How Do Genes Influence Work Life and Hospitalizations in Bipolar Disorder?

What you need to know

• Different genetic factors influence whether someone with bipolar disorder will struggle with work versus need hospitalization
• Genes linked to educational achievement and ADHD affect ability to maintain employment
• Genes specifically associated with bipolar disorder and schizophrenia influence how often someone needs hospital care

The Hidden Struggles Behind Bipolar Disorder

Living with bipolar disorder involves more than just managing mood episodes. While some people primarily struggle with severe mood swings requiring hospital stays, others face ongoing challenges maintaining stable employment - even when their moods are relatively stable. Until now, we haven’t fully understood why these different patterns occur. New research suggests that distinct genetic factors may help explain why some people with bipolar disorder face different types of challenges.

Understanding Genetic Risk Scores

To understand how genes influence different aspects of bipolar disorder, researchers use something called polygenic risk scores (PGS). These scores look at thousands of genetic variations across a person’s DNA to estimate their genetic predisposition for different traits or conditions. Think of it like a weather forecast - it can’t predict exactly what will happen, but it can indicate increased chances for certain outcomes.

Different Genes, Different Challenges

In this study of over 4,700 people with bipolar disorder, researchers found that different sets of genes were associated with different types of challenges. The genes that increased someone’s risk of needing hospitalization were not the same genes that made it harder to maintain steady employment.

Specifically, people who needed more frequent hospitalizations were more likely to have genetic variants associated with bipolar disorder and schizophrenia. However, their ability to work was more strongly influenced by genes linked to educational achievement, ADHD, and depression.

Why Employment Matters

The finding about employment is particularly important because work difficulties affect both quality of life and society’s healthcare costs. About 30-60% of people with bipolar disorder struggle to maintain full functioning at work, even when their mood symptoms are under control. In fact, unemployment and long-term sick leave account for about 75% of the societal costs associated with bipolar disorder.

Beyond Mood Episodes

These results challenge the common assumption that treating mood episodes alone will automatically improve all aspects of life for people with bipolar disorder. While managing mood swings is crucial, the genetic findings suggest that other factors - like attention, cognitive ability, and educational achievement - play important roles in determining how well someone functions at work.

What This Means for You

If you or someone you love has bipolar disorder, these findings suggest that:

• Different aspects of the disorder may need different types of support and treatment
• Struggling with work doesn’t necessarily mean mood treatment is failing
• Additional interventions targeting cognitive function or ADHD symptoms might help improve work outcomes
• A personalized treatment approach considering all aspects of functioning may be most beneficial

Conclusions

• The genetic factors that influence hospitalization rates are different from those affecting work ability
• Treatment plans should address both mood symptoms and functional challenges
• Supporting work function may require different strategies than preventing mood episodes
• Future treatments might be more effective by taking a more comprehensive, personalized approach based on each person’s specific challenges