title: High prevalence of unemployment in patients with systemic lupus erythematosus: association with organ damage and health-related quality of life.
abstract: OBJECTIVE
  To evaluate employment status in relation to organ damage, demographic factors, and health-related quality of life (HRQOL) in patients with systemic lupus erythematosus (SLE).
  
  
  METHODS
  One hundred forty-seven patients with SLE, aged 18 to 64 years, were included. Examination of self-reported HRQOL was performed using the Medical Outcome Study Short Form-36 (SF-36). Demographic factors, disease characteristics, and HRQOL were compared between patients with and without paid employment using nonparametric tests.
  
  
  RESULTS
  In 147 patients with SLE (mean age 38.4 +/- 11 yrs, mean disease duration 6.3 +/- 6.5 yrs), we found a high rate of unemployment (59%), whereas 93% of patients had previously worked. In patients who had stopped or reduced working, 75% attributed their withdrawal from work at least in part to disease-related factors. Unemployed patients had a significantly higher median age at disease onset, a higher frequency of neuropsychiatric organ damage and diabetes mellitus, and lower HRQOL than employed patients.
  
  
  CONCLUSIONS
  We found a high rate of unemployment (59%) in patients with SLE. Higher age at disease onset, neuropsychiatric organ damage, diabetes mellitus, and reduced HRQOL were associated with unemployment in patients with SLE. Our findings highlight the need to develop strategies to reduce work loss in patients with SLE, for both individual and socioeconomic reasons.
authors.affiliation: Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands. iem.bultink@vumc.nl
authors.forename: Irene E M
authors.initials: IE
authors.lastname: Bultink
authors.forename: Franktien
authors.initials: F
authors.lastname: Turkstra
authors.forename: Ben A C
authors.initials: BA
authors.lastname: Dijkmans
authors.forename: Alexandre E
authors.initials: AE
authors.lastname: Voskuyl
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D018582:Sick Leave / Q000706:statistics & numerical data*; D014478:Unemployment / Q000706:statistics & numerical data*