Employment outcomes in people with bipolar disorder: A systematic review

S. Marwaha*, A. Durrani, S. Singh

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

49 Citations (Scopus)


Objective: Employment outcome in bipolar disorder is an under investigated, but important area. The aim of this study was to identify the long-term employment outcomes of people with bipolar disorder. Method: A systematic review using the Medline, PsychInfo and Web of Science databases. Results: Of 1962 abstracts retrieved, 151 full text papers were read. Data were extracted from 25 papers representing a sample of 4892 people with bipolar disorder and a mean length of follow-up of 4.9 years. Seventeen studies had follow-up periods of up to 4 years and eight follow-up of 5-15 years. Most studies with samples of people with established bipolar disorder suggest approximately 40-60% of people are in employment. Studies using work functioning measures mirrored this result. Bipolar disorder appears to lead to workplace underperformance and 40-50% of people may suffer a slide in their occupational status over time. Employment levels in early bipolar disorder were higher than in more established illness. Conclusion: Bipolar disorder damages employment outcome in the longer term, but up to 60% of people may be in employment. Whilst further studies are necessary, the current evidence provides support for extending the early intervention paradigm to bipolar disorder.

Original languageEnglish
Pages (from-to)179-193
Number of pages15
JournalActa Psychiatrica Scandinavica
Issue number3
Publication statusPublished - 1 Sept 2013


  • Bipolar disorder
  • Employment
  • Outcome
  • Work

ASJC Scopus subject areas

  • Psychiatry and Mental health


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