title: Work impairment in bipolar disorder patients--results from a two-year observational study (EMBLEM).
abstract: OBJECTIVE
  To explore factors associated with work impairment at 2 years following an acute episode.
  
  
  METHODS
  European Mania in Bipolar disorder Longitudinal Evaluation of Medication (EMBLEM) is a prospective, observational study on the outcomes of patients with a manic/mixed episode. Work impairment was measured using a Longitudinal Interval Follow-up Evaluation (slice of LIFE) item and patients were categorised with either low or high work impairment at each observation. Baseline factors associated with work impairment at 2 years were assessed using multivariate modelling.
  
  
  RESULTS
  At baseline (n=2289), 69% of patients had high work impairment. At 2 years (n=1393), high impairment reduced to 41%. Modelling identified rapid cycling as the strongest disease-related factor associated with high work impairment at 2 years, although high work impairment at baseline had the strongest association overall. Lower levels of education, recent admissions, CGI-BP overall severity in the 12 months prior to baseline and CGI-BP mania at baseline all predicted higher work impairment. Living together in a relationship and independent housing were both significantly associated with having low work impairment at 2 years.
  
  
  CONCLUSIONS
  Work impairment in bipolar disorder is maintained over long periods, and is strongly associated with relationship status, living conditions and various disease-related factors.
authors.affiliation: Eli Lilly and Company Limited, Lilly Research Centre, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, Windlesham GU20 6PH, UK. reed_catherine@lilly.com
authors.forename: C
authors.initials: C
authors.lastname: Reed
authors.forename: I
authors.initials: I
authors.lastname: Goetz
authors.forename: E
authors.initials: E
authors.lastname: Vieta
authors.forename: M
authors.initials: M
authors.lastname: Bassi
authors.forename: J M
authors.initials: JM
authors.lastname: Haro
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014937:Work / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D014150:Antipsychotic Agents