After reviewing ten studies (eight research reports and two meta-analyses), the authors conclude that both psychological and pharmacological treatments earlier in the course of bipolar disorder (BD) are more effective than in the later stages in a range of clinical (i.e. symptomatic or relapse) and functional (i.e. vocational functioning or independent living) outcomes.
It is becoming increasingly recognised that BD is associated with a higher level of functional impairment than previously thought, particularly with regard to social adjustment and vocational functioning [ 6, 7].
It was not until 1902 that this exclusive emphasis was challenged by a reform promoting the study of modern languages and science and not until the period between World Wars I and II that education was seen to have a vocational function, other than grossly in a social-class sense, and thus to require democratization.
To examine associations between multitasking ability defined by performance on a complex task integrating multiple cognitive domains and vocational functioning in multiple sclerosis (MS).
In comparison to those who had experienced multiple admissions, the first admission group showed significantly higher vocational functioning (p = 0.034) and were more often employed (70 vs 31.8%%).
However, the number of admissions was not an independent predictor of vocational functioning after controlling for confounders using a regression analysis.
Bipolar disorders are a group of chronic lifelong recurrent psychiatric disorders characterized by episodic shifts in mood, energy, social and vocational functioning, and activity levels (Phillips and Kupfer 2013).
The greater effectiveness in improving functional outcomes in the early course may be particularly linked to the initial appearance and worsening of cognitive impairments with time, a factor which is known to independently predict vocational functioning in bipolar disorder (Gilbert et al. 2013; Torres et al. 2011).
Even mild neuropsychological impairment has been associated with decreased vocational functioning, problems with medication management, driving, and activities of daily living [5], [6].
Functioning occupied a middle ground; social function tended to be more important than vocational function.
