Psychosocial Disability in the Course of Bipolar I and II Disorders

Top Cited Papers
Open Access
Publisher Website
Google Scholar
Abstract
Bipolar disorder has been found to be associated with the following types of disability: increased suicidal behavior,1 increased health care use and costs,1,2 higher unemployment,3,4 higher dependence on public assistance,1 lower annual income,5 increased work absenteeism owing to illness,2,5,6 decreased work productivity,5 poorer overall functioning,7-9 lower quality of life,2,10 and decreased life span.11 Although informative, the conclusions are limited by methodological shortcomings such as reliance primarily on cross-sectional rather than longitudinal designs, generally small samples, using screening rather than research diagnostic methods, combining bipolar I disorder (BP-I) and bipolar II disorder (BP-II), or omitting BP-II altogether. To our knowledge, no study has examined disability in relation to all of the levels of affective symptom severity that occur over time, has compared disability for manic and depressive symptoms, or has examined disability separately for BP-I and BP-II.