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Life issues in multiple sclerosis

This article has been updated

Abstract

A diagnosis of multiple sclerosis (MS), an incurable condition, introduces great uncertainty into virtually all aspects of a person's life. From early in the disease course, people with MS are vulnerable to disempowerment, poor psychological health, and social exclusion including high unemployment. Current health-care research for people with MS is reviewed here within the context of three philosophies of disability and health-care service provision: the biomedical, biopsychosocial and sociopolitical models. Some of the uncertainties concerning the patient's life that result from MS have been reduced by improved diagnostic tools, advances in immunotherapy, multidisciplinary rehabilitation, community programs, and provision of information specifically designed to facilitate shared decision-making and empowerment. Such progress is modest, however, and substantial improvements to the psychological health, empowerment, and quality of life of people with MS requires more sociopolitically oriented research.

Key Points

  • From early in the disease course, people with multiple sclerosis (MS) are at high risk of unemployment, social exclusion and depression

  • The biomedical model offers the only realistic hope of a cure for MS, but does not address all the difficulties of living with the condition

  • The biopsychosocial and sociopolitical models of disability and health-care service provision are also needed to improve mental health, social inclusion and quality of life for patients with MS

  • Relevant data are needed to gain the backing of vital government support programs for financial assistance and social inclusion for patients with MS

  • Sociopolitical research using volunteers with MS can provide data of direct relevance to political lobbying on behalf of patients

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Change history

  • 20 October 2010

    In the version of this article initially published online, there was a typographical error in the first line of the Abstract. The error has been corrected in all electronic versions of the text.

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Acknowledgements

This work was made possible by financial support from MS Research Australia (MSRA) for the Australian MS Longitudinal Study (AMSLS). I thank Jeremy Wright and Christine Remediakis at MSRA for their excellent support, likewise Dr. Elizabeth McDonald for her support and for reading the manuscript. I also thank Chris Porter, Librarian at MS Australia, for archival assistance. Last but not least, I thank the thousands of Australians with MS who have generously helped with data collection for the AMSLS and with raising awareness of the condition.

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Simmons, R. Life issues in multiple sclerosis. Nat Rev Neurol 6, 603–610 (2010). https://doi.org/10.1038/nrneurol.2010.143

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