title: Work Participation and Executive Abilities in Patients with Relapsing-Remitting Multiple Sclerosis.
abstract: The majority of patients with Multiple Sclerosis (MS) are unable to retain employment within 10 years from disease onset. Executive abilities, such as planning, working memory, attention, problem solving, inhibition and mental flexibility may have a direct impact on the ability to maintain a job. This study investigated differences in subjective and objective executive abilities between relapsing-remitting MS patients with and without a paid job. We included 55 relapsing-remitting MS patients from a community-based sample (47 females; mean age: 47 years; 36% employed). Patients underwent neurological, cognitive and psychological assessments at their homes, including an extensive executive test battery. We found that unemployed patients had a longer disease duration (t(53)=2.76, p=0.008) and reported more organising and planning problems (χ2(1)=6.3, p=0.012), higher distractibility (Kendall's tau-b= -0.24, p=0.03) and more cognitive fatigue (U=205.0, p=0.028, r=-0.30) than employed patients. Unemployed patients completed slightly less categories on the Wisconsin Card Sorting Test (U=243.5, p=0.042, r=-0.28). Possible influential factors such as age, educational level, physical functioning, depression and anxiety did not differ between groups. In conclusion, while relapsing-remitting MS patients without a paid job reported more executive problems and cognitive fatigue than patients with a paid job, little differences were found in objective executive abilities. Further research is needed to examine possible causal relations.
authors.affiliation: National MS Foundation, Maassluis, The Netherlands; Department of Psychology, Section Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands; Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands.
authors.forename: Karin
authors.initials: K
authors.lastname: van der Hiele
authors.affiliation: National MS Foundation, Maassluis, The Netherlands; Department of Psychology, Section Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands; Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands; University of Humanistic Studies, Utrecht, The Netherlands.
authors.forename: Dennis
authors.initials: D
authors.lastname: van Gorp
authors.affiliation: Medical Psychiatric Centre PsyToBe, Rotterdam, The Netherlands.
authors.forename: Rob
authors.initials: R
authors.lastname: Ruimschotel
authors.affiliation: Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Noëlle
authors.initials: N
authors.lastname: Kamminga
authors.affiliation: Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands; University of Humanistic Studies, Utrecht, The Netherlands.
authors.forename: Leo
authors.initials: L
authors.lastname: Visser
authors.affiliation: Department of Psychology, Section Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands; Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Huub
authors.initials: H
authors.lastname: Middelkoop
mesh_terms: D000328:Adult; D004651:Employment; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000503:physiopathology* / Q000523:psychology