title: [Chronically ill and unemployed? A review on vocational status in multiple sclerosis].
abstract: BACKGROUND
  Multiple sclerosis (MS) is one of the most common neurological disorders in young adults. It is characterised by a chronic progressive course with far reaching implications on the patient's private and professional life. Based on the current literature, employment status is analysed in relation to disease-specific, therapeutic, psychosocial, and socioeconomic factors. A special emphasis is placed on the vocational status of MS patients in Germany.
  
  
  RESULTS
  According national and international studies, around 40 % of all MS patients are currently unemployed. Main reasons for early retirement are disease-specific factors such as impaired mobility, disability in the upper extremities, fatigue, and cognitive impairment. According to the German Multiple Sclerosis Registry (GMSR), these symptoms are still insufficiently treated. In patients with minor motoric impairment (EDSS ≤ 3.0), depressive symptoms seem to have a major impact on employment status. Disease progression, older age at diagnosis, and hard physical work are negative predictors in terms of employment situation. The lack of flexible working hours, the inability to have flexible resting times at work, a lack of understanding from colleagues and employers as well as the personal attitude were main non-disease-specific reasons for early retirement.
  
  
  CONCLUSIONS
  The current knowledge on the vocational status in MS is mainly based on international studies (e. g., Scandinavia, England, USA, Australia, MSIF Survey). For Germany, only the GMSR supports significant information on the employment status of MS patients. According to the GMSR, ataxia, fatigue and cognitive dysfunction are still insufficiently treated - a situation that is at least partly due to insufficient treatment options. Comprehensive studies that focus on a broad range of possible influencing factors on vocational status of German MS patients are currently lacking.
authors: Klinik u. Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Germany. Simone.Kern@uniklinikumdresden.de
authors: S
authors: S
authors: Kern
authors: M
authors: M
authors: Kühn
authors: T
authors: T
authors: Ziemssen
mesh_terms: D000367:Age Factors; D004651:Employment; D005858:Germany / Q000453:epidemiology; D006801:Humans; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D010551:Personality; D011788:Quality of Life; D012959:Socioeconomic Factors