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Employment among people with schizophrenia or bipolar disorder: A population‐based study using nationwide registers
Author(s) -
Holm Minna,
Taipale Heidi,
Tanskanen Antti,
Tiihonen Jari,
MitterdorferRutz Ellenor
Publication year - 2021
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.13254
Subject(s) - bipolar disorder , schizophrenia (object oriented programming) , psychiatry , gee , population , psychosis , psychology , bipolar i disorder , medicine , clinical psychology , generalized estimating equation , mania , cognition , statistics , environmental health , mathematics
Abstract Objective To assess the employment rate and the related background factors among people with schizophrenia or bipolar disorder. Methods We identified all people in Sweden aged 18–64 years diagnosed with schizophrenia or bipolar disorder in nationwide registers in the years 2006–2013. The identified individuals were grouped by main activity or source of income. The association between background factors and employment was analyzed with generalized estimating equations (GEE). Results Three years before the first psychosis or bipolar disorder diagnosis, 24% of the individuals with schizophrenia and 45% of the individuals with bipolar disorder were employed. However, the employment rate dropped around the time of the first diagnosis. Five years later, 10% of the individuals with schizophrenia and 34% of the individuals with bipolar disorder were employed. The most important factors associated with employment after diagnosis were a high level of education, older age at the first registered diagnosis, no substance use disorder, and a low number of previous hospitalizations. Marriage or cohabiting, higher level of education, and higher age at the first diagnosis were associated with an increased employment rate especially among people with schizophrenia, and substance use was associated with a lower employment rate, especially among people with bipolar disorder. Men with bipolar disorder had a higher employment rate than women. Conclusion The employment rate is low among people with schizophrenia and higher among people with bipolar disorder. The association of background characteristics with employment was mostly in the same direction both in schizophrenia and in bipolar disorder.