Childhood trauma and treatment compliance in people with multiple sclerosis: The mediating role of physician-patient rapport

Background: The role of childhood trauma (CT) and its impact on therapeutic adherence in patients with multiple sclerosis (MS) has been poorly explored. The aim of this study was to investigate the association between CT and treatment adherence, and to test the potential mediating role of the physician-patient rapport in this association. Methods: Two hundred and five patients with MS were enrolled and completed self-report measures assessing the main study variables. Mediation models analyzing the direct and indirect effects of CT on treatment adherence through the physician-patient rapport were performed while controlling for socio-demographic and clinical confounding factors. Results: The models showed that the total effect of CT on treatment adherence was significant (B = -0.050, p < .001) and that this association was mediated by lower interpersonal physician-patient connection (B = -0.014, p = .019). Conclusions: These findings suggest that CT may negatively affect treatment adherence in patients with MS and that this association is significantly mediated by difficulties in the physician-patient interpersonal connection, highlighting the importance of targeted psychological interventions to improve disease management and patient care.