High Prevalence of Unemployment in Patients with Systemic Lupus Erythematosus: Association with Organ Damage and Health-Related Quality of Life

IRENE E.M. BULTINK, FRANKTIEN TURKSTRA, BEN A.C. DIJKMANS, and ALEXANDRE E. VOSKUYL

ABSTRACT.

Objective. To evaluate employment status in relation to organ damage, demographic factors, and health-related quality of life (HRQOL) in patients with systemic lupus erythematosus (SLE).

Methods. One hundred forty-seven patients with SLE, aged 18 to 64 years, were included. Examination of self-reported HRQOL was performed using the Medical Outcome Study Short Form-36 (SF-36). Demographic factors, disease characteristics, and HRQOL were compared between patients with and without paid employment using nonparametric tests.

Results. In 147 patients with SLE (mean age 38.4 ± 11 yrs, mean disease duration 6.3 ± 6.5 yrs), we found a high rate of unemployment (59%), whereas 93% of patients had previously worked. In patients who had stopped or reduced working, 75% attributed their withdrawal from work at least in part to disease-related factors. Unemployed patients had a significantly higher median age at disease onset, a higher frequency of neuropsychiatric organ damage and diabetes mellitus, and lower HRQOL than employed patients.

Conclusion. We found a high rate of unemployment (59%) in patients with SLE. Higher age at disease onset, neuropsychiatric organ damage, diabetes mellitus, and reduced HRQOL were associated with unemployment in patients with SLE. Our findings highlight the need to develop strategies to reduce work loss in patients with SLE, for both individual and socioeconomic reasons. (J Rheumatol First Release Mar 15 2008)

Key Indexing Terms:

SYSTEMIC LUPUS ERYTHEMATOSUS
WORKING STATUS
ORGAN DAMAGE
QUALITY OF LIFE

---

From the Department of Rheumatology, VU University Medical Center, Amsterdam; and Department of Rheumatology, Jan van Breemen Institute, Amsterdam, The Netherlands.

I.E.M. Bultink, MD, PhD; A.E. Voskuyl, MD, PhD, Department of Rheumatology, VU University Medical Center; F. Turkstra, MD, PhD; B.A.C. Dijkmans, MD, PhD, Department of Rheumatology, Jan van Breemen Institute.

Address reprint requests to Dr. I.E.M. Bultink, Department of Rheumatology, Room 4A49, VU University Medical Center, PO box 7057, 1007 MB Amsterdam, The Netherlands. E-mail: iem.bultink@vumc.nl

Accepted for publication November 29, 2007.