Despite changes to public perceptions and legislative protection over the last 20 years, high rates of MS patients still leave the workforce prematurely, reduce working hours or change employment roles. These data have significant implications when considering social and economic impacts of MS, support the value of employment metrics as long-term outcome measures, and demonstrate the need to improve employment requirements and flexibility of working practices in individuals with MS.

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BackgroundRelapses are associated with an increase in disability for the majority of patients and many patients do not subsequently recover completely. However, the impact of post relapse changes in disability on mood in MS is currently unresearched.ObjectiveTo investigate the predictive ability of disability at relapse, depression at relapse and post-relapse changes in disability on depression ratings 6 months post-relapse.Methods139 participants were assessed for disability level on the Expanded Disability Status Scale (EDSS) and mood on the depression scale of the Hospital Anxiety and Depression Scale (HADS) during a confirmed MS relapse and 6 months post relapse.ResultsAt relapse 45.5% of participants met criteria for possible depression on the HADS. This reduced to 34.4% at 6 months. A stepped backward logistic regression demonstrated that depression and disability status at relapse were significant predictors of depression at 6 months but 6 month disability level did not predict depression. Patients likely depressed at relapse were substantially more likely to be depressed at 6 months than those not depressed at relapse (OR 11.9).ConclusionsDepression at relapse appears to be a stronger predictor of depression 6 months post-relapse than disability level or changes in disability. Assessment of depression at relapse may identify individuals who might benefit from subsequent intervention.

This conversation took place in a shared Google Doc over several occasions in April and early May 2021, between friends and colleagues, artists and writers, Hannah Clarkson and Matilda Tucker, in the context of an ongoing experiment in collaborative writing. In their individual and collective practices, Clarkson and Tucker explore potential embodiments in language(s) of thinking and dwelling in the ‘here and elsewhere’ of places and spaces they may not physically be in, across cultural, geographical and/or emotional distance. They are interested in how language can be employed as a tool for empathy beyond concrete linguistic understanding; how translation as method opens up to modalities of fictioning and collective storytelling; and writing as an experiment in sharing everyday struggles and building collective narratives of care. An attempt to bridge gaps between the here and elsewhere of Stockholm, Berlin and all the other places that in this time of pandemic we cannot be, the text below is not a conclusion but a conversation. It is a thinking out loud - or rather, on screen - together, on themes of language and translation; belonging and resisting; work and laziness; former and formless selves.