Family functioning and dyadic relationship in multiple sclerosis: preliminary data of an italian multicenter study

Introduction: Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease which not only affects physical functioning but is also associated with cognitive impairments and psychological distress. The combination of these symptoms can have a negative consequence on the family functioning (FF) of people living with MS (PwMS), with detrimental effects on couples and their dyadic relationships. In addition, the quality of relationships could be influenced by other factors, such as specific individual characteristics (such as high levels of alexithymia) or social support. For these reasons, we assessed the FF and the quality of dyadic relationships of PwMS and their partners. Specifically, we aimed to investigate the relationships between alexithymia, psychological distress (anxiety and depressive symptoms), perceived social support, dyadic relationships and FF. Methods: Couples, consisting of PwMS and their respective partners, recruited from several Italian MS centers, were invited to complete an online survey. Measures included: the Brief Family Assessment Measure 3 (FAM3) to assess FF; the Hospital Anxiety and Depression Scale (HADS) for psychological distress symptoms; the Multidimensional Scale of Perceived Social Support (MSPSS) for social support; the Toronto Alexithymia Scale (TAS-20) for alexithymia; the Dyadic Adjustment Scale (DAS) for the quality of dyadic relationships. Results: In the present study, we analyzed data from 28 couples including 16 women and 12 men with MS and their partners (mean age: 46 years). A statistically significant correlation was found between the DAS scores (r=.496, p<.007), while no correlation was found between the FAM3 scores of the PwMS and the partner. The FAM3 scores of the PwMS were significantly correlated with the DAS (r=-.643, p<.01), MSPSS (r=-.624, p<.01) and TAS-20 scores (r=.424, p<.025) as well as with the HADS-Depression scores (r=.493, p<.008) and MPSS scores (r=-.447, p<.017) of the partners. The partner's FAM3 scores was significantly correlated with his/her level of anxiety (HADS-Anxiety r=.558, p<.002) and depression scores (HADS-Depression r=.844, p<.01), with the TAS-20 (r=.466, p<.012), the MSPSS (r=-.562, p<.002) and the DAS scores (r=-.451, p<.016). Discussion: Overall, data show that couples do not rate the quality of the FF equally but agree on the quality of the dyadic relationship. Interestingly, partners’ psychological distress influenced both patients' and partners' perceptions of FF, suggesting that special attention should be paid to this aspect in clinical practice, as it could be a crucial factor for both partners.