Friday, 14 March 2014

Depression predicting loss of work

Are you depressed? If yes, you are more likely to lose your job. #MSblog #MSResearch

"This study suggests that depression is associated with loss of employment. However, when you adjust for other factors such us quality of life and fatigue the link between depression and loss of employment is lost. Why? I think the reason is that symptoms in MS are associated or linked to each other as complex. Depression, anxiety and fatigue are a good example of such a complex. If you are depressed you are more likely to be anxious and fatigued. If you are anxious you are more likely to be depressed and fatigued. If you complain of fatigue you are more likely to be depressed and anxious. Therefore depression is highly likely to be associated with loss of employment. It also makes sense and supports my clinical experience. 

"I have done a few clinic speak posts on depression in the recent past. I suggest you read these as it is clear that we have treatments for MS-related depression and no MSers should ignore their depression."


"Depression, the silent killer. Up to 50% of MSers will experience major depression in their lifetime; this is much higher than the general population or for people with other chronic disabling diseases, for example rheumatoid ...

#MSBlog #MSResearch #ClinicSpeak "For those us who see a lot of MSers we aware that there is strong link between depression and cognitive dysfunction and that both tend to get worse with increasing MS disability.

Patten et al. Depression as a predictor of occupational transition in a multiple sclerosis cohort. Funct Neurol. 2014;28(4):275-80

Background: In MS, transitions between working and not-working status may occur in association with depression. This can complicate MSers' ability to promptly obtain disability support due to an expectation that their functioning will improve after the depression resolves, a viewpoint that sees depression assuming a role as a causal determinant of disability. 


Methods: In this study, prospective data were used to model the relationship between depressive symptoms and the transition out of employment. 

Results: In unadjusted analyses, depression increased the risk of transition to non-working status, HR = 1.7 (95%CI 1.3-2.3). Adjustments for ambulation status, physical and mental quality of life composite scores and fatigue impact attenuated or eliminated the association. 

Conclusions: While depression commonly occurs around the time of occupational transitions in MS, it does not appear to be an independent or direct cause of such transitions.

"If you are not sure about being depressed you can always complete this screening questionnaire and rate it yourself. If you are depressed please discuss this with your GP, neurologist or MS clinical nurse specialist."

3 comments:

  1. Prof G,

    Could you imagine losing your job for no fault of your own? Imagine the impact on your sense of worth / your family. Could you imagine losing your driving licence? More time at home to think about your loss of independence. I hate the research posted above (both posts), as (i) they just highlight what we already know / experience and (ii) they demonstrate again that research money is being wasted on psycho babble and statements of the blindingly obvious. If only research could concentrate on what the sufferer wants i.e. Stopping the disease and repairing the damage.

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  2. I think the researchers are saying that accumulating disability leads to increased depression/loss of work. Since there is no effective treatment for progression they might as well medicate to alleviate depression. Unfortunately this does not address underlying cause but medicating may be effective in mental well being. Treat what you can mentality.

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  3. Prof G,

    I know you have a duty to present this research to highlight the severity of the disease and the greater costs it has, further than the visible effects others in society see, however, I can't agree more with the sentiments of the above poster!

    As if we weren't depressed enough already, it's got to be continaully rubbed in our faces. Please more of the research progress and less of the stuff that makes you want to buy that one way ticket to Zurich!


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