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Socio-economic functioning in patients with bipolar disorder and their unaffected siblings – results from a nation-wide population-based longitudinal study

Published online by Cambridge University Press:  26 May 2021

Kimie Stefanie Ormstrup Sletved Open the ORCID record for Kimie Stefanie Ormstrup Sletved [Opens in a new window] ,
Simon Christoffer Ziersen ,
Per Kragh Andersen ,
Maj Vinberg  and
Lars Vedel Kessing
Kimie Stefanie Ormstrup Sletved*
Affiliation:
Copenhagen Affective disorder Research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark
Simon Christoffer Ziersen
Affiliation:
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
Per Kragh Andersen
Affiliation:
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
Maj Vinberg
Affiliation:
Copenhagen Affective disorder Research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Psychiatric Research Unit, Psychiatric Centre North Zealand, Hillerød, Denmark
Lars Vedel Kessing
Affiliation:
Copenhagen Affective disorder Research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
*
Author for correspondence: Kimie Stefanie Ormstrup Sletved, E-mail: Kimie.stefanie.ormstrup.sletved@regionh.dk
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Abstract

Background

Few studies have reported real-life data on socio-economic functioning in patients with bipolar disorder and their unaffected first-degree relatives.

Methods

We used Danish nation-wide population-based longitudinal register linkage to investigate socio-economic functioning in 19 955 patients with bipolar disorder, their 13 923 siblings and 20 sex, age and calendar-matched control individuals from the general population. Follow-up was from 1995 to 2017.

Results

Patients with a diagnosis of bipolar disorder had lower odds of having achieved the highest educational level [OR 0.75 (95% confidence interval (CI) 0.73–0.77)], being employed [OR 0.16 (95% CI 0.159–0.168)], having achieved the 80% highest quartile of income [OR 0.33 (95% CI 0.32–0.35)], cohabitating [OR 0.44 (95% CI 0.43–0.46)] and being married [OR 0.54 (95% CI 0.52–0.55)] at first contact to hospital psychiatry as inpatient or outpatient compared with control individuals from the general population. Similarly, siblings to patients with bipolar disorder had a lower functioning within all five socio-economic areas than control individuals. Furthermore, patients and partly siblings showed substantially decreased ability to enhance their socio-economic functioning during the 23 years follow-up compared to controls.

Conclusions

Socio-economic functioning is substantially decreased in patients with bipolar disorder and their siblings and does not improve during long-term follow-up after the initial hospital contact, highlighting a severe and overlooked treatment gap.

Keywords

Bipolar disordercohabitationeducationemploymentincomemarital statusrelativesfirst-degree relativessiblingshigh-risksocio-economic functioning
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 3 , February 2023 , pp. 706 - 713
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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