Objective: Much of the global burden of bipolar disorder results from impairment in work functioning when patients are depressed. Although it is well recognized that depression is associated with work absence and reduced productivity, there is little information on which specific symptoms are most impairing. This study sought to determine which depressive symptoms were perceived by patients with bipolar disorder as most interfering with their work functioning.
Methods: Consecutive patients meeting DSM-IV criteria for bipolar disorder I or II were assessed at a Mood Disorders outpatient clinic. All patients completed a standard assessment that included validated symptom and functioning scales, as well as a self-rated questionnaire asking specifically about symptoms that interfered with work functioning.
Results: Data from 54 patients with bipolar disorder (type I=11, type II=43) were available. The mean score on the Quick Inventory of Depressive Symptomatology (QIDS-SR) was 14.9 ± 5.5, indicating moderately to markedly severe depression, and 90% of patients rated their work functioning as moderately to severely impaired, according to the Sheehan Disability Scale. The depressive symptoms that patients most rated as impairing work functioning were: feeling physically slowed down, lack of motivation, low energy, low mood, trouble concentrating, and sleeping too much.
Conclusions: Some depressive symptoms are perceived by patients as more distressing and interfering with work functioning than others. Understanding the symptomatology affecting work impairment may help to select treatments and monitor outcome to ensure optimal recovery of work functioning during treatment for bipolar disorder.