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

UMMS Affiliation

Department of Psychiatry

Publication Date


Document Type



Adolescent; Adult; Bipolar Disorder; Cost of Illness; Depression; Diagnostic and Statistical Manual of Mental Disorders; Disabled Persons; Employment; Female; Health Status; Humans; Male; Personality Inventory; Psychiatric Status Rating Scales; Psychometrics; Questionnaires; Severity of Illness Index; Sick Leave


Mental and Social Health | Psychiatry | Psychiatry and Psychology


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.

DOI of Published Version



Soc Psychiatry Psychiatr Epidemiol. 2009 Jul;44(7):515-22. doi: 10.1007/s00127-008-0464-4. Link to article on publisher's site

Journal/Book/Conference Title

Social psychiatry and psychiatric epidemiology

Related Resources

Link to Article in PubMed

PubMed ID