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Background There is conflicting evidence regarding the educational level and its importance for social and occupational functioning in bipolar disorder (BD). The aim of this study was to investigate how educational achievement relates to function in BD compared with the general population, and which clinical factors are associated with level of education. Methods Hospitalized patients with DSM-IV BD (N = 257; 69.3% BD I; 25.7% BD II; 5.1 BD NOS; 51.4% females) were consecutively recruited from mental health clinics throughout Norway and compared with a geographically matched reference sample from the general population (N = 56,540) on levels of education, marital status, income, and disability benefits. Further analyses of association were carried out using logistic regression analyses. Results A significantly higher proportion of subjects in the BD group than in the reference group was single, had low income, or was disabled. No between-group difference was found in educational level. In the reference group education was inversely correlated with the risk of being disabled, but no such relationship was found in the BD group. Rapid cycling and recurring depressive episodes were the only clinical characteristics associated with low educational level. Limitations Acutely admitted patients might not be representative for milder forms of disease. Conclusions Despite similar levels of education, BD patients had lower social and occupational function than the general population, and no association was found between education and disability for BD patients.

Background The aims of this study were to compare clinical characteristics and educational and occupational functioning in two Bipolar Disorder (BD) samples recruited respectively from acutely admitted inpatients and public outpatient clinics and to investigate if the two BD samples differed in the same way in education and work ability from the general population. Methods DSM-IV BD patients were consecutively recruited from acute wards throughout Norway (N = 252; 69.8% BD I; 25.0% BD II; 5.2% BD NOS) and from outpatient clinics in the Oslo region (N = 230; 60.4% BD I; 33.5% BD II; 6.1% BD NOS) and demographic and clinical characteristics were compared. A reference sample from the general population (N = 100 869) was used to compare levels of education, marital status and disability benefits. Results The acute ward sample was older, and had more men, more BD I disorder, more hospitalisations and suicide attempts, longer illness duration, an earlier age of onset and first treatment and used a higher number of antipsychotics, anticonvulsants and lithium than the outpatient sample. Both samples were educated to the same level as their respective reference populations, but received disability benefit and were single to a higher but similar degree. Conclusions Clinical differences between the BD samples had no consequence for educational achievement and receipt of disability benefit compared to the general population indicating that other factors than severity of illness play a role for education and work abilities in BD patients.