We conducted a systematic review in order to identify the long term employment outcomes of people with Bipolar Disorder. Our aims were to identify the proportions working over time, the nature of employment status change over time and whether employment rates after a single episode are different to rates in recurrent Bipolar Disorder.

We searched Medline, PsychInfo and Web of Science databases and used a predetermined decision tree to select papers for full text usage.

Out of 1410 abstracts retrieved, a total of 119 papers were selected for full text retrieval and 19 papers identified which met the full criteria for inclusion and data extraction. An assessment framework to assess the quality of papers was used to aid the analysis. There were few high quality studies. Most studies with samples of people with established Bipolar Disorder suggest that over a period of 5–15 years of follow-up, approximately 40–60% of people were in employment. However Bipolar Disorder appears to lead to underperformance whilst in employment and 40–50% of people may suffer a slide of their occupational status over time. Those with a first episode of Bipolar Disorder had a higher rate of employment than those with multiple episodes.

Bipolar disorders damage employment prospects for sufferers in the short and longer term, but up to around 60% of people may be able to recover to the extent that they are in paid work. Maximal damage to employment functioning may occur in the early phases of Bipolar Disorder.