title: Frequency of subsyndromal symptoms and employment status in patients with bipolar disorder.
abstract: OBJECTIVE
  This study investigated the frequency of episodes and subsyndromal symptoms based on employment status in patients with bipolar disorder.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Dept. of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany. michael.bauer@uniklinikum-dresden.de
authors.forename: Michael
authors.initials: M
authors.lastname: Bauer
authors.forename: Tasha
authors.initials: T
authors.lastname: Glenn
authors.forename: Paul
authors.initials: P
authors.lastname: Grof
authors.forename: Natalie L
authors.initials: NL
authors.lastname: Rasgon
authors.forename: Wendy
authors.initials: W
authors.lastname: Marsh
authors.forename: Kemal
authors.initials: K
authors.lastname: Sagduyu
authors.forename: Martin
authors.initials: M
authors.lastname: Alda
authors.forename: Ute
authors.initials: U
authors.lastname: Lewitzka
authors.forename: Johanna
authors.initials: J
authors.lastname: Sasse
authors.forename: Eliza
authors.initials: E
authors.lastname: Kozuch-Krolik
authors.forename: Peter C
authors.initials: PC
authors.lastname: Whybrow
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology*; D017281:Cost of Illness; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012720:Severity of Illness Index; D018582:Sick Leave / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires