Relationship between mood episode and employment status of outpatients with bipolar disorder: Retrospective cohort study from the multicenter treatment survey for bipolar disorder in psychiatric clinics (musubi) project

Abstract

Objective: The objective of this study was to clarify the relationship between mood episode and employment in patients with bipolar disorder to help improve their employment status. Methods: All medical records of patients with bipolar disorder who visited 176 member clinics of the Japanese Association of Neuro-Psychiatric Clinics in September-October 2016 were investigated in September-October 2017. Details of the medical care received were investigated using a survey sheet, which included employment status. Odds ratios of mood episodes for employment status were analyzed using a logistic regression model. Results: Among patients aged 60 years or less, 2292 described their occupation. On univariate analysis, odds ratios were statistically significant for depressive episode (OR=2.68 [1.50-4.78] p=0.001) and manic episode (OR=2.64 [1.07-6.47] p=0.034), whereas no significant difference was noted for mixed episode (OR=1.72 [0.69-4.33] p=0.246). On multivariate analysis, odds ratios were statistically significant for depressive episode (OR=2.16 [1.13-4.13], p=0.020) and manic episode (OR=3.55 [1.36-9.25], p=0.010), whereas no significant difference was noted for mixed episode (OR=1.83 [0.65-5.14] p=0.254). Conclusion: Employment status among these patients with bipolar disorder receiving outpatient treatment was 43.5%. Compared to remission episodes, manic and depressive episodes were associated with a higher risk of unemployment.