This study explored the clinical and psychosocial predictors of work adjustment in 52 Bipolar I patients over a 2-year longitudinal period and examined associations between work functioning and social relationships, personality features, stressful life events, and clinical variables. Analyses indicated that psychosocial variables (personality disorder symptoms and social functioning) added significantly to prediction of work functioning after clinical variables were entered. Stressful life events were not associated with work adjustment. Overall, presence of a good quality supportive relationship was the strongest unique predictor of work. The results highlight the need to study functional outcomes in patients, especially because they appear only modestly associated with clinical status.