Persistent unemployment common in bipolar disorder
By Mark Cowen
02 November 2010
Bipolar Disord 2010; 12: 720–726

MedWire News: Persistent unemployment is a common problem among people with bipolar disorder, and is significantly associated with the presence of certain comorbidities, say US researchers.

"The negative impact of bipolar disorder on occupational functioning is well established," explain Mark Zimmerman (Bayside Medical Center, Providence, Rhode Island) and colleagues.

"However, few studies have examined the persistence of unemployment, and no studies have examined the association between diagnostic comorbidity and sustained unemployment."

To address this, the researchers studied 206 patients with bipolar I or II disorder who were aged an average of 35.8 years.

All of the participants supplied information regarding their employment history over the previous 5 years, including the amount of time they had taken off work due to psychiatric problems. Persistent unemployment was defined as missing up to 2 years or more of work during this period.

They were also assessed using the Structured Clinical Interview for DSM-IV and the Structured Interview for DSM-IV Personality.

The researchers found that 82.5% of patients reported taking some time off work due to psychiatric problems, while 34.5% missed up to 2 years or more of work.

Analysis revealed that persistent unemployment was significantly associated with current panic disorder, at an odds ratio of 2.3, and a lifetime history of alcohol use disorder, at an OR of 1.6.

Older age and a greater number of depressive episodes were also associated with an increased risk for persistent unemployment, the researchers note.

Zimmerman and team conclude in the journal Bipolar Disorders: "The results of the present study indicate that not only do a large percentage of patients presenting for the treatment of bipolar disorder miss some time from work due to psychiatric reasons, but that the persistence of employment problems is considerable."

They add: "Repeated episodes of depression and comorbid panic and alcohol use disorder were independent correlates of persistent unemployment.

"It is therefore of public health significance to determine if current treatments are effective in bipolar disorder patients with current anxiety or alcohol use disorders, and if not, to attempt to develop treatments that are effective."

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

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