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This study aimed to identify mental health, physical health, demographic and disease characteristics relating to work productivity in people with multiple sclerosis (MS). In this cross-sectional study, 236 employed people with MS (median age = 42 years, 78.8% female) underwent neurological and neuropsychological assessments. Additionally, they completed questionnaires inquiring about work productivity (presenteeism: reduced productivity while working, and absenteeism: loss of productivity due to absence from work), mental and physical health, demographic and disease characteristics. Multiple linear and logistic regression analyses were performed with presenteeism and absenteeism as dependent variables, respectively. A model with mental and physical health factors significantly predicted presenteeism  F (11,202) = 11.33,  p  &lt; 0.001,  R2  = 0.38; a higher cognitive ( p  &lt; 0.001) and physical impact ( p  = 0.042) of fatigue were associated with more presenteeism. A model with only mental health factors significantly predicted absenteeism;  χ2 (11)=37.72,  p  &lt; 0.001, with  R2  = 0.27 (Nagelkerke) and  R2  = 0.16 (Cox and Snell). Specifically, we observed that more symptoms of depression ( p  = 0.041) and a higher cognitive impact of fatigue ( p  = 0.011) were significantly associated with more absenteeism. In people with MS, both cognitive and physical impact of fatigue are positively related to presenteeism, while symptoms of depression and cognitive impact of fatigue are positively related to absenteeism.Implications for rehabilitationMultiple sclerosis (MS) affects people of working age, significantly interfering with work productivity.Higher cognitive and physical impact of fatigue were associated with more presenteeism in workers with MS.A higher cognitive impact of fatigue and more depressive symptoms were associated with absenteeism in workers with MS.Occupational and healthcare professionals should be aware of the impact of both physical and mental health on work productivity in workers with MS. Multiple sclerosis (MS) affects people of working age, significantly interfering with work productivity. Higher cognitive and physical impact of fatigue were associated with more presenteeism in workers with MS. A higher cognitive impact of fatigue and more depressive symptoms were associated with absenteeism in workers with MS. Occupational and healthcare professionals should be aware of the impact of both physical and mental health on work productivity in workers with MS.

Self-reported work productivity in people with multiple sclerosis and its association with mental and physical health