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Factors related to difficulties with employment in patients with multiple sclerosis: a review of 2002–2011 literature

Schiavolin, Silviaa; Leonardi, Matildea; Giovannetti, Ambra M.a; Antozzi, Carlob; Brambilla, Laurab; Confalonieri, Paolob; Mantegazza, Renatob; Raggi, Albertoa

International Journal of Rehabilitation Research: June 2013 - Volume 36 - Issue 2 - p 105–111
doi: 10.1097/MRR.0b013e32835c79ea
Review articles

We assess the knowledge available on the difficulties experienced by multiple sclerosis (MS) patients in work-related activities. A literature review was carried out using the keywords ‘multiple sclerosis’ and ‘employment’ or ‘work’ through PubMed and EMBASE. Papers reporting patient-derived data on difficulties at work as primary or secondary outcome measures and published in the period 2002–December 2011 were searched. A total of 26 papers were selected, for a total of 32 507 patients (mean age 46.2 years; 42.1% with relapsing-remitting MS). Most papers reported observational studies or cross-sectional surveys focused on health-related quality of life and MS costs. Symptoms more frequently addressed are fatigue, mobility and cognitive impairments. Limited research has been carried out on the working environment. We found a relatively small number of papers published in the last 10 years on the difficulties that patients with MS can experience at work, and this kind of information always appeared as a secondary outcome. In general, it is possible to affirm that MS has a strong impact on patients’ employment status, as the mean unemployment rate was 59%. Research on factors promoting maintenance of remunerative employment is required.

Departments of aNeurology, Public Health and Disability Unit

bNeurology IV, Neuromuscular Diseases and Neuroimmunology, Neurological Institute C. Besta, IRCCS Foundation, Milano Italy

Correspondence to Silvia Schiavolin, PsyD, Neurology, Public Health and Disability Unit, Neurological Institute C. Besta, IRCCS Foundation, Via Celoria 11, 20133 Milano, Italy Tel: +39 02 2394 2949; fax: +39 02 2394 2442; e-mail:

Received July 10, 2012

Accepted November 4, 2012

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins