The impact of self-perceived limitations, stigma and sense of coherence on quality of life in multiple sclerosis patients: results of a cross-sectional study.

The study looked at associations at one point in time, so it cannot show that sense of coherence, stigma or limitations caused changes in quality of life. The sample came from an older multiple sclerosis cohort and did not include patients diagnosed within the past 10 years, so results may not apply to newly diagnosed or younger patients. Disease progression and disability level were based on patient reports and self-reported walking ability, not always equivalent to a neurologist's classification. The analysis used one-tailed tests and removed variables step by step until only significant effects remained, which can make the reported associations look stronger than they are. Although respondents and non-respondents did not differ in gender, age and years since diagnosis, 185 patients responded from 302 eligible patients, so non-response could still matter.

The authors declared no potential conflicts of interest and received no financial support for the research, authorship or publication.

Do not conclude that improving sense of coherence or reducing stigma will improve quality of life. This was a cross-sectional survey, so it shows associations at one time point and cannot determine cause and effect. It also did not test any therapy or programme.