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Occupational functioning and work impairment in association with personality disorder trait-scores

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

According to the DSM, functional impairment is a main criterion for the general definition of personality disorders (PDs), but research suggests that some PDs might not be related to impaired functioning. Occupational functioning has rarely been examined in all ten DSM PDs.

Methods

We analysed 511 adults aged 20–41 years from the general population of the canton of Zurich, Switzerland, using data from the Epidemiology Survey of the Zurich Programme for Sustainable Development of Mental Health Services. All PDs were assessed with dimensional trait-scores and associations with indicators of occupational functioning were analysed with generalised linear models.

Results

Each PD revealed at least a weak association with some form of occupational impairment. Most PDs, especially from cluster A and B, were significantly related to occupational dysfunction, in particular low education level, conflicts in the workplace, dismissal or demotion, and unemployment. In contrast, obsessive–compulsive PD was mostly unrelated to occupational functioning. A total personality pathology dose–response relationship was observed for low education level, conflicts in the workplace, dismissal or demotion, and unemployment.

Conclusions

Impairment in occupational functioning is an important aspect particularly of cluster A and B PDs. Assuming that functional impairment is a predictor of illness severity, we advocate that clinicians should carefully explore indicators of occupational functioning in the diagnosis, prognosis, and treatment of PDs. The findings discussed herein have implications for general treatment, interventions in the work environment, or re-integration of patients into the labour force.

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Acknowledgments

ZInEP was supported by a private donation. The donor had no further role in the experimental design, the collection, analysis, and interpretation of data, the writing of this report, or the decision to submit this paper for publication.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, PO Box 1930, 8021, Zurich, Switzerland

    Michael P. Hengartner, Mario Müller, Stephanie Rodgers, Wulf Rössler & Vladeta Ajdacic-Gross

  2. Collegium Helveticum, a Joint Research Institute between the University of Zurich and the Swiss Federal Institute of Technology, Zurich, Switzerland

    Wulf Rössler

Authors
  1. Michael P. Hengartner
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  2. Mario Müller
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  3. Stephanie Rodgers
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  4. Wulf Rössler
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  5. Vladeta Ajdacic-Gross
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Corresponding author

Correspondence to Michael P. Hengartner.

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Hengartner, M.P., Müller, M., Rodgers, S. et al. Occupational functioning and work impairment in association with personality disorder trait-scores. Soc Psychiatry Psychiatr Epidemiol 49, 327–335 (2014). https://doi.org/10.1007/s00127-013-0739-2

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  • DOI: https://doi.org/10.1007/s00127-013-0739-2

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