Abuse in individuals with multiple sclerosis: the SocialMS Italian study

Background: Disability increases the risk of abuse, rendering individuals with multiple sclerosis (MS) more vulnerable. However, research on abuse within MS populations is limited, with no studies in Italy. We aim to explore abuse and MS in Italy. Methods: The SocialMS is a cross-sectional observational study based on anonymous, self-administered questionnaires completed by adults with MS. The questionnaire was organized into three sections: demographics, MS characteristics and social determinants of health (SDOH). Participants were asked whether they had ever experienced abuse, the relationship with the abuser and whether they believed MS could increase the risk of abuse. Disability was assessed by Patient Determined Disease Steps (PDDS) scale. Parametric and non-parametric comparisons, Gradient Boosting Machine and clustering analysis were conducted to identify victim profiles; logistic regression to study the impact of MS on abuse risk. Results: 1004 participants (68.8 % females) followed at 66 MS centers were included. The mean age was 44.1 years (standard deviation: 11.6), the median PDDS was 1.0 (interquartile range: 0.0; 3.0). 235 participants (23.4 %) reported abuse (emotional or psychological: 20.2 %, sexual: 2.5 %, physical: 5.6 %, financial: 4.2 %). Key variables defining the victims included younger age, living alone, higher BMI, smoking, comorbidities, disability, female sex, non-heterosexual orientation, lower health literacy, poor socioeconomic status and tangible support. For over half of respondents, MS increases abuse risk, particularly for those with greater disability. Conclusion: This work emphasizes the ethical and social importance of protecting the most vulnerable individuals and serves as a starting point for future research on targeted interventions.