Work Participation and Executive Abilities in Patients with Relapsing-Remitting Multiple Sclerosis

Karin van der Hiele; Dennis van Gorp; Rob Ruimschotel; Noëlle Kamminga; Leo Visser; Huub Middelkoop

doi:10.1371/journal.pone.0129228

Work Participation and Executive Abilities in Patients with Relapsing-Remitting Multiple Sclerosis

PLoS One. 2015 Jun 17;10(6):e0129228. doi: 10.1371/journal.pone.0129228. eCollection 2015.

Authors

Karin van der Hiele¹, Dennis van Gorp², Rob Ruimschotel³, Noëlle Kamminga⁴, Leo Visser⁵, Huub Middelkoop⁶

Affiliations

¹ 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.
² 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.
³ Medical Psychiatric Centre PsyToBe, Rotterdam, The Netherlands.
⁴ Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.
⁵ Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands; University of Humanistic Studies, Utrecht, The Netherlands.
⁶ Department of Psychology, Section Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands; Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.

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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Employment*
Executive Function*
Female
Humans
Male
Middle Aged
Multiple Sclerosis, Relapsing-Remitting / physiopathology*
Multiple Sclerosis, Relapsing-Remitting / psychology

Grants and funding

This research was financially supported by the National MS Foundation The Netherlands. The first author, Karin van der Hiele, was employed by the National MS Foundation and had a role in study design, data collection and analysis, decision to publish, and preparation of the manuscript. The second author, Dennis van Gorp, is currently affiliated with the National MS Foundation. Volunteers working for the National MS Foundation helped with data collection by sending out questionnaires.