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The burden of multiple sclerosis and patients’ coping strategies
  1. Lorena Lorefice,
  2. Giuseppe Fenu,
  3. Jessica Frau,
  4. Giancarlo Coghe,
  5. Maria Giovanna Marrosu and
  6. Eleonora Cocco
  1. Department of Medical Sciences and Public Health, Multiple Sclerosis Centre, University of Cagliari, Cagliari, Italy
  1. Correspondence to Dr Lorena Lorefice, Multiple Sclerosis Centre, Department of Medical Sciences and Public Health, University of Cagliari, Ospedale “Binaghi”, via Is Guadazzonis, 2, Cagliari 09126, Italy; lorena.lorefice{at}


Objectives Multiple sclerosis (MS) is a chronic disease that mainly affects young people. Patients with MS experience several emotional responses to changed perceptions of themselves and manage this situation in ways focused on controlling the overall burden of disease. This present study aimed to evaluate differences between patients with MS and healthy controls (HCs) in coping styles, identifying the MS clinical features that influence adaptive responses.

Methods Patients with MS, according to the McDonald 2010 criteria, and HCs were recruited. Coping strategies were assessed using the Coping Orientation to the Problems Experienced (COPE-NVI; Italian version) questionnaire.

Results A cohort of 135 patients with MS (female: 89/135, 65.9%) and 94 HCs (female: 64/94, 68%) were enrolled. Impaired social support and problem solving was noted for MS group (p=0.005). In the MS group, the social support worsened with increasing disease duration (p=0.002) independently of the level of disability. Associations between a higher Expanded Disability Status Scale score and avoidance strategies (p<0.01), as well between avoidance strategies and a previous depression diagnosis (p<0.001) were reported.

Conclusion Our findings highlight the negative impact of MS on various aspects of patients’ life. Therefore, psychosocial interventions are needed to increase adaptive coping mechanisms aimed to manage the burden of MS.

  • multiple sclerosis
  • disease burden
  • coping strategies
  • psychosocial intervention
  • supportive care

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  • Contributors LL, GF, MGM and EC drafted/revised the manuscript, participated in study concept or design, analysis or interpretation of data and carried out study supervision. JF and GC participated in design and acquisition of data.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Informed consent was obtained from all participants included in the study and the local ethics committee approved the study (University of Cagliari).

  • Provenance and peer review Not commissioned; internally peer reviewed.