Psychopathology in amyotrophic lateral sclerosis: A preliminary study with 27 ALS patients

Abstract

Considering the few studies published on the psychopathology of ALS patients, we carried out a preliminary study evaluating depression, anxiety, emotional reactions and coping strategies in such patients. Twenty-seven ALS patients were included and evaluated using a semi-structured interview, after which they were asked to complete a questionnaire. The rater asessed the DSM-IV criteria for a major depressive episode, dysthymia and generalized anxiety, using the MADRS scale for depression, the Covi anxiety scale and the Depressive Mood scale. Subsequently, patients completed the Ways of Coping checklist. Patients were neither anxious nor depressed. Patients whose diagnosis was recent (less than six months) presented greater emotional deficit. Patients younger than 50 years of age used problem focused strategies more frequently. Those having received the diagnosis in the preceeding six months used emotion focused strategies significantly more often.The absence of characterized depression and anxiety confirmed results of the literature. The significance of this study is found in the observation of specific emotional reactions present in the first six months following diagnosis disclosure. The results show that it is useful to continue the affective evaluation of these patients and to undertake longitudinal studies starting at the time of diagnosis disclosure.

Depression in amyotrophic lateral sclerosis

“…18 Previous studies rarely examined the temporal pattern of depression prevalence and were mostly based on small numbers of patients (range 27-131). [6][7][8][9][10][11][12][13][19][20][21] A recent meta-analysis identified a total of 3,190 patients with ALS from 103 studies on ALS and depression, 22 whereas in the present study, we were able to enroll 1,752 patients in a single study.…”

“…Multiple studies have shown that patients with ALS are more likely to develop depression than ALS-free individuals, although the reported prevalence of depression varies greatly. [6][7][8][9][10][11][12][13] Different measurements of depression together with the varying representativeness of the patient samples used in previous studies may partly explain the different prevalences reported so far.…”

Emotional adjustment in amyotrophic lateral sclerosis (ALS)

“…ALS patients used significantly less often active coping strategies like thinking about the situation or taking adequate steps compared to cancer patients. This lack of active coping strategies might be a sign of a healthy avoidance and denial known to be a successful strategy at the beginning of the disease ALS [13,19,32]. Cancer patients in this study had no visible physical impairments and were, therefore, not as preoccupied with their disease as ALS patients.…”

Investigating the Psychological Effects Associated with Motor Neuron Degeneration in Persons Diagnosed with ALS

“…Once motor neuron cells die, there is no regaining or replacing them. Through the death of these cells, ALS brings on slow onset paralysis and respiratory failure that eventually lead to the death of the person with the condition (Bungener et al, 2005). Despite a deep understanding of the genetic processes involved in the degradation of motor neurons in persons with ALS, this is superficial knowledge in comparison to the unknown root of the disease's irreversible processes.…”

“…The behavioral impairments (such as hopelessness, anger, and feelings of despair and isolation) indicate psychological and social shifts following diagnosis that are important to address. These shifts often manifest over the six months following diagnosis and can be accompanied by anosognosia relative to the physical degeneration that is characteristic of the condition (Bungener at al., 2005). While helpful preliminary findings, the act of studying ALS longitudinally gives a more complete picture of disease progression.…”