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Multiple sclerosis is associated with psychological distress and stigma, which are related to psychological well-being and engagement in health-promoting behaviors. The aim of this study was to examine the association between stigma, psychological well-being, and physical activity, while also exploring relationships with perceived health status and sociodemographic/clinical variables in people with multiple sclerosis. One hundred and twenty-seven participants with multiple sclerosis completed an online survey assessing depression, anxiety and stress (DASS-21), stigma (SSCI-8), happiness (OHQ-8), perceived health status (SF-12) and physical activity (IPAQ-Single Item). Regression models were used to determine the predictors for the psychological outcomes and the level of physical activity. In addition, an open-ended question, analyzed using qualitative content analysis, was used to explore participants’ perceived needs to improve their quality of life. Internalized stigma significantly predicted higher levels of depression (OR = 1.57, 95% CI [1.27–1.94], p  < 0.001), anxiety (OR = 1.24, 95% CI [1.03–1.49], p  = 0.021), stress (OR = 1.47, 95% CI [1.15–1.87], p  = 0.002), and a lower level of happiness (OR = 0.36, 95% CI [0.24–0.56], p  < 0.001). Internalized stigma was also associated with lower weekly physical activity (OR = 0.50 [CI 95% = 0.31–0.83], p  = 0.007). In addition, the qualitative analysis revealed a strong demand for expert-guided physical activity, psychological support, and person-centered care. Internalized stigma was associated with both the psychological well-being and health behaviors of people with multiple sclerosis. An integrated care approach may support not only psychological well-being but also physical activity, contributing to a higher quality of life.

Background: Stroke-induced immunosuppression (SII) represents a negative rehabilitative prognostic factor associated with poor motor performance at discharge from a neurorehabilitation unit (NRB). This study aims to evaluate the association between SII and gait impairment at NRB admission. Methods: Forty-six stroke patients (65.4 ± 15.8 years, 28 males) and 42 healthy subjects (HS), matched for age, sex, and gait speed, underwent gait analysis using an inertial measurement unit at the lumbar level. Stroke patients were divided into two groups: (i) the SII group was defined using a neutrophil-to-lymphocyte ratio ≥ 5, and (ii) the immunocompetent (IC) group. Harmonic ratio (HR) and short-term largest Lyapunov’s exponent (sLLE) were calculated as measures of gait symmetry and stability, respectively. Results: Out of 46 patients, 14 (30.4%) had SII. HR was higher in HS when compared to SII and IC groups (p < 0.01). HR values were lower in SII when compared to IC subjects (p < 0.01). sLLE was lower in HS when compared to SII and IC groups in the vertical and medio-lateral planes (p ≤ 0.01 for all comparisons). sLLE in the medio-lateral plane was higher in SII when compared to IC subjects (p = 0.04). Conclusions: SII individuals are characterized by a pronounced asymmetric gait and a more impaired dynamic gait stability. Our findings underline the importance of devising tailored rehabilitation programs in patients with SII. Further studies are needed to assess the long-term outcomes and the role of other clinical features on gait pattern.

Background: Stigma is a pervasive, though understudied, psychosocial factor affecting people with multiple sclerosis. This review synthesizes the literature on the impact of perceived, enacted, and internalized stigma on psychological health and illness identity in PwMS. Methods: A comprehensive narrative review approach was adopted, integrating findings from peer-reviewed quantitative and qualitative studies. Databases including PubMed, PsycINFO, and Scopus were searched using combinations of terms such as “multiple sclerosis”, “stigma”, “internalized stigma”, “mental health”, and “illness identity”. Studies were included if they reported on stigma-related outcomes in PwMS, discussed psychological or identity variables, or examined interventions aimed at reducing stigma or enhancing adaptive identity. The analysis focused on thematic synthesis, identifying recurrent findings, mediating mechanisms, and clinical implications. Results: Stigma in MS is consistently linked to higher depression, anxiety, and lower quality of life. Internalized stigma disrupts illness identity, often fostering engulfment and rejection of the self. Psychological mediators—such as cognitive fusion, diminished self-compassion, and weakened sense of coherence—amplify these outcomes. Particularly vulnerable are individuals with progressive disease, severe disability, minority status, or limited social support. A recursive loop emerges: stigma triggers psychological distress, which increases stigma awareness and social withdrawal. In addition to traditional psychological interventions, several emerging approaches have shown promise in reducing internalized stigma and fostering adaptive identity integration. Conclusions: Stigma is a central factor in emotional suffering and identity fragmentation in PwMS. Integrative, narrative-informed, and culturally sensitive interventions are essential to reduce stigma and foster resilience. Future research should prioritize longitudinal, mixed-method approaches to develop effective, scalable solutions.