Objective:

Many but not all persons with bipolar disorder require hospital care because of severe mood episodes. Likewise, some but not all patients experience long-term occupational dysfunction that extends beyond acute mood episodes. It is not known whether these dissimilar outcomes of bipolar disorder are driven by different polygenic profiles. Here, polygenic scores (PGSs) for major psychiatric disorders and educational attainment were assessed for associations with occupational functioning and psychiatric hospital admissions in bipolar disorder.

Methods:

A total of 4,782 patients with bipolar disorder and 2,963 control subjects were genotyped and linked to Swedish national registers. Longitudinal measures from at least 10 years of registry data were used to derive percentage of years without employment, percentage of years with long-term sick leave, and mean number of psychiatric hospital admissions per year. Ordinal regression was used to test associations between outcomes and PGSs for bipolar disorder, schizophrenia, major depressive disorder, attention deficit hyperactivity disorder (ADHD), and educational attainment. Replication analyses of hospital admissions were conducted with data from the Bipolar Disorder Research Network cohort (N=4,219).

Results:

Long-term sick leave and unemployment in bipolar disorder were significantly associated with PGSs for schizophrenia, ADHD, major depressive disorder, and educational attainment, but not with the PGS for bipolar disorder. By contrast, the number of hospital admissions per year was associated with higher PGSs for bipolar disorder and schizophrenia, but not with the other PGSs.

Conclusions:

Bipolar disorder severity (indexed by hospital admissions) was associated with a different polygenic profile than long-term occupational dysfunction. These findings have clinical implications, suggesting that mitigating occupational dysfunction requires interventions other than those deployed to prevent mood episodes.

中文翻译：

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双相情感障碍中不同多基因特征的职业功能障碍与入院的关系

 客观的：

许多（但不是全部）双相情感障碍患者因严重的情绪发作而需要住院治疗。同样，一些但不是所有患者都会经历长期的职业功能障碍，其范围超出了急性情绪发作的范围。目前尚不清楚双相情感障碍的这些不同结果是否是由不同的多基因特征驱动的。在这里，评估了主要精神疾病和教育程度的多基因评分（PGS）与双相情感障碍的职业功能和精神科住院的关系。

 方法：

共有 4,782 名双相情感障碍患者和 2,963 名对照受试者进行了基因分型，并与瑞典国家登记册相关联。使用至少 10 年登记数据的纵向测量来得出失业年数百分比、长期病假年数百分比以及每年精神病院入院的平均人数。序数回归用于测试双相情感障碍、精神分裂症、重度抑郁症、注意力缺陷多动障碍 (ADHD) 和教育程度的结果与 PGS 之间的关联。使用双相情感障碍研究网络队列 (N=4,219) 的数据对入院情况进行重复分析。

 结果：

双相情感障碍的长期病假和失业与精神分裂症、ADHD、重度抑郁症和教育程度显着相关，但与双相情感障碍的 PGS 无关。相比之下，每年住院人数与双相情感障碍和精神分裂症的较高 PGS 相关，但与其他 PGS 无关。

 结论：

双相情感障碍的严重程度（以入院情况为索引）与与长期职业功能障碍不同的多基因特征相关。这些发现具有临床意义，表明缓解职业功能障碍需要除预防情绪发作以外的干预措施。