The Economic Impact of Bipolar Disorder
Bipolar disorder is a mental health condition that affects millions of people worldwide. It is characterized by episodes of extreme mood swings, ranging from mania to depression. Bipolar disorder can have a significant impact on the quality of life, social functioning, and productivity of individuals living with the condition, as well as their families and caregivers. In this article, we will explore the economic burden of bipolar disorder in different aspects, such as direct health care costs, indirect costs, and humanistic costs.
Direct health care costs are the expenses associated with the diagnosis, treatment, and management of bipolar disorder. These include hospitalizations, outpatient visits, medications, laboratory tests, and other services. According to a systematic review of studies from the United States, the annual per patient direct health care costs of bipolar disorder ranged from $3,462 to $36,053, depending on the study design, data source, and severity of the condition1. The main drivers of direct health care costs were hospitalizations and medications, which accounted for 40% to 80% and 10% to 30% of the total costs, respectively1.
Indirect costs are the losses associated with the reduced or impaired ability to work or perform other activities due to bipolar disorder. These include absenteeism, presenteeism, unemployment, disability, premature mortality, and caregiver burden. According to a study of employed adults in the United States, the annual per patient indirect costs of bipolar disorder were estimated to be $14,109, which was significantly higher than the indirect costs of other chronic conditions, such as diabetes, asthma, and arthritis2. The main drivers of indirect costs were presenteeism and absenteeism, which accounted for 62% and 23% of the total costs, respectively2.
Humanistic costs are the intangible losses associated with the diminished health-related quality of life (HRQoL) and well-being of individuals with bipolar disorder and their families and caregivers. HRQoL is a multidimensional concept that reflects the physical, mental, and social aspects of health. Bipolar disorder can adversely affect HRQoL by causing emotional distress, functional impairment, social isolation, stigma, and discrimination. According to a cross-sectional study of adults in the United States, the HRQoL of individuals with bipolar disorder, measured by the EuroQol 5-Dimension Health Questionnaire (EQ-5D), was significantly lower than the HRQoL of the general population (0.69 vs. 0.79)3. The main factors associated with lower HRQoL were depressive symptom severity, comorbid anxiety, and substance use disorders3.
The economic burden of bipolar disorder is not only influenced by the condition itself, but also by the availability and effectiveness of treatment. Bipolar disorder is often underdiagnosed, misdiagnosed, or undertreated, which can lead to worse outcomes and higher costs. Studies have shown that only a minority of patients with bipolar disorder receive adequate treatment according to national guidelines, and that many patients experience delays in diagnosis and treatment initiation4 . Treatment that targets the reduction of depressive symptoms, which are more prevalent and disabling than manic symptoms, may reduce the economic and humanistic burden of bipolar disorder31.
In conclusion, bipolar disorder is a serious and costly condition that affects not only the individuals living with it, but also their families, caregivers, and society as a whole. The economic impact of bipolar disorder can be measured in terms of direct health care costs, indirect costs, and humanistic costs, which are all substantial and vary depending on the severity and treatment of the condition. Improving the detection, diagnosis, and treatment of bipolar disorder may improve the outcomes and quality of life of patients, as well as reduce the economic burden of the condition.