Mapi Group, Stockholm, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Mapi Group, Stockholm, Sweden.
Mult Scler Relat Disord. 2018 Aug;24:145-150. doi: 10.1016/j.msard.2018.07.002. Epub 2018 Jul 3.
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.
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).
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.
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.
多项研究调查了多发性硬化症（MS）对离婚风险的影响。然而，目前的证据尚无定论，并且受到例如小样本人群、随访时间短、以及/或缺乏对照组等因素的限制。本回顾性观察性研究的目的是评估 MS 对离婚风险的长期影响。
在全国性的疾病特异性登记处（瑞典多发性硬化症登记处）中确定了 1975 年至 2012 年间被诊断患有 MS 的瑞典患者，并根据年龄、性别、居住地区域和婚姻状况与一般人群对照进行匹配。我们使用生存分析来估计指数后（即 MS 诊断日期）离婚的累积发生率。
我们的最终样本包括 3998 名患者和 15992 名一般人群对照（平均年龄 44 岁；73%为女性）。平均随访时间为 10 年（范围：1-37 年）。未调整的 Kaplan-Meier 失败函数显示患者和对照组之间离婚的累积发生率无显著差异（对数秩检验，p=0.902），或 MS 女性患者与女性对照组之间（p=0.157）。相比之下，MS 男性患者被估计比男性对照组离婚的发生率明显更高（p=0.040）。Cox 比例风险模型结果显示，在控制年龄、居住地区域和诊断年份后，MS 男性患者在随访期间离婚的风险比男性对照组高 21%（风险比：1.21，p=0.032）。未发现 MS 女性患者的调整后风险增加。
我们表明，MS 与男性离婚风险增加相关，但与女性无关。我们的结果有助于为卫生政策和临床干预提供信息，例如关系咨询计划，并强调该疾病的社会经济负担。
