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

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.