Laure Peter-Derex, Emmanuel Fort, Benjamin Putois, Nora Martel, François Ricordeau, Hélène Bastuji, Isabelle Arnulf, Lucie Barateau, Patrice Bourgin, Yves Dauvilliers, Rachel Debs, Pauline Dodet, Benjamin Dudoignon, Patricia Franco, Sarah Hartley, Isabelle Lambert, Michel Lecendreux, Laurene Leclair-Visonneau, Damien Léger, Martine Lemesle-Martin, Antoine Léotard, Smaranda Leu-Semenescu, Nadège Limousin, Régis Lopez, Nicole Meslier, Jean-Arthur Micoulaud-Franchi, Christelle Charley-Mocana, Marie-Pia d'Ortho, Pierre Philip, Elisabeth Ruppert, Sylvie de La Tullaye, Manon Brigandet, Jennnifer Margier, Benjamin Rolland, Barbara Charbotel, Stéphanie Mazza
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引用次数: 0
Abstract
Study objectives: This multi-center comparative cross-sectional study aimed to describe educational and occupational pathways, quantify effort/reward imbalance at work and identify factors associated with professional prognosis in patients with narcolepsy type 1 (NT1).
Methods: Adult patients with NT1 and controls answered online questionnaires (Epworth sleepiness Scale, Beck Depression Inventory II, Siegrist questionnaire, Adult Self-Report, and a questionnaire on academic and professional trajectories) and were compared using sex- and age-adjusted logistic regressions. Clinical, demographic and psycho-social factors associated with patients' professional prognosis, as assessed by a composite score based on occupational-related outcomes, were explored with a generalized linear model.
Results: We included 235 patients (63.8% women, 36.4±14.7 years, 86.5% treated, 66.4% with childhood onset) and 166 controls (69.9% women, 40.3±14.4 years). No difference was observed between patients and controls for graduation, but patients reported more interruptions, absenteeism and lateness during schooling. No difference was observed for employment rate (69.5% vs 77.0%), but income was lower in patients who reported more unwanted changes in position and part-time work, with increased effort-reward imbalance (OR=2.28 95%CI[1.20-4.33], p=0.01). Impaired professional prognosis was associated with depression (p<0.0001) and attention disorders (p=0.03), while being narcoleptic during schooling was a protective factor (p=0.02).
Conclusions: Most patients with NT1 manage to achieve their careers goals, but at the cost of an effort/reward imbalance. Early diagnosis might allow a better adjustment to the disease. The strong impact of psycho-cognitive comorbidities on professional outcomes stresses the need to consider psycho-cognitivo-social dimensions in patient care.
期刊介绍：
Journal of Clinical Sleep Medicine focuses on clinical sleep medicine. Its emphasis is publication of papers with direct applicability and/or relevance to the clinical practice of sleep medicine. This includes clinical trials, clinical reviews, clinical commentary and debate, medical economic/practice perspectives, case series and novel/interesting case reports. In addition, the journal will publish proceedings from conferences, workshops and symposia sponsored by the American Academy of Sleep Medicine or other organizations related to improving the practice of sleep medicine.
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