Web-based family-reported outcomes to assess family functioning in multiple sclerosis: an Italian multicenter digital survey

BACKGROUND AND OBJECTIVES: Multiple sclerosis (MS) affects not only individuals but also family dynamics. Scalable, digitally delivered assessments may support routine screening of psychosocial and relational needs across the household. This study aimed to investigate perceived family functioning in families living with MS, using a web-based, multi-informant approach, focusing on relationship quality and psychosocial factors. METHODS: This Italian multicenter, cross-sectional study recruited families with a member diagnosed with MS. Participants included individuals with MS (PwMS), partners, adolescent children, and other adult relatives. Families without self-reported chronic illness were included as a comparison group. Participants completed anonymous, validated online questionnaires. Standardized instruments included: Hospital Anxiety and Depression Scale (HADS), Family Assessment Measure-III (FAM-III), Multidimensional Scale of Perceived Social Support (MSPSS), Toronto Alexithymia Scale (TAS-20), Dyadic Adjustment Scale (DAS), and Inventory of Parent and Peer Attachment (IPPA). RESULTS: The final sample consisted of 50 families: 50 PwMS (mean age: 42.6 ± 11.4 years), 34 partners (mean age: 45.2 ± 10.6 years), 25 adolescent children (mean age: 16.2 ± 3.6 years), 25 adult relatives (mean age: 47.2 ± 17.7 years). Compared with controls, PwMS reported lower anxiety (median HADS-A: 6.5 vs. 9; p = 0.002), higher dyadic adjustment (median DAS: 109.5 vs. 104.5; p = 0.024) and greater perceived support from significant others (median MSPSS: 27 vs. 24; p = 0.047). Adolescent children showed stronger attachment to parents (IPPA total mother: 94 vs. 83; father: 92.5 vs. 76.5; both p < 0.001) and peers (IPPA total peers: 98 vs. 90; p = 0.016). In PwMS, higher disability correlated with more severe depressive symptoms (ρ = 0.55, p < 0.001) and poorer family functioning (ρ = 0.37, p = 0.009). DISCUSSION: A web-based, standardized, multi-informant assessment can capture family functioning and key psychosocial correlates in MS, supporting the design of digitally enabled screening pathways to identify families who may benefit from early psychological or relational interventions.