Childhood trauma significantly reduces treatment adherence among multiple sclerosis patients in Italy, and much of that negative impact stems from a weaker physician-patient relationship, according to a study published in Multiple Sclerosis and Related Disorders. Researchers found that early adverse experiences make it harder for patients to consistently follow prescribed therapies and establish trust with their healthcare providers.
How Childhood Trauma Impacts Multiple Sclerosis Care
In multiple sclerosis, an autoimmune disease affecting the central nervous system, consistently taking prescribed treatments is key for controlling disease activity and improving long-term outcomes. However, cognitive, behavioral, and psychiatric symptoms often complicate how patients engage with their medical teams. According to the study authors, childhood trauma plays a recognized role in determining disease course and severity, yet its relational consequences remain scarcely studied.
Childhood trauma links directly to difficulties with emotional regulation, trust, and interpersonal relationships with healthcare providers. These psychological barriers can heavily influence daily treatment decisions and follow-up schedules. To explore this dynamic, an observational study was conducted in Rome between December 2024 and December 2025.
Pro Tip: Healthcare providers managing autoimmune conditions can benefit from screening patients for early life adversity to identify those at risk for poor treatment adherence.
Study Demographics and Medication Adherence Findings
The study enrolled 205 adults with multiple sclerosis at a single center in Rome. Participants had a mean age of 38.36 years, and the cohort was predominantly female at 75.1%. Most participants presented with relapsing forms of the disease. Regarding treatment regimens, almost 80% received high-efficacy disease-modifying therapies, 13.7% took moderate- or low-efficacy medications, and 6.8% received no treatment at all.
Participants completed validated questionnaires, including the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Medical Interview Satisfaction Scale, and the Morisky Medication Adherence Scale. Statistical analyses revealed that more severe or frequent childhood trauma associated significantly with lower medication adherence and poorer physician-patient rapport. Patients reporting more severe early trauma were significantly less likely to take medication consistently or report high trust in their doctors.
The Mediating Role of the Physician-Patient Relationship
A stronger physician-patient relationship directly correlates with higher treatment adherence. Furthermore, statistical mediation models demonstrated that the quality of this relationship partly explains the link between early trauma and low compliance. According to the research team, adverse childhood experiences influence treatment-taking behaviors by disrupting trust and communication channels with healthcare providers.
The authors noted that childhood trauma remains largely underrecognized in routine multiple sclerosis care. Recognizing these experiences helps clinicians identify patients who require additional psychological support. “Physicians should be increasingly aware of the potential presence of [childhood trauma] in patients with MS … and consider incorporating [childhood trauma] assessment into clinical evaluation to identify patients who may benefit from targeted psychological interventions,” the researchers wrote.
Did You Know? High-efficacy disease-modifying therapies effectively reduce multiple sclerosis activity and slow disease progression, but they can carry greater safety risks that require close monitoring by a trusted physician.
Limitations and Future Research Directions
The observational design and reliance on self-reported measures represent key limitations of the study. Because researchers utilized questionnaires completed by patients, establishing a definitive cause-and-effect relationship remains challenging. Additionally, scores indicated a high chance of childhood idealization or potential underreporting by participants.
Future studies must investigate whether targeted psychological interventions for multiple sclerosis patients with a history of childhood trauma can successfully improve treatment adherence and clinical outcomes. Integrating relational and psychological dimensions into routine clinical management stands out as a modifiable target for optimizing long-term care.
Frequently Asked Questions
How does childhood trauma affect multiple sclerosis treatment?
Childhood trauma is linked to difficulties with trust and emotional regulation, which can strain relationships with healthcare providers and lead to lower medication adherence, according to the study.
What therapies were most common among study participants?
Almost 80% of the 205 participants evaluated in Rome received high-efficacy disease-modifying therapies.
Can improving the doctor-patient relationship help?
Yes. Researchers found that a strong physician-patient relationship largely mediates the negative impact of childhood trauma, suggesting that better communication and trust can improve long-term care.
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