The long-term impact of multiple sclerosis on the risk of divorce

Background: Several studies have investigated the impact of multiple sclerosis (MS) on the risk of divorce. However, current evidence is inconclusive and limited by e.g. small sample populations, short follow-up, and/or lack of a control group. The objective of this retrospective, observational study was to estimate the long-term impact of MS on the risk of divorce. Methods: Swedish patients diagnosed with MS between 1975 and 2012 were identified in a nationwide disease-specific register (the Swedish Multiple Sclerosis Registry) and matched with general population controls based on age, sex, region of residency, and marital status. We used survival analysis to estimate the cumulative incidence proportion of divorce after index (i.e. the MS diagnosis date). Results: Our final sample comprised 3998 patients and 15,992 general population controls (mean age 44 years; 73% female). Mean follow-up was 10 years (range: 1-37 years). Unadjusted Kaplan-Meier failure functions revealed no significant differences in the cumulative incidence proportion of divorce between patients and controls (log-rank test, p = 0.902), or women with MS and female controls (p = 0.157). In contrast, men with MS were estimated to have a notably higher incidence of divorce compared with male controls (p = 0.040). Cox proportional-hazards model outcomes showed that men with MS had a 21% higher risk (HR: 1.21,p = 0.032) of divorce across follow-up compared with male controls when controlling for age, region of residency, and year of diagnosis. No significant adjusted risk increase was found for women with MS. Conclusions: We show that MS is associated with an increased risk of divorce among men, but not women. Our result should be helpful to inform health policy and clinical interventions, such as relationship counselling programs, and highlight the socio-economic burden of the disease.