Physical and Mental Health Outcomes Following Unemployment: A Preliminary Report

Background: Unemployment rates in multiple sclerosis (MS) are as high as 80% with a majority becoming unemployed within the first 5 to 10 years of diagnosis. Given the known physical and mental health outcomes associated with becoming unemployed in the general population, it is conceivable that individuals with MS will experience the same outcomes, and possible further reductions in health and well-being.

Objectives: The present study aimed to examine the immediate (6 month) outcomes of becoming unemployed among a small sample of individuals with MS.

Methods: A large sample of individuals with MS were followed as part of a prospective, longitudinal study examining the antecedents and consequences of unemployment in MS. Within the first year, nine individuals left the workforce. A comparable sample who stayed employed were matched to this sample on gender, age, education, and disease course. The groups were then compared on physical and mental health variables to determine the outcomes of becoming unemployed.

Results: Those who left the workforce reported significantly greater mood (ƞ² = .27, .028) and vegetative (ƞ² = .33, .012) symptoms of depression following leaving. They also endorsed increases of harm avoidance (ƞ² = .34, .011) and neuroticism (ƞ² = .17, .089), accompanied with lower levels of extraversion (ƞ² = .26, .031). Together, these attributes are akin to a Type D personality, which is associated with many negative health outcomes. Those who left also reported lower levels of social support (ƞ² = .17, .093) and MS self-efficacy (ƞ² = .11, .178), known contributors to depression and other poor outcomes in MS. But, perhaps of greater importance is that more than half (56%) of the individuals who left work were only within 5 years of diagnosis and the majority (89%) had a relapsing remitting course, suggesting a decline in 6 months early on in the disease process.   

Conclusions: While only preliminary data, these findings suggest that individuals who leave the workforce (particularly early on in the disease process), may experience negative outcomes. Findings suggest that early intervention may be warranted to assure that individuals with MS maintain their work status for as long as possible and be aware of the outcomes that can ensue after leaving the workforce and ways to buffer their effects.