Psychosocial impairment associated with bipolar II disorder.
BACKGROUND
Significant research has looked at the psychosocial impairment associated with bipolar I disorder and major depressive disorder. Far less is known about the impact of bipolar II disorder. The present study assessed the social and work impairment associated with bipolar II disorder and whether these are more or less severe than those associated with bipolar I disorder or major depressive disorder.


METHODS
Psychiatric outpatients with bipolar II disorder (n=89), bipolar I disorder (n=45) and major depressive disorder (n=1251) were assessed cross-sectionally by highly trained raters using semi-structured interviews. Participants were in a major depressive episode. Groups were compared on a series of indicators of psychosocial functioning.


RESULTS
Bipolar I and II disorder were associated with greater absenteeism from work due to psychopathology compared to major depressive disorder. The bipolar disorders also had higher rates of hospitalization and suicide attempts. Bipolar II disorder had fewer hospitalization than bipolar I disorder which may have led to slightly less severe work impairment. Both conditions had similar rates of serious suicide attempts.


CONCLUSIONS
The study was cross-sectional and retrospective. Furthermore, the sample consisted of outpatients seeking treatment, limiting generalizability to other settings.


CONCLUSIONS
Bipolar II disorder is associated with serious work impairment and a high number of serious suicide attempts. The level of impairment is more similar than it is different from that associated with bipolar I disorder. Clinicians would be mistaken to presume that the "softer" bipolar spectrum, specifically bipolar II disorder, is less impairing than bipolar I disorder.
Ruggero
Camilo J
CJ
Department of Psychiatry and Human Behavior, Brown Medical School, Rhode Island Hospital, Providence, RI, United States. Camilo_Ruggero@brown.edu
Chelminski
Iwona
I
Young
Diane
D
Zimmerman
Mark
M
D000041:Absenteeism; D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology* / Q000534:rehabilitation; D003430:Cross-Sectional Studies; D003710:Demography; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015588:Observer Variation; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015995:Prevalence; D011584:Psychology; D015203:Reproducibility of Results; D012919:Social Behavior; D013405:Suicide / Q000706:statistics & numerical data; D017132:Workplace / Q000706:statistics & numerical data