Borderline Personality, Bipolar Disorders Hamper Employment
By Janice Wood Associate News Editor
Reviewed by John M. Grohol, Psy.D. on December 12, 2012
A new study confirms that people diagnosed with borderline personality disorder and bipolar disorder have difficulty hanging on to a job.
Mark Zimmerman, M.D., the director of outpatient psychiatry at Rhode Island Hospital, and his colleagues found that depressed patients with borderline personality disorder were significantly more likely to have been persistently unemployed, as compared to patients with depression who do not have borderline personality disorder.
When looking at patients with bipolar disorder, no distinct differences were found between those who have a co-existing (co-morbid) diagnosis of borderline personality disorder and those who do not, he noted.
“Bipolar disorder incurs a very high cost on patients, the mental health care system and society as compared to many other mental illnesses, and it is ranked as one of the leading causes of disability in the world,” Zimmerman said.
“Bipolar disorder often leads to profound disruptions at work and social functioning, and also carries with it an increased risk of suicide.”
Previous studies in the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, led by Zimmerman, found that more than 80 percent of patients with bipolar disorder reported missing some time from work due to psychiatric reasons in the previous five years, and more than one-third missed up to two years or more from work.
This latest study found that nearly 30 percent of patients reported not missing any time from work in the past five years due to psychiatric illness, and 28 percent reported missing anywhere from a few days up to one month from work.
Persistent unemployment, defined as missing up to two years or more from work, was present in 13 percent of patients, and 4 percent were chronically unemployed throughout the five-year period.
The study also found that significantly more depressed patients with borderline personality disorder received disability payments at some time during the five-year period than depressed patients without the personality disorder.
Both bipolar disorder and borderline personality disorder are associated with impaired job functioning and the ability to hold a job, the researcher said. Efforts to improve detection of borderline personality disorder in depressed patients might be as important as the recognition of bipolar disorder, he noted.
“There has been a great deal of discussion about appropriate diagnosis of bipolar disorder, which has led to over-diagnosis,” Zimmerman said. “However, the over-diagnosis of bipolar disorder has been to the neglect of borderline personality disorder diagnosis.
“Some bipolar disorder experts are calling for expansion of the disorder’s diagnostic boundary, and this could lead to even more diagnoses of bipolar disorder. If this happens, there is cause for concern that those patients with borderline personality disorder will not be properly diagnosed or appropriately treated.”
บุคลิกภาพเส้นขอบ โรค Bipolar ตะกร้างานโดยเจนิสดิคคินไม้ทีมข่าวแก้ไขตรวจทาน โดยจอห์น M. Grohol, Psy.D เมื่อ 12 ธันวาคม 2012การศึกษาใหม่ยืนยันว่า คนที่วินิจฉัยโรคบุคลิกภาพเส้นขอบกับโรค bipolar มีปัญหาแขวนอยู่กับงานหมาย Zimmerman นพ. กรรมการ ผู้ป่วยนอกจิตเวชโรงพยาบาลโรดไอส์แลนด์และผู้ร่วมงานของเขาพบว่า ผู้ป่วยซึมเศร้ากับโรคบุคลิกภาพเส้นขอบได้อย่างมีนัยสำคัญยิ่งที่ได้สามารถคนตกงาน เมื่อเทียบกับผู้ป่วยที่มีภาวะซึมเศร้าที่ไม่มีโรคบุคลิกภาพเส้นขอบมองผู้ป่วย ด้วยโรค bipolar ที่เขาตรวจพบความแตกต่างไม่แตกต่างกันระหว่างผู้ที่มีการวินิจฉัย (co-morbid) อยู่ร่วมของเส้นขอบบุคลิกภาพผิดปกติ และผู้ที่ไม่ได้ สังเกต"โรค Bipolar ใช้ต้นทุนสูงมากในผู้ป่วย ระบบดูแลสุขภาพจิต และสังคมโดยเปรียบเทียบกับโรคจิตมากอื่น ๆ และการจัดอันดับเป็นหนึ่งในสาเหตุของความพิการในโลก Zimmerman กล่าวว่า "โรค Bipolar มักทำให้หยุดชะงักอย่างลึกซึ้งในการทำงานและการทำงานทางสังคม และยัง ยึดกับเสี่ยงฆ่าตัวตาย"วิธีโรดไอแลนด์โครงการประเมินวิเคราะห์ปรับปรุงและบริการ (ไมดาส) นำ โดย Zimmerman ศึกษาก่อนหน้านี้พบว่า มากกว่าร้อยละ 80 ของผู้ป่วยโรค bipolar รายงานขาดเวลาจากการทำงานเนื่องจากสาเหตุทางจิตเวชในห้าปีก่อนหน้านี้ และมากกว่าหนึ่งในสามไม่ถึงสองปี หรือเพิ่มเติมจากงานThis latest study found that nearly 30 percent of patients reported not missing any time from work in the past five years due to psychiatric illness, and 28 percent reported missing anywhere from a few days up to one month from work. Persistent unemployment, defined as missing up to two years or more from work, was present in 13 percent of patients, and 4 percent were chronically unemployed throughout the five-year period.The study also found that significantly more depressed patients with borderline personality disorder received disability payments at some time during the five-year period than depressed patients without the personality disorder.Both bipolar disorder and borderline personality disorder are associated with impaired job functioning and the ability to hold a job, the researcher said. Efforts to improve detection of borderline personality disorder in depressed patients might be as important as the recognition of bipolar disorder, he noted.“There has been a great deal of discussion about appropriate diagnosis of bipolar disorder, which has led to over-diagnosis,” Zimmerman said. “However, the over-diagnosis of bipolar disorder has been to the neglect of borderline personality disorder diagnosis.“Some bipolar disorder experts are calling for expansion of the disorder’s diagnostic boundary, and this could lead to even more diagnoses of bipolar disorder. If this happens, there is cause for concern that those patients with borderline personality disorder will not be properly diagnosed or appropriately treated.”
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