The association between employment and psychological health in adults with multiple sclerosis was examined (N = 33 studies). Standardised mean differences (Hedges’ g) between those employed and those not in the workforce were calculated. Employed peers reported significantly greater quality of life and mood, cited fewer work and multiple sclerosis–related difficulties and were more likely to adopt problem-focused coping strategies, considered to be more effective in managing specific stressors. These data are consistent with the positive by-products of maintaining work with multiple sclerosis. Further research is needed to determine the longitudinal course of coping for those who remain employed.
*Al-AsmiAAl-RawahiSAl-MoqbaliZS. (2015) Magnitude and concurrence of anxiety and depression among attendees with multiple sclerosis at a tertiary care Hospital in Oman. BMC Neurology15: 131.
2.
*BaumstarckKPelletierJAghababianV. (2012) Is the concept of quality of life relevant for multiple sclerosis patients with cognitive impairment? Preliminary results of a cross-sectional study. PLoS ONE7(1): e30627.
3.
*Baumstarck-BarrauKSimeoniMCReuterF. (2011) Cognitive function and quality of life in multiple sclerosis patients: A cross-sectional study. BMC Neurology11: 17.
4.
*BaylorCYorkstonKBamerA. (2010) Variables associated with communicative participation in people with multiple sclerosis: A regression analysis. American Journal of Speech-Language Pathology19(2): 143–153.
5.
BeattyWWBlancoCRWilbanksSL. (1995) Demographic, clinical, and cognitive characteristics of multiple sclerosis patients who continue to work. Journal of Neurologic Rehabilitation9: 167–173.
6.
*BeiskeAGBaumstarckKNilsenRM. (2012) Validation of the Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire in Norwegian patients. Acta Neurologica Scandinavia125(3): 171–179.
7.
BishopMRumrillPD (2015) Multiple sclerosis: Etiology, symptoms, incidence and prevalence, and implications for community living and employment. Work52(4): 725–734.
8.
*BishopMFrainMPRumrillPD. (2009) The relationship of self-management and disease modifying therapy use to employment status among adults with multiple sclerosis. Journal of Vocational Rehabilitation31: 119–127.
9.
BishopMRumrillPDRoesslerRT (2015) Quality of life among people with multiple sclerosis: Replication of a three-factor prediction model. Work52(4): 757–765.
10.
*BishopMRumrillPDJrTimblinRI (2016) Medical, psychosocial, and vocational aspects of multiple sclerosis: Implications for rehabilitation professionals. Journal of Rehabilitation82(2): 6–13.
11.
Bøe LundeHMTelstadWGryttenN. (2014) Employment among patients with multiple sclerosis-a population study. PLoS ONE9(7): e103317.
12.
BogenschutzMIngeKJRumrillPDJr. (2016) Barriers to and facilitators of employment among Americans with multiple sclerosis: Results of a qualitative focus group study. Journal of Rehabilitation82(2): 59–69.
13.
BritellCWCooperLDLawN (1993) Medical, functional, and legal aspects of vocational rehabilitation for people with multiple sclerosis. NeuroRehabilitation3(4): 39–47.
14.
BuchananRJStuifbergenAChakravortyBJ. (2006) Urban/rural differences in access and barriers to health care for people with multiple sclerosis. Journal of Health and Human Services Administration29: 360–375.
15.
BuscheKDFiskJDMurrayTJ. (2003) Short term predictors of unemployment in multiple sclerosis patients. Canadian Journal of Neurological Sciences30(2): 137–142.
16.
*CaddenMArnettP (2015) Factors associated with employment status in individuals with multiple sclerosis. International Journal of MS Care17(6): 284–291.
17.
*ChiuCYChanFSharpSE. (2015) Employment as a health promotion intervention for persons with multiple sclerosis. Work52: 749–756.
18.
CohenJ (1992) A power primer. Psychological Bulletin112(1): 155.
19.
*CostaDCSáMJMCalheirosJM (2013) Social characteristics and quality of life of Portuguese multiple sclerosis patients. Neurology and Therapy2: 43–56.
20.
CoyneKSBoscoeANCurrieBM. (2015) Understanding drivers of employment changes in a multiple sclerosis population. International Journal of MS Care17(5): 245–252.
21.
CummingG (2012) Understanding the New Statistics: Effect Sizes, Confidence Intervals, and Meta-Analysis. New York: Routledge.
22.
DooganCPlayfordED (2014) Supporting work for people with multiple sclerosis. Multiple Sclerosis20(6): 646–650.
23.
DorstynDSRobertsRMMurphyG. (2016) Piloting an email-based resource package for job-seekers with multiple sclerosis. Disability and Rehabilitation. Epub ahead of print 10April. DOI: 10.3109/09638288.2016.1161847.
24.
EcclesFJRSimpsonJ (2011) A review of the demographic, clinical and psychosocial correlates of perceived control in three chronic motor illnesses. Disability and Rehabilitation33: 1065–1088.
25.
*EdgeleyKSullivanMJLDehouxE (1991) A survey of multiple sclerosis: II. Determinants of employment status. Canadian Journal of Rehabilitation4(3): 127–132.
26.
Fantoni-QuintonSKwiatkowskiAVermerschP. (2015) Impact of multiple sclerosis on employment and use of job-retention strategies: The situation in France. Journal of Rehabilitation Medicine48(6): 535–540.
27.
*FernandezOFernandezVBaumstarck-BarrauK. (2011) Validation of the Spanish version of the Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire. BMC Neurology11: 127.
*FlensnerGLandtblomAMSoderhamn. (2013) Work capacity and health-related quality of life among individuals with multiple sclerosis reduced by fatigue: A cross-sectional study. BMC Public Health13: 224.
30.
FraserRTJohnsonEKClemmonsDC. (2003) Vocational rehabilitation in multiple sclerosis (MS): A profile of clients seeking services. Work21(1): 69–76.
31.
*GoveroverYStroberLChiaravollotiN. (2015) Factors that moderate activity limitation and participation restriction in people with multiple sclerosis. American Journal of Occupational Therapy69: 1–9.
32.
*GullickEE (1997) Correlates of quality of life among persons with multiple sclerosis. Nursing Research46(6): 305–311.
33.
HarboHFGoldRTintoréM (2013) Sex and gender issues in multiple sclerosis. Therapy Advances in Neurological Disorders6(4): 237–248.
34.
*HartoonianNTerrillALBeierML. (2015) Predictors of anxiety in multiple sclerosis. Rehabilitation Psychology60(1): 91–98.
35.
HigginsJPThompsonSGDeeksJJ. (2003) Measuring inconsistency in meta analyses. BMJ: British Medical Journal327(7414): 557–560.
36.
HigginsJPTGreenDG (eds). (2011). Cochrane. In: Handbook for Systematic Reviews of Interventions. Version 5.1.0 (Updated March 2011). The Cochrane Collaboration. Available from: www.cochrane-handbook.org.
37.
*HobartJLampingDFitzpatrickR. (2001) The Multiple Sclerosis Impact Scale (MSIS-29): A new patient-based outcome measure. Brain124(Pt 5): 962–973.
38.
HonanCABrownRFBatchelorJ (2015) Perceived cognitive difficulties and cognitive test performance as predictors of employment outcomes in people with multiple sclerosis. Journal of the International Neuropsychological Society21(2): 156–168.
39.
*HonanCABrownRFHineDW (2014) The multiple sclerosis work difficulties questionnaire (MSWDQ): Development of a shortened scale. Disability and Rehabilitation36(8): 635–641.
40.
*HonanCABrownRFHineDW. (2012) The Multiple Sclerosis Work Difficulties Questionnaire. Multiple Sclerosis Journal18(6): 871–880.
41.
*HonarmandKAkbarNKouN. (2011) Predicting employment status in multiple sclerosis patients: The utility of the MS functional composite. Journal of Neurology258: 244–249.
JellieBSweetlandJRiaziA. (2014) Staying at work and living with MS: A qualitative study of the impact of a vocational rehabilitation intervention. Disability and Rehabilitation36(19): 1594–1599.
44.
JohnsonKLYorkstonKMKlasnerER. (2004) The cost and benefits of employment: A qualitative study of experiences of persons with multiple sclerosis. Archives of Physical Medicine and Rehabilitation85(2): 201–209.
45.
*JonesKHFordDVJonesPA. (2013) The physical and psychological impact of multiple sclerosis using the MSIS-29 via the web portal of the UK MS register. PLoS ONE8(1): e55422.
46.
JulianLJVellaLVollmerT. (2008) Employment in multiple sclerosis: Exiting and re-entering the work force. Journal of Neurology255(9): 1354–1360.
47.
KhanFNgLTurner-StokesL (2009) Effectiveness of vocational rehabilitation intervention on the return to work and employment of persons with multiple sclerosis. Cochrane Database of Systematic Reviews1: CD007256.
48.
KhanFTurner-StokesLNgL. (2007) Multidisciplinary rehabilitation for adults with multiple sclerosis. Cochrane Database of Systematic Reviews18(2): CD006036.
49.
KinsingerSWLattieEMohrDC (2010) Relationship between depression, fatigue, subjective cognitive impairment, and objective neuropsychological functioning in patients with multiple sclerosis. Neuropsychology24(5): 573–580.
50.
Kirk-BrownAKVan DijkPASimmonsRD. (2014) Disclosure of diagnosis of multiple sclerosis in the workplace positively affects employment status and job tenure. Multiple Sclerosis20(7): 871–876.
51.
*KochLCRumrillPDJrRoesslerRT. (2001) Illness and demographic correlates of quality of life among people with multiple sclerosis. Rehabilitation Psychology46(2): 154–164.
52.
*KolzetJQuinnHZemonV. (2015) Predictors of body image related sexual dysfunction in men and women with multiple sclerosis. Sexuality and Disability33: 63–73.
53.
*KrauseIKernSHorntrichA. (2013) Employment status in multiple sclerosis: Impact of disease-specific and non-disease-specific factors. Multiple Sclerosis19(13): 1792–1799.
54.
*KrokavcovaMNagyovaIRosenbergerJ. (2012) Employment status and perceived health status in younger and older people with multiple sclerosis. International Journal of Rehabilitation Research35(1): 40–47.
55.
*KrokavcovaMNagyovaIvan DijkJP. (2010) Self-rated health and employment status in patients with multiple sclerosis. Disability and Rehabilitation32(21): 1742–1748.
McCabeMPMcKernSMcDonaldE (2004) Coping and psychological adjustment among people with multiple sclerosis. Journal of Psychosomatic Research56(3): 355–361.
58.
McDonaldWICompstonAEdanG. (2001) Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the diagnosis of multiple sclerosis. Annals of Neurology50(1): 121–127.
59.
McFaddenEHortonMCFordHL. (2012) Screening for the risk of job loss in multiple sclerosis (MS): Development of an MS-specific Work Instability Scale (MS-WIS). Multiple Sclerosis Journal18(6): 862–870.
60.
Messmer UccelliMSpecchiaCBattagliaMA. (2009) Factors that influence the employment status of people with multiple sclerosis: A multi-national study. Journal of Neurology256(12): 1989–1996.
61.
BorensteinMichaelHedgesLarry VHigginsJulian PTRothsteinHannah R (2009) Introduction to Meta-Analysis. Chichester: John Wiley & Sons.
62.
MilanliogluAÖzdemirPGCilingirV. (2014) Coping strategies and mood profiles in patients with multiple sclerosis. Arquivos de neuro-psiquiatria72(7): 490–495.
63.
*MilnerAPageALaMontagneAD (2013) Long-term unemployment and suicide: A systematic review and meta-analysis. PLoS ONE8(1): e51333.
64.
MilnerAPageALaMontagneAD (2014) Cause and effect in studies on unemployment, mental health and suicide: A meta-analytic and conceptual review. Psychological Medicine44(5): 909–917.
65.
MitchellAJBenito-LeónGonzálezJMM. (2005) Quality of life and its assessment in multiple sclerosis: Integrating physical and psychological components of wellbeing. The Lancet Neurology4: 556–566.
66.
MoherDLiberatiATetzlaffJ. (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA statement. Annals of Internal Medicine151: 264–269.
67.
*MoorePHardingKEClarksonH. (2013) Demographic and clinical factors associated with changes in employment in multiple sclerosis. Multiple Sclerosis Journal19(12): 1647–1654.
68.
NeathJRoesslerRTMcMahonBT. (2007) Patterns in perceived employment discrimination for adults with multiple sclerosis. Work29(3): 255–274.
69.
NyenhuisDLRaoSMZajeckaJM. (1995) Mood disturbance versus other symptoms of depression in multiple sclerosis. Journal of the International Neuropsychological Society1(3): 291–296.
70.
*O’BrienMT (1993) Multiple sclerosis: The relationship among self-esteem, social support and coping behaviour. Applied Nursing Research6(2): 54–63.
71.
*O’ConnorRJCanoSJRamióiTorrentàL. (2005) Factors influencing work retention for people with multiple sclerosis: Cross-sectional studies using qualitative and quantitative methods. Journal of Neurology252(8): 892–896.
72.
OrwinRG (1983) A fail-safe N for effect size in meta-analysis. Journal of Educational Statistics8(2): 157–159.
73.
*PackTGSzironyGMKushnerJD. (2014) Quality of life and employment in persons with multiple sclerosis. Work49(2): 281–287.
74.
PolmanCHReingoldSCBanwellB. (2011) Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Annals of Neurology69(2): 292–302.
75.
PolmanCHReingoldSCEdanG. (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the ‘McDonald Criteria’. Annals of Neurology58(6): 840–846.
76.
PompeiiLAMoonSDMcCroryDC (2005) Measures of physical and cognitive function and work status among individuals with multiple sclerosis: A review of the literature. Journal of Occupational Rehabilitation15(1): 69–84.
77.
PonzioMBrichettoGZaratinP. (2015) Workers with disability: The case of multiple sclerosis. Neurological Sciences36(10): 1835–1841.
78.
PoserCMPatyDWScheinbergL. (1983) New diagnostic criteria for multiple sclerosis: Guidelines for research protocols. Annals of Neurology13: 227–231.
79.
RaggiACovelliVSchiavolinS. (2015) Work-related problems in multiple sclerosis: A literature review on its associates and determinants. Disability and Rehabilitation38(10): 936–944.
80.
RiaziAHobartJLampingD. (2003) Using the SF-36 measure to compare the health impact of multiple sclerosis and Parkinson’s disease with normal population health profiles. Journal of Neurology, Neurosurgery and Psychiatry74(6): 710–714.
81.
RumrillPDSteffenJMSumnerG (1996) Job retention interventions for persons with multiple sclerosis. Work6(3): 185–190.
82.
*SchairerLCFoleyFWZemonV. (2014) The impact of sexual dysfunction on health-related quality of life in people with multiple sclerosis. Multiple Sclerosis Journal20(5): 610–616.
83.
SchiavolinSLeonardiMGiovannettiAM (2013) Factors related to difficulties with employment in patients with multiple sclerosis: A review of 2002–2011 literature. International Journal of Rehabilitation Research36(2): 105–111.
84.
ShahrbanianSAuaisMDuquetteP. (2013) Does pain in individuals with multiple sclerosis affect employment? A systematic review and meta-analysis. Pain Research and Management18(5): e94–e100.
85.
SimmonsRDTribeKLMcDonaldEA (2010) Living with multiple sclerosis: Longitudinal changes in employment and the importance of symptom management. Journal of Neurology257(6): 926–936.
86.
SkokouMSoubasiEGourzisP (2012) Depression in multiple sclerosis: A review of assessment and treatment approaches in adult and pediatric populations. International Scholarly Research Notices Neurology2012: 427102.
87.
*SmithMMArnettPA (2005) Factors related to employment status changes in individuals with multiple sclerosis. Multiple Sclerosis11: 602–609.
88.
*SolariARadiceD (2001) Health status of people with multiple sclerosis: A community mail survey. Neurological Sciences22: 307–315.
89.
*StroberLBArnettPA (2015) Unemployment among women with multiple sclerosis: The role of coping and perceived stress and support in the workplace. Psychology, Health & Medicine. Epub ahead of print 12October. DOI: 10.1080/13548506.2015.1093645.
90.
SweetlandJHowseEPlayfordD (2012) A systematic review of research undertaken in vocational rehabilitation for people with multiple sclerosis. Disability and Rehabilitation34(24): 2031–2038.
91.
SweetlandJRiaziACanoSJ. (2007)Vocational rehabilitation services for people with multiple sclerosis: What patients want from clinicians and employers. Multiple Sclerosis13(9): 1183–1189.
92.
*TadićDDajićV (2013) Quality of life in patients with multiple sclerosis in Republic of Srpska. Medicinski Glasnik10(1): 113–119.
93.
Van DenendT (2006) Employment needs of people with multiple sclerosis: A review of current literature and application to occupational therapy practice. Occupational Therapy in Health Care20(1): 61–77.
94.
*Van der HieleKMiddelkoopHARuimschotelR. (2014) A pilot study on factors involved with work participation in the early stages of multiple sclerosis. PLoS ONE9(8): e105673.
95.
*Van der HieleKvan GorpDRuimschotelR. (2015) Work participation and executive abilities in patients with relapsing-remitting multiple sclerosis. PLoS ONE10(6): e0129228.
96.
ViswanathanMAnsariMTBerkmanNDChangSHartlingLMcPheetersLM. . . TreadwellJR (2012) Assessing the risk of bias of individual studies in systematic reviews of health care interventions. Agency for Healthcare Research and Quality Methods Guide for Comparative Effectiveness Reviews (AHRQ Publication No. 12-EHC047-EF). Retrieved from: www.effectivehealthcare.ahrq.gov/
97.
YorkstonKMBamerAJohnsonK. (2012) Satisfaction with participation in multiple sclerosis and spinal cord injury. Disability and Rehabilitation34(9): 747–753.
98.
ZwibelHLSmrtkaJ (2011) Improving quality of life in multiple sclerosis: An unmet need. The American Journal of Managed Care. 17(Suppl. 5): S139–S145.
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