부산대학교 도서관

Atsuko Ikenouchi,1,2 Yusuke Konno,1,3 Yoshihisa Fujino,3 Naoto Adachi,4 Yukihisa Kubota,4 Takaharu Azekawa,4 Hitoshi Ueda,4 Koji Edagawa,4 Eiichi Katsumoto,4 Eiichiro Goto,4 Seiji Hongo,4 Masaki Kato,5,6 Takashi Tsuboi,5,7 Norio Yasui-Furukori,5,8 Atsuo Nakagawa,5,9 Toshiaki Kikuchi,5,9 Koichiro Watanabe,5,7 Reiji Yoshimura1,5 1Department of Psychiatry, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan; 2Medical Center for Dementia, Hospital of the University of Occupational and Environmental Health, Japan, Kitakyushu, Japan; 3Department of Environmental Epidemiology, Institute of Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan; 4The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan; 5The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; 6Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan; 7Department of Neuropsychiatry, Kyorin University, Tokyo, Japan; 8Department of Psychiatry, Dokkyo Medical University, Tochigi, Japan; 9Department of Neuropsychiatry, Keio University, Tokyo, JapanCorrespondence: Atsuko Ikenouchi, Department of Psychiatry, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu, 807-8555, Japan, Tel +81-93-691-7253, Fax +81-93-692-4894, Email atsuko-i@med.uoeh-u.ac.jpPurpose: To clarify the relationship between the length of unstable periods and employment status of patients with bipolar disorder.Patients and Methods: Medical records of outpatients with bipolar disorder who visited 176 member clinics of the Japanese Association of Neuro-Psychiatric Clinics were investigated during September–October 2016, and details of their medical care and employment were surveyed using a questionnaire. The odds ratios (ORs) of length of unstable period and unemployment were analyzed with a logistic regression model.Results: The study included 816 patients, of whom 707 were employed full-time (continuous employment) and 70 were unemployed (loss of employment). Univariate analysis showed that ORs were statistically significant for patients who were unstable for “almost all” of the year (OR = 10.4 [4.48– 24.28] p < 0.001), but not for “few” unstable periods (OR = 1.06 [0.56– 1.98] p = 0.849) and for “significant” unstable periods (OR = 1.65 [0.73– 3.74] p = 0.231) were not significantly different. Multivariate analysis showed that ORs were statistically “significant” for patients who were unstable for “almost all” (OR = 12.1 [4.37– 33.3] p < 0.001), but not for “few” unstable periods (OR = 1.07 [0.55– 2.07] p = 0.846) and for “significant” unstable periods (OR = 1.62 [0.66– 3.98] p = 0.290) did not differ significantly.Conclusion: Patients with bipolar disorder with a long unstable period were associated with a higher risk of unemployment.Keywords: mood disorder, loss of employment, nationwide study, real world