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Employment trends in schizophrenia and bipolar disorder in Spain: a nationwide register-based study (2018-2023).

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Τίτλος: Employment trends in schizophrenia and bipolar disorder in Spain: a nationwide register-based study (2018-2023).
Συγγραφείς: Llorca-Bofí V; Barcelona Clínic Schizophrenia Unit (BCSU), Hospital Clínic de Barcelona, Neuroscience Institute, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain. vicentllorcabofi@gmail.com.; Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Catalonia, Spain. vicentllorcabofi@gmail.com.; Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. vicentllorcabofi@gmail.com., Anmella G; Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Catalonia, Spain.; Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.; Bipolar and Depressive Disorders Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain., Guinart D; Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.; Institut de Salut Mental, Hospital del Mar, Barcelona, Spain.; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA., Paredes-Coronel C; Clinical and Organizational Innovations Unit, Quirónsalud 4-H Network, Madrid, Spain.; Instituto de Investigación Sanitaria, Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain., Hidalgo-Mazzei D; Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Catalonia, Spain.; Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.; Bipolar and Depressive Disorders Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain., Vieta E; Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Catalonia, Spain.; Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.; Bipolar and Depressive Disorders Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain., Bioque M; Barcelona Clínic Schizophrenia Unit (BCSU), Hospital Clínic de Barcelona, Neuroscience Institute, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain. mbioque@clinic.cat.; Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Catalonia, Spain. mbioque@clinic.cat.; Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. mbioque@clinic.cat.
Πηγή: European archives of psychiatry and clinical neuroscience [Eur Arch Psychiatry Clin Neurosci] 2026 Sep; Vol. 276 (6), pp. 3137-3145. Date of Electronic Publication: 2026 Jun 04.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Springer International Country of Publication: Germany NLM ID: 9103030 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-8491 (Electronic) Linking ISSN: 09401334 NLM ISO Abbreviation: Eur Arch Psychiatry Clin Neurosci Subsets: MEDLINE
Imprint Name(s): Original Publication: Berlin ; New York : Springer International, c1990-
Ιατρικοί όροι (MeSH): Schizophrenia*/epidemiology , Employment*/trends , Employment*/statistics & numerical data , Registries*/statistics & numerical data , Bipolar Disorder*/epidemiology, Spain/epidemiology ; Humans ; Adult ; Female ; Middle Aged ; Male ; Young Adult
Περίληψη: Background: Employment is a key determinant of recovery in severe mental illness, yet longitudinal evidence from Southern Europe is limited. We aimed to examine national trends in employment status among individuals with schizophrenia and bipolar disorder in Spain between 2018 and 2023.
Methods: We conducted a register-based trend study using the Spanish Primary Care Clinical Database (BDCAP), including adults aged 20-64 years with schizophrenia (n = 139,594), bipolar disorder (n = 148,968), or other diagnoses (n = 25,953,622). Employment status was classified as employed, unemployed, economically inactive, disability pensions, or other statuses. Trends were analysed with Joinpoint regression, reporting Average Annual Percent Change (AAPC) with 95% CIs.
Results: In 2023, 15.2% of people with schizophrenia and 38.3% with bipolar disorder were employed, versus 62.5% with other conditions. Disability pensions were received by 49.3% and 26.5%, compared with 6.3% in other diagnoses. Between 2018 and 2023, employment rose modestly in schizophrenia (AAPC =  + 2.2; 95% CI 0.8-3.6; p < 0.001) and bipolar disorder (+ 2.4; 95% CI 1.6-3.2; p < 0.001), while disability pensions declined (-5.5; 95% CI - 8.9 to - 2.1; p = 0.003; and - 7.2; 95% CI - 9.4 to - 5.1; p < 0.001). The "other statuses" category grew sharply (schizophrenia + 52.8; bipolar disorder + 35.4; both p < 0.001). Sex-stratified analyses showed parallel trends, except for economic inactivity, which declined more steeply among women (Δ trend =  + 3.1, p = 0.029; + 2.7, p = 0.031; + 3.2, p = 0.008).
Conclusions: Employment outcomes remain poor for people with schizophrenia and bipolar disorder in Spain. Most improvements likely reflect administrative changes rather than genuine integration into work.
(© 2026. The Author(s).)
Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests.
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Contributed Indexing: Keywords: Bipolar disorder; Employment; Longitudinal trends; Population-based data; Schizophrenia; Spain
Entry Date(s): Date Created: 20260603 Date Completed: 20260829 Latest Revision: 20260901
Update Code: 20260901
PubMed Central ID: PMC13525965
DOI: 10.1007/s00406-026-02279-x
PMID: 42236526
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1433-8491
DOI:10.1007/s00406-026-02279-x