Occupational disability in bipolar disorder: analysis of predictors of being on severe disablement benefit (PREBIS study data)

• Published in: Acta psychiatrica Scandinavica Vol. 127; no. 5; pp. 403 - 411
• Main Authors: Grande, I., Goikolea, J. M., de Dios, C., González-Pinto, A., Montes, J. M., Saiz-Ruiz, J., Prieto, E., Vieta, E.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-05-2013; Blackwell
• Subjects: Adult; Adult and adolescent clinical studies; Biological and medical sciences; Bipolar disorder; Bipolar Disorder - epidemiology; Bipolar Disorder - psychology; Bipolar disorders; clinical trial; Comorbidity; Disability insurance; Disabled Persons - psychology; Disabled Persons - statistics & numerical data; employment; Employment - psychology; Employment - statistics & numerical data; Female; Follow-Up Studies; Humans; Logistic Models; Longitudinal Studies; Male; Medical sciences; Mood disorders; occupational adjustment; outcome; Proportional Hazards Models; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Recurrence; Risk Factors; Spain - epidemiology; Time Factors; Spain; Mood disorder; Handicap; Disability; Occupational adjustment; Employment; disability insurance; Insurance; Clinical trial; Bipolar disorder; Predictive factor; outcome
• ISSN: 0001-690X; 1600-0447
• DOI: 10.1111/acps.12003

Grande I, Goikolea JM, de Dios C, González‐Pinto A, Montes JM, Saiz‐Ruiz J, Prieto E, Vieta E, for the PREBIS group. Occupational disability in bipolar disorder: analysis of predictors of being on severe disablement benefit PREBIS study data).
Objective:  Patients diagnosed with bipolar disorder (BD) are reported to have significant work impairment during interepisode intervals. This study was carried out to assess potential predictors of occupational disability in a longitudinal follow‐up of euthymic patients.
Method:  We included 327 euthymic patients diagnosed with BD type I or type II, 226 of whom were employed and 101 were receiving a severe disablement benefit (SDB). Sociodemographic data were studied and episode recurrence was assessed along a 1‐year follow‐up. Logistic regression analysis was applied to determine predictors of receiving SDB. Cox regression was built to study recurrences.
Results:  Predictors of receiving SDB were: axis II comorbidity [Odds Ratio (OR) = 2.94, CI: 1.26–6.86, P = 0.013], number of manic episodes (OR = 1.21, CI: 1.10–1.34, P < 0.001), being without stable partner (OR = 2.44, CI: 1.34–4.44, P = 0.004) and older age (OR = 1.08, CI: 1.05–1.12, P < 0.001). Bipolar patients receiving SDB presented more episodic recurrences regardless of polarity than employed bipolar patients (P = 0.002). The time until recurrence in 25% of the bipolar patients receiving SDB was 6.08 months (CI: 4.44–11.77) being 13.08 months (CI: 9.60 to –) in the employed group.
Conclusion:  Occupational disability in bipolar patients is associated with axis II comorbidity, more previous manic episodes, not having a stable relationship, older age, and more recurrences at 1‐year follow‐up.