Association of Occupational Dysfunction and Hospital Admissions With Different Polygenic Profiles in Bipolar Disorder

Area of Science:

• Psychiatry
• Genetics
• Public Health

Background:

• Bipolar disorder (BD) presents with varied severity, including severe mood episodes necessitating hospitalization and long-term occupational dysfunction.
• The genetic underpinnings of these distinct BD outcomes remain unclear.
• Investigating polygenic profiles may elucidate differing etiological pathways.

Purpose of the Study:

• To examine associations between polygenic scores (PGSs) for psychiatric disorders and educational attainment with occupational functioning and psychiatric hospital admissions in individuals with bipolar disorder.
• To determine if distinct polygenic profiles underlie severe mood episodes versus chronic occupational impairment in BD.

Main Methods:

• Utilized Swedish national registers for 4,782 BD patients and 2,963 controls, analyzing over 10 years of longitudinal data.
• Derived measures of unemployment, long-term sick leave, and psychiatric hospital admissions.
• Assessed associations using ordinal regression with PGSs for BD, schizophrenia, major depressive disorder, ADHD, and educational attainment, with replication for hospital admissions.

Main Results:

• Long-term occupational dysfunction (sick leave, unemployment) in BD was linked to PGSs for schizophrenia, ADHD, major depressive disorder, and educational attainment, but not the BD PGS.
• Psychiatric hospital admissions in BD were associated with higher PGSs for bipolar disorder and schizophrenia.
• These findings indicate divergent genetic influences on different BD outcomes.

Conclusions:

• Bipolar disorder severity, measured by hospital admissions, is associated with a distinct polygenic profile compared to long-term occupational dysfunction.
• These results suggest that interventions targeting occupational dysfunction in BD may need to differ from those aimed at preventing mood episodes.
• Understanding these genetic differences could lead to more personalized treatment strategies for bipolar disorder.