{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:01:40Z","timestamp":1781640100945,"version":"3.54.5"},"reference-count":54,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004047","name":"Karolinska Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In Sweden, many people with multiple sclerosis (PwMS) remain employed due to flexible work and social insurance support. However, as MS progresses, work income declines while reliance on sickness absence (SA) and disability pension (DP) increases. Self-rated health, a holistic measure of physical and mental well-being, is informative in the work context. This study aims to explore factors associated with combined categorical indicators that integrate employment status and self-rated health and examines factors associated with different employment-health states.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This population-based study included survey responses from 4329 PwMS linked to national register data. We categorized participants into four employment\u2013health groups based on self-rated health (high vs. low EQ-VAS) and employment status (working vs. receiving SA\/DP). Groups comparisons were conducted to describe differences in sociodemographic, clinical, mental health, and work-related characteristics. Multinomial logistic regression was then used to examine factors associated with group membership.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Women, older individuals, and those with progressive MS or more visible symptoms were more likely to be receiving SA\/DP. Depressive symptoms were more common among participants reporting low self-rated health, regardless of employment status, while disability, fatigue, and reduced work ability were associated with poorer health and reduced labor market participation. Fatigue emerged as a prevalent symptom across all groups, including those still working. Participants working despite low health reported insufficient or absent workplace adjustments, suggesting unmet support needs. Career and educational decisions were also influenced by MS, with many participants reducing working hours or avoiding job changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Employment status among PwMS did not perfectly reflect individual\u2019s overall well-being, particularly regarding mental health and fatigue. Nevertheless, clear group-level differences between those who were employed and those who were receiving part-time SA\/DP underscore the importance of early, tailored interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12883-026-04809-5","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T08:05:11Z","timestamp":1773216311000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Employment status and self-rated health in people with multiple sclerosis in Sweden"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8957-661X","authenticated-orcid":false,"given":"Alejandra","family":"Machado","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6544-6888","authenticated-orcid":false,"given":"Jessica","family":"Dervish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7874-4243","authenticated-orcid":false,"given":"Emilie","family":"Friberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"4809_CR1","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1177\/1352458517708682","volume":"23","author":"L Brundin","year":"2017","unstructured":"Brundin L, Kobelt G, Berg J, Capsa D, Eriksson J. New insights into the burden and costs of multiple sclerosis in Europe: results for Sweden. Mult Scler J. 2017;23:179\u201391.","journal-title":"Mult Scler J"},{"key":"4809_CR2","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1016\/j.jval.2017.09.021","volume":"21","author":"E Landfeldt","year":"2018","unstructured":"Landfeldt E, Castelo-Branco A, Svedbom A, L\u00f6froth E, Kavaliunas A, Hillert J. Personal income before and after diagnosis of multiple sclerosis. Value Health. 2018;21:590\u20135.","journal-title":"Value Health"},{"key":"4809_CR3","doi-asserted-by":"publisher","first-page":"1730","DOI":"10.1177\/1352458515570767","volume":"21","author":"M Wiberg","year":"2015","unstructured":"Wiberg M, Friberg E, Stenbeck M, Alexanderson K, Norlund A, Hillert J, Tingh\u00f6g P. Sources and level of income among individuals with multiple sclerosis compared to the general population: a nationwide population-based study. Mult Scler. 2015;21:1730\u201341.","journal-title":"Mult Scler"},{"key":"4809_CR4","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1080\/14034950410021808","volume":"63","author":"K Alexanderson","year":"2004","unstructured":"Alexanderson K, Norlund A. Swedish Council on Technology Assessment in Health Care (SBU). Chapter 1. Aim, background, key concepts, regulations, and current statistics. Scand J Public Health Suppl. 2004;63:12\u201330.","journal-title":"Scand J Public Health Suppl"},{"key":"4809_CR5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020392","volume":"8","author":"C Murley","year":"2018","unstructured":"Murley C, Mogard O, Wiberg M, Alexanderson K, Karampampa K, Friberg E, et al. Trajectories of disposable income among people of working ages diagnosed with multiple sclerosis: a nationwide register-based cohort study in Sweden 7 years before to 4 years after diagnosis with a population-based reference group. BMJ Open. 2018;8:20392.","journal-title":"BMJ Open"},{"key":"4809_CR6","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1111\/ene.13863","volume":"26","author":"A Castelo-Branco","year":"2019","unstructured":"Castelo-Branco A, Landfeldt E, Svedbom A, L\u00f6froth E, Kavaliunas A, Hillert J. Clinical course of multiple sclerosis and labour-force absenteeism: a longitudinal population-based study. Eur J Neurol. 2019;26:603\u20139.","journal-title":"Eur J Neurol"},{"key":"4809_CR7","doi-asserted-by":"publisher","DOI":"10.1177\/20552173241304324","volume":"11","author":"FS Teni","year":"2025","unstructured":"Teni FS, Machado A, Dervish J, Fink K, Gyllensten H, Friberg E. Factors associated with self-reported work ability among people with multiple sclerosis in Sweden. Multiple Sclerosis Journal \u2013 Experimental, Translational and Clinical. 2025;11:20552173241304324.","journal-title":"Multiple Sclerosis Journal \u2013 Experimental, Translational and Clinical"},{"key":"4809_CR8","doi-asserted-by":"publisher","DOI":"10.1177\/2055217318822134","volume":"5","author":"A Kavaliunas","year":"2019","unstructured":"Kavaliunas A, Tingh\u00f6g P, Friberg E, Olsson T, Alexanderson K, Hillert J, et al. Cognitive function predicts work disability among multiple sclerosis patients. Multiple Sclerosis Journal - Experimental, Translational and Clinical. 2019;5:205521731882213.","journal-title":"Multiple Sclerosis Journal - Experimental, Translational and Clinical"},{"key":"4809_CR9","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1177\/1352458518769837","volume":"25","author":"G Kobelt","year":"2019","unstructured":"Kobelt G, Langdon D, J\u00f6nsson L. The effect of self-assessed fatigue and subjective cognitive impairment on work capacity: the case of multiple sclerosis. Mult Scler. 2019;25:740\u20139.","journal-title":"Mult Scler"},{"key":"4809_CR10","doi-asserted-by":"publisher","first-page":"2031","DOI":"10.3109\/09638288.2012.669019","volume":"34","author":"J Sweetland","year":"2012","unstructured":"Sweetland J, Howse E, Playford ED. A systematic review of research undertaken in vocational rehabilitation for people with multiple sclerosis. Disabil Rehabil. 2012;34:2031\u20138.","journal-title":"Disabil Rehabil"},{"key":"4809_CR11","volume":"8","author":"E van Egmond","year":"2022","unstructured":"van Egmond E, van der Hiele K, van Gorp D, et al. Work difficulties in people with multiple sclerosis: the role of anxiety, depression and coping. Mult Scler J Exp Transl Clin. 2022;8:20552173221116282.","journal-title":"Mult Scler J Exp Transl Clin"},{"key":"4809_CR12","doi-asserted-by":"publisher","DOI":"10.1177\/20552173221090653","author":"D Ellenberger","year":"2022","unstructured":"Ellenberger D, Parciak T, Brola W, Hillert J, Middleton R, Stahmann A, et al. Comparison of employment among people with Multiple Sclerosis across Europe. Mult Scler J Exp Transl Clin. 2022;8. https:\/\/doi.org\/10.1177\/20552173221090653.","journal-title":"Mult Scler J Exp Transl Clin"},{"key":"4809_CR13","doi-asserted-by":"publisher","first-page":"106911","DOI":"10.1016\/j.msard.2025.106911","volume":"106","author":"CA Young","year":"2026","unstructured":"Young CA, Rog D, Tanasescu R, Sharrack B, Kalra S, Mills R, et al. Employment status in people with multiple sclerosis: profile, dynamic changes and determinants over time. Mult Scler Relat Disord. 2026;106:106911. https:\/\/doi.org\/10.1016\/j.msard.2025.106911.","journal-title":"Mult Scler Relat Disord"},{"key":"4809_CR14","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1002\/hec.1361","volume":"18","author":"P B\u00f6ckerman","year":"2009","unstructured":"B\u00f6ckerman P, Ilmakunnas P. Unemployment and self-assessed health: evidence from panel data. Health Econ. 2009;18:161\u201379.","journal-title":"Health Econ"},{"key":"4809_CR15","unstructured":"Swedish Discrimination law [Diskrimineringslag]. 2008:567. https:\/\/www.riksdagen.se\/sv\/dokument-och-lagar\/dokument\/svensk-forfattningssamling\/diskrimineringslag-2008567_sfs-2008-567\/. Accessed 11 Feb 2026."},{"key":"4809_CR16","doi-asserted-by":"publisher","first-page":"e058948","DOI":"10.1136\/bmjopen-2021-058948","volume":"12","author":"BK Vitturi","year":"2022","unstructured":"Vitturi BK, Rahmani A, Dini G, et al. Occupational outcomes of people with multiple sclerosis: a scoping review. BMJ Open. 2022;12:e058948.","journal-title":"BMJ Open"},{"key":"4809_CR17","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1191\/1352458505ms1204oa","volume":"11","author":"MM Smith","year":"2005","unstructured":"Smith MM, Arnett PA. Factors related to employment status changes in individuals with multiple sclerosis. Mult Scler. 2005;11:602\u20139.","journal-title":"Mult Scler"},{"key":"4809_CR18","doi-asserted-by":"publisher","first-page":"e0267115","DOI":"10.1371\/journal.pone.0267115","volume":"17","author":"D Hamplov\u00e1","year":"2022","unstructured":"Hamplov\u00e1 D, Klus\u00e1\u010dek J, Mr\u00e1\u010dek T. Assessment of self-rated health: the relative importance of physiological, mental, and socioeconomic factors. PLoS One. 2022;17:e0267115.","journal-title":"PLoS One"},{"key":"4809_CR19","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1007\/s11136-013-0537-z","volume":"23","author":"Y Feng","year":"2014","unstructured":"Feng Y, Parkin D, Devlin NJ. Assessing the performance of the EQ-VAS in the NHS PROMs programme. Qual Life Res. 2014;23:977\u201389.","journal-title":"Qual Life Res"},{"key":"4809_CR20","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1177\/13524585231164295","volume":"29","author":"E Rodriguez Llorian","year":"2023","unstructured":"Rodriguez Llorian E, Zhang W, Khakban A, et al. Employment status, productivity loss, and associated factors among people with multiple sclerosis. Mult Scler. 2023;29:866\u201374.","journal-title":"Mult Scler"},{"key":"4809_CR21","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1007\/s10926-023-10142-2","volume":"34","author":"A Machado","year":"2024","unstructured":"Machado A, Murley C, Dervish J, Teni FS, Friberg E. Work adjustments by types of occupations amongst people with multiple sclerosis: a survey study. J Occup Rehabil. 2024;34:461\u201371. https:\/\/doi.org\/10.1007\/s10926-023-10142-2.","journal-title":"J Occup Rehabil"},{"key":"4809_CR22","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1177\/1352458517690821","volume":"23","author":"RH Benedict","year":"2017","unstructured":"Benedict RH, DeLuca J, Phillips G, LaRocca N, Hudson LD, Rudick R. Validity of the symbol digit modalities test as a cognition performance outcome measure for multiple sclerosis. Mult Scler. 2017;23:721\u201333.","journal-title":"Mult Scler"},{"key":"4809_CR23","doi-asserted-by":"publisher","first-page":"e087563","DOI":"10.1136\/bmjopen-2024-087563","volume":"14","author":"A Machado","year":"2024","unstructured":"Machado A, Wredendal E, Fink K, Friberg E. Workplace and social support, treatment satisfaction, and their impact on quality of life in Swedish women with multiple sclerosis: a cross-sectional survey study. BMJ Open. 2024;14:e087563.","journal-title":"BMJ Open"},{"key":"4809_CR24","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s40258-017-0310-5","volume":"15","author":"NJ Devlin","year":"2017","unstructured":"Devlin NJ, Brooks R. EQ-5D and the EuroQol group: past, present and future. Appl Health Econ Health Policy. 2017;15:127\u201337.","journal-title":"Appl Health Econ Health Policy"},{"key":"4809_CR25","doi-asserted-by":"crossref","unstructured":"EuroQol - a new facility for the measurement of health-related quality of life. Health Policy. 1990;16:199\u2013208.","DOI":"10.1016\/0168-8510(90)90421-9"},{"key":"4809_CR26","doi-asserted-by":"publisher","first-page":"S28","DOI":"10.1016\/j.apmr.2011.01.025","volume":"92","author":"D Cella","year":"2011","unstructured":"Cella D, Nowinski C, Peterman A, Victorson D, Miller D, Lai J-S, Moy C. The neurology quality-of-life measurement initiative. Arch Phys Med Rehabil. 2011;92:S28\u201336.","journal-title":"Arch Phys Med Rehabil"},{"key":"4809_CR27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12955-023-02115-z","volume":"21","author":"FS Teni","year":"2023","unstructured":"Teni FS, Burstr\u00f6m K, Devlin N, et al. Experience-based health state valuation using the EQ VAS: a register-based study of the EQ-5D-3L among nine patient groups in Sweden. Health Qual Life Outcomes. 2023;21:1\u201317.","journal-title":"Health Qual Life Outcomes"},{"key":"4809_CR28","doi-asserted-by":"publisher","first-page":"197","DOI":"10.5127\/jep.008310","volume":"2","author":"J DeCoster","year":"2011","unstructured":"DeCoster J, Gallucci M, Iselin A-M. Best practices for using median splits, artificial categorization, and their continuous alternatives. J Experimental Psychopathol. 2011;2:197\u2013209.","journal-title":"J Experimental Psychopathol"},{"key":"4809_CR29","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1007\/s11136-021-02982-3","volume":"31","author":"FS Teni","year":"2022","unstructured":"Teni FS, Gerdtham U-G, Leidl R, Henriksson M, \u00c5str\u00f6m M, Sun S, Burstr\u00f6m K. Inequality and heterogeneity in health-related quality of life: findings based on a large sample of cross-sectional EQ-5D-5L data from the Swedish general population. Qual Life Res. 2022;31:697\u2013712.","journal-title":"Qual Life Res"},{"key":"4809_CR30","unstructured":"The Swedish Social Insurance Agency [F\u00f6rs\u00e4kringskassan]. Social Insurance in Figures 2016. Stockholm, Sweden: Swedish Social Insurance Agency; 2016. Available from: https:\/\/www.forsakringskassan.se\/download\/18.68ee6a4218b7864af03455\/1708521584925\/social-insurance-in-figures-2016.pdf"},{"key":"4809_CR31","doi-asserted-by":"publisher","DOI":"10.3390\/jpm11101006","volume":"11","author":"PK Coyle","year":"2021","unstructured":"Coyle PK. What can we learn from sex differences in MS? J Pers Med. 2021;11:1006.","journal-title":"J Pers Med"},{"key":"4809_CR32","doi-asserted-by":"publisher","first-page":"e024836","DOI":"10.1136\/bmjopen-2018-024836","volume":"9","author":"M Wiberg","year":"2019","unstructured":"Wiberg M, Murley C, Tingh\u00f6g P, Alexanderson K, Palmer E, Hillert J, et al. Earnings among people with multiple sclerosis compared to references, in total and by educational level and type of occupation: a population-based cohort study at different points in time. BMJ Open. 2019;9:e024836.","journal-title":"BMJ Open"},{"key":"4809_CR33","doi-asserted-by":"publisher","first-page":"e0288998","DOI":"10.1371\/journal.pone.0288998","volume":"18","author":"A Machado","year":"2023","unstructured":"Machado A, Azad A, Pettersson E, Hillert J, Alexanderson K, Friberg E. Gender differences in earnings among people with multiple sclerosis and associations with type of occupation and family composition: a population-based study with matched references. PLoS One. 2023;18:e0288998.","journal-title":"PLoS One"},{"key":"4809_CR34","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2020.102077","volume":"42","author":"C Murley","year":"2020","unstructured":"Murley C, Karampampa K, Alexanderson K, Hillert J, Friberg E. Diagnosis-specific sickness absence and disability pension before and after multiple sclerosis diagnosis: an 8-year nationwide longitudinal cohort study with matched references. Mult Scler Relat Disord. 2020;42:102077.","journal-title":"Mult Scler Relat Disord"},{"key":"4809_CR35","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1038\/s41582-022-00735-5","volume":"18","author":"R Dobson","year":"2022","unstructured":"Dobson R, Rice DR, D\u2019hooghe M, et al. Social determinants of health in multiple sclerosis. Nat Rev Neurol. 2022;18:723\u201334.","journal-title":"Nat Rev Neurol"},{"key":"4809_CR36","doi-asserted-by":"publisher","first-page":"e2520142","DOI":"10.1001\/jamanetworkopen.2025.20142","volume":"8","author":"J Guo","year":"2025","unstructured":"Guo J, Olsson T, Hillert J, Alfredsson L, Hedstr\u00f6m AK. Education, lifestyle risk factors, and treatment choices and multiple sclerosis progression. JAMA Netw Open. 2025;8:e2520142.","journal-title":"JAMA Netw Open"},{"key":"4809_CR37","doi-asserted-by":"publisher","first-page":"102519","DOI":"10.1016\/j.msard.2020.102519","volume":"46","author":"DM Conradsson","year":"2020","unstructured":"Conradsson DM, Forslin M, Fink K, Johansson U, von Koch L, Johansson S. Employment status of people with multiple sclerosis in relation to 10-year changes in functioning and perceived impact of the disease. Mult Scler Relat Disord. 2020;46:102519. https:\/\/doi.org\/10.1016\/j.msard.2020.102519.","journal-title":"Mult Scler Relat Disord"},{"key":"4809_CR38","doi-asserted-by":"publisher","first-page":"e0198975","DOI":"10.1371\/journal.pone.0198975","volume":"13","author":"MW Enns","year":"2018","unstructured":"Enns MW, Bernstein CN, Kroeker K, et al. The association of fatigue, pain, depression and anxiety with work and activity impairment in immune mediated inflammatory diseases. PLoS One. 2018;13:e0198975.","journal-title":"PLoS One"},{"key":"4809_CR39","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1111\/ane.12714","volume":"136","author":"JF Pearson","year":"2017","unstructured":"Pearson JF, Alla S, Clarke G, et al. Multiple Sclerosis impact on employment and income in New Zealand. Acta Neurol Scand. 2017;136:223\u201332.","journal-title":"Acta Neurol Scand"},{"key":"4809_CR40","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1007\/s10926-019-09850-5","volume":"30","author":"CH Marck","year":"2020","unstructured":"Marck CH, Aitken Z, Simpson S, Weiland TJ, Kavanagh A, Jelinek GA. Predictors of change in employment status and associations with quality of life: a prospective international study of people with multiple sclerosis. J Occup Rehabil. 2020;30:105\u201314.","journal-title":"J Occup Rehabil"},{"key":"4809_CR41","volume":"8","author":"E van Egmond","year":"2022","unstructured":"van Egmond E, van der Hiele K, van Gorp D, et al. Work difficulties in people with multiple sclerosis: the role of anxiety, depression and coping. Mult Scler J Exp Transl Clin. 2022;8:20552173221116282.","journal-title":"Mult Scler J Exp Transl Clin"},{"key":"4809_CR42","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1007\/s10926-023-10149-9","volume":"34","author":"M Ponzio","year":"2024","unstructured":"Ponzio M, Podda J, Pignattelli E, et al. Work Difficulties in People with Multiple Sclerosis. J Occup Rehabil. 2024;34:606\u201317.","journal-title":"J Occup Rehabil"},{"key":"4809_CR43","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckae144.1106","volume":"34","author":"H Bruggeman","year":"2024","unstructured":"Bruggeman H, H\u00e9roufosse J, Van der Heyden J, Smith P. The relationship between mental health and employment: a systematic review of cohort studies. Eur J Public Health. 2024;34:ckae144.1106.","journal-title":"Eur J Public Health"},{"key":"4809_CR44","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-021-02396-1","volume":"21","author":"A Oliva Ramirez","year":"2021","unstructured":"Oliva Ramirez A, Keenan A, Kalau O, Worthington E, Cohen L, Singh S. Prevalence and burden of multiple sclerosis-related fatigue: a systematic literature review. BMC Neurol. 2021;21:468.","journal-title":"BMC Neurol"},{"key":"4809_CR45","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1007\/s11136-022-03204-0","volume":"32","author":"M Plow","year":"2023","unstructured":"Plow M, Gunzler DD, Chang JHC. Characterizing fatigue phenotypes with other symptoms and clinically relevant outcomes among people with multiple sclerosis. Qual Life Res. 2023;32:151\u201360.","journal-title":"Qual Life Res"},{"key":"4809_CR46","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1007\/s40120-021-00239-2","volume":"10","author":"L Lakin","year":"2021","unstructured":"Lakin L, Davis BE, Binns CC, Currie KM, Rensel MR. Comprehensive approach to management of multiple sclerosis: addressing invisible symptoms\u2014a narrative review. Neurol Ther. 2021;10:75\u201398.","journal-title":"Neurol Ther"},{"key":"4809_CR47","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2022.103666","volume":"59","author":"H Morris-Bankole","year":"2022","unstructured":"Morris-Bankole H, Ho AK. Uncovering patterns of real-world psychological support seeking and the patient experience in multiple sclerosis. Mult Scler Relat Disord. 2022;59:103666.","journal-title":"Mult Scler Relat Disord"},{"key":"4809_CR48","doi-asserted-by":"publisher","first-page":"936","DOI":"10.3109\/09638288.2015.1070295","volume":"38","author":"A Raggi","year":"2016","unstructured":"Raggi A, Covelli V, Schiavolin S, Scaratti C, Leonardi M, Willems M. Work-related problems in multiple sclerosis: a literature review on its associates and determinants. Disabil Rehabil. 2016;38:936\u201344.","journal-title":"Disabil Rehabil"},{"key":"4809_CR49","volume":"11","author":"FS Teni","year":"2025","unstructured":"Teni FS, Machado A, Dervish J, Fink K, Gyllensten H, Friberg E. Factors associated with self-reported work ability among people with multiple sclerosis in Sweden. Mult Scler J Exp Transl Clin. 2025;11:20552173241304324.","journal-title":"Mult Scler J Exp Transl Clin"},{"key":"4809_CR50","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1177\/1352458514540971","volume":"21","author":"SE Frndak","year":"2015","unstructured":"Frndak SE, Kordovski VM, Cookfair D, Rodgers JD, Weinstock-Guttman B, Benedict RHB. Disclosure of disease status among employed multiple sclerosis patients: association with negative work events and accommodations. Mult Scler J. 2015;21:225\u201334.","journal-title":"Mult Scler J"},{"key":"4809_CR51","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2020.110252","volume":"138","author":"A Ratajska","year":"2020","unstructured":"Ratajska A, Glanz BI, Chitnis T, Weiner HL, Healy BC. Social support in multiple sclerosis: associations with quality of life, depression, and anxiety. J Psychosom Res. 2020;138:110252.","journal-title":"J Psychosom Res"},{"key":"4809_CR52","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1111\/ane.13664","volume":"146","author":"A Machado","year":"2022","unstructured":"Machado A, Murley C, Hillert J, Alexanderson K, Friberg E. Self-employment, sickness absence, and disability pension in multiple sclerosis. Acta Neurol Scand. 2022;146:283\u201394.","journal-title":"Acta Neurol Scand"},{"key":"4809_CR53","volume":"2017","author":"L Vijayasingham","year":"2017","unstructured":"Vijayasingham L, Jogulu U, Allotey P. Work change in multiple sclerosis as motivated by the pursuit of illness-work-life balance: a qualitative study. Mult Scler Int. 2017;2017:8010912.","journal-title":"Mult Scler Int"},{"key":"4809_CR54","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-18844-9","volume":"24","author":"C Murley","year":"2024","unstructured":"Murley C, Dervish J, Machado A, Sv\u00e4rd V, Wennman-Larsen A, Hillert J, et al. Exploring the working life of people with multiple sclerosis during the COVID-19 pandemic in Sweden. BMC Public Health. 2024;24:1389.","journal-title":"BMC Public Health"}],"container-title":["BMC Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12883-026-04809-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-026-04809-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-026-04809-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T19:50:42Z","timestamp":1781639442000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12883-026-04809-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,11]]},"references-count":54,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4809"],"URL":"https:\/\/doi.org\/10.1186\/s12883-026-04809-5","relation":{},"ISSN":["1471-2377"],"issn-type":[{"value":"1471-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,11]]},"assertion":[{"value":"25 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by a local ethics committee, specifically the Swedish Ethical Review Authority (Dnr 2020\u201304996). All participants in the survey provided informed consent by submitting the completed questionnaire. Individuals with MS included in the Swedish MS Registry had previously provided consent to their neurologist for their data to be entered into the registry for both clinical and research purposes. This study was conducted in accordance with the ethical principles of the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"AM: previous salary funded partly by unrestricted research grants from Biogen as well as from Celgene\/Bristol-Myers Squibb. JD: salary funded partly by unrestricted research grants from Celgene\/Bristol-Myers Squibb. EF: salary funded partly by an unrestricted research grant from Biogen and has received unrestricted research grants from Celgene\/Bristol-Myers Squibb, honoraria for serving on advisory board for Sanofi, and speaker\u2019s fees from Merck and Sanofi.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"229"}}