OBJECTIVES: To characterize work productivity in relapsing multiple sclerosis 
(MS) by using a work productivity scale and to identify associations between 
work productivity and disability, depression, fatigue, anxiety, cognition, and 
health-related quality of life.
METHODS: Three hundred seventy-seven subjects with a clinically isolated 
syndrome or relapsing remitting MS participated in the study. Subjects underwent 
neurological examinations and completed patient-reported outcome and cognitive 
measures. Subjects also completed the Work Productivity and Activity Impairment 
Questionnaire: General Health to quantify absenteeism (missing work because of 
health problems), presenteeism (impairment while working), overall work 
impairment, and daily activity impairment attributable to health problems. 
Univariate correlations and multivariate models were used to determine the 
associations between each work productivity variable and clinical, 
patient-reported outcome, and cognitive measures.
RESULTS: Seventy-six percent of subjects were employed. Fourteen percent of 
working subjects reported absenteeism, and 47% reported presenteeism. The mean 
work time lost because of absenteeism was 4%, and the mean work time lost 
because of presenteeism was 12%. Absenteeism was not significantly associated 
with disease or patient-reported outcome measures. Statistically significant 
correlations (0.32-0.53) were found between presenteeism and increasing 
disability, fatigue, depression, anxiety, and reduced quality of life. No 
associations were observed between presenteeism and disease duration or 
cognitive function.
CONCLUSIONS: Subjects with clinically isolated syndrome/relapsing remitting MS 
reported substantial work productivity losses due to presenteesim. Presenteeism 
was associated with increasing fatigue, depression, anxiety, and reduced quality 
of life. It is possible that the early identification and treatment of fatigue 
and mental health symptoms may improve productivity while working and extend 
employment for individuals with MS.