ORIGINAL PAPER

Social Psychiatry and Psychiatric Epidemiology

, Volume 44, Issue 7, pp 515-522

First online:

Frequency of subsyndromal symptoms and employment status in patients with bipolar disorder

  • Michael BauerAffiliated withDept. of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität DresdenDept. of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA) Email author 
  • , Tasha GlennAffiliated withChronoRecord Association Inc.
  • , Paul GrofAffiliated withMood Disorders Center of OttawaDept. of Psychiatry, University of Toronto
  • , Natalie L. RasgonAffiliated withDept. of Psychiatry and Behavioral Sciences, Stanford School of Medicine
  • , Wendy MarshAffiliated withDept. of Psychiatry, University of Massachusetts
  • , Kemal SagduyuAffiliated withDept. of Psychiatry, University of Missouri, Kansas City School of Medicine
  • , Martin AldaAffiliated withDept. of Psychiatry, Dalhousie University
  • , Ute LewitzkaAffiliated withDept. of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
  • , Johanna SasseAffiliated withDept. of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
    • , Eliza Kozuch-KrolikAffiliated withDept. of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
    • , Peter C. WhybrowAffiliated withDept. of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA)

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Abstract

Objective

This study investigated the frequency of episodes and subsyndromal symptoms based on employment status in patients with bipolar disorder.

Methods

Patients with bipolar disorder (n = 281) provided daily self-reported mood ratings for 5 months, returning 46,292 days of data. Data were analyzed using three employment status groups: disabled (n = 75), full-time employee or full-time student (n = 135), and other (n = 71). Demographic characteristics were compared by employment status. A univariate general linear model with employment status and other demographic variables as fixed factors and covariates was used to analyze the percent of days in episodes and percent of days with subsyndromal symptoms.

Results

While there was no significant difference in the percent of days in episodes among the employment groups, disabled patients suffered subsyndromal symptoms of depression twice as frequently as those in the full-time group. Disabled patients spent 15% more days either in episodes or with subsyndromal symptoms than those in the full-time group, equivalent to about 45 extra sick days a year.

Conclusion

Frequent subsyndromal symptoms, especially depressive, may preclude full-time responsibilities outside the home and contribute to disability in bipolar disorder. Additional treatments to reduce the frequency of subsyndromal symptoms are needed.

Keywords

bipolar disorder employment disability subsyndromal symptoms