Risk Factors for Unemployment in People With MS Identified in Study

Factors related to disease and personality, as well as specific health-related behaviors, are among the main determinants that can put people with multiple sclerosis (MS) at risk of unemployment, a study suggests.

In particular, MS disease course, fatigue, self-efficacy (belief in one’s own abilities to cope, in this case, with their disease), and diet/exercise were found to affect the risk of unemployment in MS.

These findings highlight the importance of considering these factors as targets for intervention to help keep MS patients employed.

The study, “Determinants of unemployment in multiple sclerosis (MS): The role of disease, person-specific factors, and engagement in positive health-related behaviors,” was published in the journal Multiple Sclerosis and Related Disorders.

The unemployment rate among people with MS is high — up to 80% — and it especially affects patients in the early stages of the disease.

“Risk of unemployment is highest during the first three to five years after diagnosis, so we need to be able to intervene early to prevent job losses, and their subsequent impact on physical and mental health, as well as on personal and family finances,” Lauren Strober, PhD, author of the study, said in a press release.

Thus, it is important to identify risk factors and behaviors that may affect employment and therefore be targets for intervention.

To address this issue, Strober, a senior research scientist at the Center for Neuropsychology and Neuroscience Research at Kessler Foundation, evaluated demographic, disease, and individual factors as well as health-related behaviors and their associated risk for unemployment in a group of MS patients.

The study involved 252 people with MS, ages 20–64, who were working at least part time. Participants were divided into two groups: those who were considered “at risk” and those “not at risk” for unemployment. Of the participants, 67 were defined as at risk for leaving the workforce because they were considering reducing their working hours or leaving their jobs in the near future.

Both groups were compared according to factors such as disease features, personality, and health-related behaviors.

Strober found that some disease-related factors were different between the two groups. Particularly, people at risk of unemployment were more likely to have a progressive disease course, fatigue, sleep problems, pain, anxiety, and depression.

This group also showed less belief in their ability to control their own lives, lower levels of self-efficacy, and more difficulty in dealing with their disease.

In terms of personality, people at risk were more likely to be moody and tended to be less conscientious, extraverted, and agreeable than those who were not at risk.

Patients considered not at risk for unemployment were more likely to engage in positive health-related behaviors such as healthy diets, exercise, and social and intellectual activities, compared with MS patients at risk.

Overall, according to Strober, the factors that most significantly distinguished both groups were disease course, fatigue, self-efficacy, and diet/exercise. These factors should be considered in personalized interventions for MS patients to maintain their employment status and/or make appropriate work accommodations.

“This study points to factors related to risk of unemployment that may be amenable to early intervention,” Strober said. “While further research is needed, professionals who provide MS care should be aware of the potential impact of this diagnosis on future employment, and be prepared to intervene before individuals leave the work force.”