact on professional functioning. Further evaluation of affecting factors is crucial for preventing occupational disability.

本研究旨在系统地评估双相谱系（BS）障碍对职业功能的影响。鉴于即使是亚临床症状也可能干扰功能，评估双相谱系对就业的预后价值显得尤为相关。研究目的在于探讨BS障碍对职业功能的影响。研究材料与方法：本研究遵循PRISMA指南，对文献（包括队列研究和横断面研究）进行了系统回顾，以研究BS障碍与就业之间的关联。BS障碍的定义基于Angst提出的二维BS概念。评估了职业结果及影响就业的因素。研究结果：共纳入74项研究。BS障碍中的所有障碍均对职业状况、工作表现、工作成本和薪酬产生了负面影响，其中以双相障碍（BD）的影响最为不利，其次是边缘型人格障碍（BPD）、重度抑郁症（MDD）和抑郁症（dysthymia）。就业率分别为40%至75%（BD）、33%至67%（BPD）、61%至88%（MDD）和86%（抑郁症）。影响就业的最主要因素包括认知障碍、症状数量/严重程度，尤其是亚临床症状（主要为抑郁症状）、年龄、教育程度和共病（物质滥用、人格障碍、焦虑、抑郁、ADHD、PTSD）。结论：双相谱系症状对职业功能产生负面影响。进一步评估影响因素对于预防职业残疾至关重要。