Occupation and education level in functional motor disorders

Background: The role of occupational background in functional motor disorders (FMDs) remains poorly defined. Controlled data using standardized occupational classifications and information on education level are limited. Objective: To assess the association between occupational background and FMDs in working-age individuals and to examine the role of education level in this relationship. Methods: We conducted a case-control study using data from the Italian Registry of Functional Motor Disorders. Patients aged 30-65 years with available occupational information were included and compared with healthy controls. Occupations were classified according to the 2021 Italian National Institute of Statistics classification. Education level was expressed as years of schooling. Multivariable logistic regression models were used to assess the association between occupational categories and FMD status after adjustment for age, sex, and years of schooling. Results: A total of 479 patients with FMDs and 252 healthy controls were included. Patients had fewer years of schooling than controls, and the distribution of occupational categories differed between groups. In particular, qualified professions in commercial activities and services, artisans and skilled workers, and machine operators were more frequently represented among patients. In multivariable analysis, these occupational categories and years of schooling remained independently associated with FMD status. Healthcare professions did not differ between patients and controls. Conclusions: Occupational background and education level were independently associated with FMDs in working-age individuals. These findings support the view that occupational factors may be relevant as possible precipitating or maintaining factors within the biopsychosocial model of FMDs, without implying a causal relationship.