Unemployment and work disability in individuals with chronic fatigue syndrome/myalgic encephalomyelitis: study from Spain (2019) Castro-Marrero et al

[John Mac]

Study conducted by a Hospital CFS/ME unit in Barcelona, Spain.

Background
Few reports have examined the association between unemployment and work disability in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). This study explored the key determinants of work disability in a CFS/ME cohort.

Methods
A community-based prospective study included 1086 CFS/ME patients aged 18–65 years. Demographic and clinical characteristics and outcome measures were recorded. Multiple linear regression analysis was performed to identify key risk indicators of work disability.

Results
Four hundred and fifty patients with CFS/ME were employed (41.4%) and 636 were unemployed (58.6%). Older age at pain onset (OR: 1.44; 95% CI: 1. 12–1.84, autonomic dysfunction (OR: 2.21; 95% CI: 1.71–2.87), neurological symptom (OR: 1.66; 95% CI: 1. 30–2.13) and higher scores for fatigue (OR: 2.61; 95% CI: 2.01–3.39), pain (OR: 2.09; 95% CI: 1.47–2.97), depression (OR: 1.98; 95% CI: 1. 20–3.26), psychopathology (OR: 1.98; 95% CI: 1.51–2.61) and sleep dysfunction (OR: 1.47; 95% CI: 1. 14–1.90) were all associated with a higher risk of work disability due to illness.

Conclusions
Using an explanatory approach, our findings suggest that unemployment is consistently associated with an increased risk of work disability due to CFS/ME, although further more rigorous research is now needed to help in targeting interventions at the workplace.

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7225-z

 

[Peter T]

This looks a potentially interesting study, but I am struggling to understand it at present.

I could not work out what is meant by ‘work disability’ independent of ‘work status’. Are they trying to distinguish between people unable to work because of their ME from people unemployed for other reasons?

 

[Hoopoe]

The presence of a larger number of symptoms was indicative of unemployment in all clinical groups in the univariate analysis. However, in the multivariate model only autonomic dysfunction symptoms remained as a significant predictive factor.

This sounds interesting. This seems to suggest that the treatment that can reverse these symptoms might have the biggest impact on ability to work.

 

[Trish]

I've had a quick look through it. They studied hundreds of patients with ME attending a clinic - lots of questionnaires. The outcome was that those not in work, or on extended sick leave, had slightly more symptoms and lower function. No surprises there - if you're sicker you're less able to work.

The conclusion focuses on the suggestion that this study can be used somehow to inform individualised rehabilitation strategies and workplace adjustments. They don't demonstrate that this is a feasible or appropriate approach or how the study would be helpful for this. Sounds too like AfME's approach to me.