The impact of bipolar disorder upon work functioning: A qualitative analysis

Authors: Migliore, A., Timmons, J., Butterworth, J., & Lugas, J.
Year Published 2007
Publication Bipolar Disorders
Volume 9
Number 1
Pages 126-143
Publisher John Wiley & Sons, Inc.

One important but sometimes poorly-captured area of functioning concerns an individual's ability to work. Several quantitative studies have now indicated that bipolar disorder (BD) can have a severe, and often enduring, negative impact upon occupational functioning. While this data indicates that employment rates are relatively low in this patient population, it throws little light on the specific ways in which this complex psychiatric condition can affect work, or upon how these effects are subjectively interpreted by individuals with BD.


In order to further explain the relationship between bipolar disorder (BD) and work, the authors report here on a series of exploratory qualitative interviews undertaken to develop a disease-specific measure of quality of life in BD.


Most of this initial sample consisted of outpatients with BD. The second stage of the study actively recruited patients with BD from the University of British Columbia hospital in and outpatient departments.


To be eligible to participate, affected individuals had to be 18 years or older and fluent in English; no limitations were placed on the type of BD they had been diagnosed with. Demographic and diagnostic details were recorded on a standardized report form at the onset of each interview, but no confirmation of diagnosis was made. More females than males responded to our recruitment advertisements, resulting in there being more interviews with females (67%). Also, more interviews were conducted with people (64%) with a diagnosis of BD type I than BD type II or not otherwise specified/spectrum.

Data Collection

All of the interviews were tape recorded, transcribed verbatim and coded by the first author using basic qualitative research methods which included the following steps: (i) the transcripts were initially read through (without coding) in order to gain an overview of the main issues and themes raised by participants; (ii) the transcripts were read again several times, with all pertinent references to work being highlighted and detailed memos being made concerning emerging themes;?(iii) the number of participants describing a particular theme, and the frequency with which themes were mentioned, was recorded, as were instances where opposing viewpoints were apparent; and (iv) themes for discussion were selected on the basis of how many participants mentioned them, and how frequently they were mentioned.


There was no control or comparison condition.


Respondents described the different ways in which the symptoms of depression and hypomania presented in the workplace. Five main themes emerged from the data: lack of continuity in work history, loss, illness management strategies in the workplace, stigma and disclosure in the workplace, and interpersonal problems at work.


The qualitative data obtained through this study highlights the often complex, varied and intermittent effects of an episodic condition such as BD upon work functioning, and points to the importance of developing more sophisticated and precise measures of occupational functioning for this population.

Disabilities Emotional disturbance
Populations Male & Female
Outcomes Other
NIDILRR Funded Yes
Research Design Qualitative
Peer Reviewed Yes