University of Toronto, 27 King's College Circle, Toronto, ON, M5S 1A1, Canada.
J Neurol. 2011 Feb;258(2):244-9. doi: 10.1007/s00415-010-5736-8. Epub 2010 Sep 12.
As many as two-thirds of multiple sclerosis (MS) patients are unable to retain employment. Neurological and cognitive status are known to be significant predictors of unemployment, but the relationship between the two is unclear. Furthermore, the association between employment status and depression, anxiety, and personality has not been adequately explored in MS patients. This study examined the demographic, neurological, neuropsychological, and personality factors associated with unemployment in MS. We also sought to determine the utility of the Multiple Sclerosis Functional Composite (MSFC), a measure of MS-related disability incorporating physical and cognitive measures, in predicting employment status. A consecutive sample of 106 MS patients (61.3% unemployed) completed the Brief Repeatable Battery of Neuropsychological Tests (BRBN), Hospital Anxiety and Depression Scale (HADS), and NEO Five-Factor Personality Inventory. The MSFC emerged as the most robust predictor of employment status in MS patients, exceeding the predictive value of the EDSS. Together with NEO "Agreeableness" and HADS Depression subscore, the MSFC accounted for 49.8% of the variance in employment status. Unemployment was also associated with a progressive disease course, longer disease duration, and being female. While Global Cognitive Impairment did not differentiate between groups, unemployed patients scored significantly lower on three of five BRBN indices: Symbol Digit Modality Test, Paced Auditory Serial Addition Test, and Word List Generation. The findings highlight the utility of the MSFC as a predictor of unemployment in MS. Furthermore, a strong association was found between unemployment and the personality construct "Agreeableness", and severity of depression.
多达三分之二的多发性硬化症（MS）患者无法维持就业。神经和认知状态是失业的重要预测因素，但两者之间的关系尚不清楚。此外，MS 患者的就业状况与抑郁、焦虑和人格之间的关系尚未得到充分探讨。本研究探讨了与 MS 患者失业相关的人口统计学、神经学、神经心理学和人格因素。我们还试图确定多发性硬化症功能综合评定（MSFC）在预测就业状况方面的效用，该评定是一种衡量多发性硬化症相关残疾的综合评定，包含身体和认知测量。连续样本 106 例 MS 患者（61.3%失业）完成了简短重复神经心理测试（BRBN）、医院焦虑和抑郁量表（HADS）和 NEO 五因素人格量表。MSFC 是 MS 患者就业状况的最有力预测因素，超过了 EDSS 的预测价值。与 NEO“宜人性”和 HADS 抑郁分量表一起，MSFC 解释了就业状况变异的 49.8%。失业也与进行性疾病过程、更长的疾病持续时间和女性有关。虽然总体认知障碍不能区分两组，但失业患者在 BRBN 的五个指数中的三个指数上得分显著较低：符号数字模态测试、定速听觉序列加法测试和单词列表生成。这些发现突出了 MSFC 作为 MS 患者失业预测因素的效用。此外，失业与人格结构“宜人性”和抑郁严重程度之间存在很强的关联。
