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

Dept. of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
Social Psychiatry (Impact Factor: 2.54). 12/2008; 44(7):515-22. DOI: 10.1007/s00127-008-0464-4
Source: PubMed


This study investigated the frequency of episodes and subsyndromal symptoms based on employment status in patients with bipolar disorder.
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.
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.
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.

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    • "It may be particularly beneficial for those with bipolar disorder to obtain information online due to the disability and poor quality of life that may follow a diagnosis (Huxley and Baldessarini 2007; Michalak et al. 2005; Bauer et al. 2009). For patients with a recent diagnosis, information learned on web sites may reinforce that bipolar disorder is a serious illness with a complex and unpredictable course, which requires specialized help from a psychiatrist and treatment with psychotropic drugs. "
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    ABSTRACT: Adults routinely use the Internet as a source of health information. Patients with bipolar disorder and caregivers should be encouraged to increase their knowledge of this complex illness, including through the Internet. However, patients, caregivers, and physicians should be aware of potential perils when searching the Internet for health information, including loss of privacy, quality of web site content, and Internet scams. This review summarizes these cautionary issues. The digital divide remains and includes a lack of technical skills and competency in searching and appraising web sites, in addition to limited access to the Internet. Physicians should provide patients with a list of trustworthy web sites and a brief printed handout on concerns related to searching the Internet. More studies of the use of the Internet by patients with bipolar disorder are needed.
    Full-text · Article · Oct 2013
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    • "Daily access to a home computer was required throughout the study. However, the demographic profile of the patients who use ChronoRecord is similar to that in other studies of bipolar disorder [12]. This study did not include patients with bipolar disorder who were not receiving treatment, and patients who never experience hypomania that lasts for 4 days. "
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    ABSTRACT: Brief hypomania lasting less than 4 days may impair functioning and help to detect bipolarity. This study analyzed brief hypomania that occurred in patients with bipolar disorder who were diagnosed according to the DSM-IV criteria. Daily self-reported mood ratings were obtained from 393 patients (247 bipolar I and 146 bipolar II) for 6 months (75,284 days of data, mean 191.6 days). Episodes of hypomania were calculated using a 4, 3, 2, and single day length criterion. Brief hypomania occurred frequently. With a decrease in the minimum criterion from 4 days to 2 days, there were almost twice as many patients with an episode of hypomania (102 vs. 190), and more than twice as many episodes (305 vs. 863). Single days of hypomania were experienced by 271 (69%) of the sample. With a 2-day episode length, 33% of all hypomania remained outside of an episode. There was no significant difference in the percent of hypomanic days outside of an episode between patients with bipolar I and II disorders. There were no significant differences in the demographic characteristics of patients who met the 4-day minimum as compared with those who only experienced episodes of hypomania using a shortened length criterion. Decreasing the minimum length criterion for an episode of hypomania will cause a large increase in the number of patients who experience an episode and in the aggregate number of episodes, but will not distinguish subgroups within a sample who meet the DSM-IV criteria for bipolar disorder. Frequency may be an important dimensional aspect of brief hypomania. Clinicians should regularly probe for brief hypomania.
    Full-text · Article · Aug 2011 · European Archives of Psychiatry and Clinical Neuroscience
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    • "Data reported here were collected in a multi-center study of patients with bipolar disorder investigating the relationship between employment status and subsyndromal symptoms described elsewhere [24]. Inclusion in the study required a DSM-IV diagnosis of bipolar disorder, an age of 18 years or older, that patients were currently receiving pharmacological treatment for bipolar disorder, and a willingness to complete daily self-reporting of mood for 5 months using computer software in their native language. "
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    ABSTRACT: Objective. Many patients with bipolar disorder take adjunctive medications for anxiety. Using naturalistic data, we investigated the relationship between the use of adjunctive anxiolytics and the time spent in episodes or with subsyndromal mood symptoms. Methods. This was a post-hoc analysis of 310 patients with bipolar disorder who previously recorded mood and medications daily for 5 months using ChronoRecord software. One hundred patients were taking adjunctive anxiolytics for at least 50% of days; 210 were not. Of the 100 patients, 73 were taking a benzodiazepine. All patients taking anxiolytics were also receiving treatments for bipolar disorder. Results. Patients with bipolar disorder who were taking adjunctive medications for anxiety spent more time ill. Comparing patients who were taking or not taking anxiolytics, the mean days spent either in any episode or with subsyndromal symptoms was 45.6 vs. 29.6%, respectively (P
    Full-text · Article · Jul 2009 · International Journal of Psychiatry in Clinical Practice
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