Should I stay or should I go? A prospective investigation examining individual factors impacting employment status among individuals with multiple sclerosis (MS).
Lauren B Strober, Nancy Chiaravalloti, John DeLuca
PMID 29355118WHAT IT FOUND
Among employed people with multiple sclerosis, those considering leaving work had higher physical fatigue, lower self-efficacy, and relied more on behavioral disengagement than humor.
This pattern appeared early in the disease course, suggesting psychosocial factors drive job decisions before physical disability peaks.
Key findings
01In the final statistical model, physical fatigue, use of humor, and behavioral disengagement were the most significant predictors distinguishing those considering leaving work from those staying.
02Individuals considering reducing hours or leaving reported greater anxiety, more negative self-evaluative symptoms, and lower general and MS-specific self-efficacy compared to those staying employed.
03Half of the participants considering leaving the workforce had been diagnosed with MS within the past three years, whereas 55% of the staying group had a disease duration of nine years or more.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was very small (40 participants total), limiting the generalizability of the findings. All participants had relapsing-remitting MS, so results do not apply to those with progressive forms of the disease. The study relied on self-reported intent to leave rather than actual employment status changes over time, so it captures a snapshot of decision-making rather than long-term outcomes. No objective measures of disease severity (like EDSS) or cognitive testing were included, meaning physical and cognitive impairments could not be directly correlated with the psychological findings.
Declared interests
The authors declare no conflicts of interest. The study was approved by the Institutional Review Board of Kessler Foundation.
The easy way to misread this
Do not assume that physical disability or disease progression is the primary driver of unemployment in these early-stage patients. The data suggests that psychosocial factors like fatigue, low self-efficacy, and poor coping strategies are more predictive of leaving work than the length of time since diagnosis or objective disease severity.