Employment outcomes in people with bipolar disorder: a systematic review

Acta Psychiatr Scand. 2013 Sep;128(3):179-93. doi: 10.1111/acps.12087. Epub 2013 Feb 4.


Objective: Employment outcome in bipolar disorder is an under investigated, but important area. The aim of this study was to identify the long-term employment outcomes of people with bipolar disorder.

Method: A systematic review using the Medline, PsychInfo and Web of Science databases.

Results: Of 1962 abstracts retrieved, 151 full text papers were read. Data were extracted from 25 papers representing a sample of 4892 people with bipolar disorder and a mean length of follow-up of 4.9 years. Seventeen studies had follow-up periods of up to 4 years and eight follow-up of 5-15 years. Most studies with samples of people with established bipolar disorder suggest approximately 40-60% of people are in employment. Studies using work functioning measures mirrored this result. Bipolar disorder appears to lead to workplace underperformance and 40-50% of people may suffer a slide in their occupational status over time. Employment levels in early bipolar disorder were higher than in more established illness.

Conclusion: Bipolar disorder damages employment outcome in the longer term, but up to 60% of people may be in employment. Whilst further studies are necessary, the current evidence provides support for extending the early intervention paradigm to bipolar disorder.

Keywords: bipolar disorder; employment; outcome; work.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Bipolar Disorder* / epidemiology
  • Bipolar Disorder* / psychology
  • Employee Performance Appraisal / methods*
  • Employment* / psychology
  • Employment* / statistics & numerical data
  • Epidemiologic Research Design
  • Humans
  • Task Performance and Analysis
  • Time