Chapter 6. The Economic and Social Burden of Bipolar Disorder

  1. Mario Maj3,
  2. Hagop S. Akiskal4,
  3. Juan José López-Ibor5 and
  4. Norman Sartorius6
  1. Professor Joseph F. Goldberg1 and
  2. Dr. Carrie L. Ernst2

Published Online: 25 APR 2002

DOI: 10.1002/047084650X.ch6

Bipolar Disorder, Volume 5

Bipolar Disorder, Volume 5

How to Cite

Goldberg, J. F. and Ernst, C. L. (2002) The Economic and Social Burden of Bipolar Disorder, in Bipolar Disorder, Volume 5 (eds M. Maj, H. S. Akiskal, J. J. López-Ibor and N. Sartorius), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/047084650X.ch6

Editor Information

  1. 3

    University of Naples, Italy

  2. 4

    University of California, San Diego, USA

  3. 5

    Complutense University of Madrid, Spain

  4. 6

    University of Geneva, Switzerland

Author Information

  1. 1

    New York Presbyterian Hospital, Payne Whitney Clinic, Box 140, 525 E 68th Street, New York, NY 10021, USA

  2. 2

    Departments of Medicine and Psychiatry, Harvard Medical School, Boston, MA, USA

Publication History

  1. Published Online: 25 APR 2002
  2. Published Print: 12 APR 2002

ISBN Information

Print ISBN: 9780471560371

Online ISBN: 9780470846506



  • bipolar disorder;
  • economics;
  • pharmacoeconomics;
  • service utilization;
  • disease burden;
  • disability


Despite advances in the treatment of bipolar illness, it remains a disorder associated with high psychosocial and functional disability. Less than 20% of the total economic costs associated with bipolar illness have been linked with direct treatment; the vast majority of its associated economic burden derives from consequences of under-treatment, delayed or inappropriate treatment, or nontreatment. Burden includes occupational impairment (e.g., worker absenteeism and diminished productivity), loss of independent community living, forensic problems, suicide, and family and caregiver demands. Lithium has dramatically reduced overall illness costs, while newer pharmacotherapies may further help to reduce both direct and indirect illness expenses. Illness burden has further diminished by improved early diagnosis and the psychotherapies that integrate relapse prevention, medication compliance, and cognitive, interpersonal and family-based illness dimensions. Issues regarding diagnosis, treatment, and functional rehabilitation are considered as a focus for future clinical and research efforts in order to reduce costs from both an economic and psychosocial perspective.