The influence of coping styles on long-term employment in multiple sclerosis: A prospective study.
BACKGROUND
The aim was to investigate predictive values of coping styles, clinical and demographic factors on time to unemployment in patients diagnosed with multiple sclerosis (MS) during 1998-2002 in Norway.


METHODS
All patients ( N = 108) diagnosed with MS 1998-2002 in Hordaland and Rogaland counties, Western Norway, were invited to participate in the long-term follow-up study in 2002. Baseline recordings included disability scoring (Expanded Disability Status Scale (EDSS)), fatigue (Fatigue Severity Scale (FSS)), depression (Beck Depression Inventory (BDI)), and questionnaire assessing coping (the Dispositional Coping Styles Scale (COPE)). Logistic regression analysis was used to identify factors associated with unemployed at baseline, and Cox regression analysis to identify factors at baseline associated with time to unemployment during follow-up.


RESULTS
In all, 41 (44%) were employed at baseline. After 13 years follow-up in 2015, mean disease duration of 22 years, 16 (17%) were still employed. Median time from baseline to unemployment was 6 years (±5). Older age at diagnosis, female gender, and depression were associated with patients being unemployed at baseline. Female gender, long disease duration, and denial as avoidant coping strategy at baseline predicted shorter time to unemployment.


CONCLUSIONS
Avoidant coping style, female gender, and longer disease duration were associated with shorter time to unemployment. These factors should be considered when advising patients on MS and future employment.
KG Jebsen MS Research Centre, Institute of Clinical Medicine, University of Bergen, Bergen, Norway/Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway.
Nina
N
Grytten
Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway.
Anne Br
AB
Skår
Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway.
Jan Harald
JH
Aarseth
Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
Jorg
J
Assmus
Department of Neurology, Stavanger University Hospital, Stavanger, Norway/Neuroscience Research Group, Stavanger University Hospital, Stavanger, Norway/Institute of Clinical Medicine, University of Bergen, Bergen, Norway.
Elisabeth
E
Farbu
Department of Research, Stavanger University Hospital, Stavanger, Norway.
Kirsten
K
Lode
Institute of Clinical Medicine, University of Bergen, Bergen, Norway.
Harald I
HI
Nyland
Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway/Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway.
Tori
T
Smedal
KG Jebsen MS Research Centre, Institute of Clinical Medicine, University of Bergen, Bergen, Norway/Norwegian Multiple Sclerosis Registry and Biobank, Department of Neurology, Haukeland University Hospital, Bergen, Norway.
Kjell Morten
KM
Myhr
D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D017281:Cost of Illness; D003863:Depression / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D018868:Insurance, Disability; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D015999:Multivariate Analysis; D009664:Norway; D016017:Odds Ratio; D010415:Pensions; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014478:Unemployment
Multiple sclerosis; epidemiology