Social Aspects of the Workplace Among Individuals with Bipolar Disorder

Background and Purpose: Bipolar disorder (BD) is characterized by recurrent mood episodes and profound impairments in psychosocial functioning. Occupational disability is one of the most problematic impairments for individuals with BD due to high rates of unemployment and work impairments. Current evidence indicates that social stressors at work—such as social isolation, conflict with others, and stigmas—are common experiences for employed individuals with BD. Yet, few studies have examined the relationship between social stressors at work and overall occupational functioning, instead focusing on individual clinical features of the disorder. The goal of this study is to identify associations of mood and social aspects of the work environment to predict work status (working vs. not working) and work functioning among a sample of individuals with BD. Based on current research, it is hypothesized that—out of a subset of demographic, mood symptoms, and social aspects of the work environment—higher depressive symptomatology, lower levels of social support, and higher degrees of stigma will be associated with poorer work functioning and unemployment.

Methods: This cross-sectional study recruited participants from an ongoing, naturalistic, longitudinal study of BD (the Prechter Longitudinal Study of BD) at a large university in the Midwestern United States. 400 adult participants (over 18) with a DSM-IV diagnosis of bipolar I disorder or bipolar II disorder were invited to participate via a mailed letter with self-report measures included. The response rate for this mailing was 32% (129 participants). The sample included 61 non-working adults with BD (mean age of 47 years, SD 5 13.31) and 68 working adults with BD (mean age of 51 years, SD 5 12.35). This study employed logistic and linear regressions to determine which demographic variables, mood symptoms, and social aspects of the work environment (exclusion, conflict, social support, stigma) were associated with work status (working vs. not working) and work functioning forindividuals with bipolar disorder I and II.

Results: Greater stigma and exclusion at work (p < .05) are associated with unemployment among adult individuals with BD, and higher degrees of depression and conflict at work (p < .05) are associated with work impairments for employed individuals.

Conclusions/Implications: By examining two distinct measures of work outcomes (work status and work functioning) within the same group of participants, this study provides a unique insight, revealing that predictors of occupational functioning vary based on the specific measure of work outcomes used. This study also emphasizes the need for treatments that address the clinical features of BD and intervene in the work environment to improve functioning and prevent unemployment among individuals with BD.