The Italian Version of the ALS Depression Inventory-12

Abstract

Introduction: Depression is a comorbidity in patients with amyotrophic lateral sclerosis (ALS). However, its diagnosis is challenged by the co-occurrence of a similar frontotemporal (FT) behavioral symptom—i.e., apathy. Moreover, its psychometric evaluation is confounded by motor disabilities. This study aimed at investigating psychometric properties and feasibility of the ALS Depression Inventory (ADI-12), a self-report questionnaire set up for this issue—as measuring mood changes without referring to movement.Methods: Eighty-five ALS patients were administered the ADI-12 and underwent cognitive (Mini-Mental State Examination, MMSE), quality of life (McGill Quality of Life Questionnaire, MQoL) and further anxiety/mood (Hospital Anxiety and Depression Scale, HADS) assessments. Reliability, validity, sensitivity, and specificity of the ADI-12 were explored.Results: Principal component analyses revealed two related components—“Negative Mood and Lack of Energy” (ME) and “Anhedonia” (A). Both components and the inventory as a whole were internally consistent and highly related to HADS-D. ADI-12-total score was also associated with HADS-A. ADI-12 measures were inversely related to MQoL. ADI-12-total/sub-scales were not related to either MMSE or disease-related outcomes. Estimates of depression yielded by HADS-D and ADI-12 were 11.1 and 35.3%.Discussion: The ADI-12 is a valid, reliable and usable feasibile tool to assess depression in Italian ALS patients independently from motor disabilities. Its interplay with psycho-social outcomes is in agreement with previous studies. The lack of association with cognition suggests that the ADI-12 is partially independent from FT spectrum disorders. The disagreement in depression rates between the ADI-12 and HADS-D suggests the need to ALS-specific mood scales.

Cognition and motor phenotypes in ALS: a retrospective study

“…Moreover, at variance with previous reports [12], the present findings appear not to support the widespread notion of bulbar ALS phenotype being more strongly associated with cognitive impairment [22], since bulbar ALS patients did not differ from any of the other groups. Although caution should be exerted when interpreting the present results due to the small number of bulbar ALS patients included (N = 13), it is worth noting that they are in line with recent ones reporting no differences in FTD-like behavioral alterations between patients showing or not bulbar involvement [20,23].…”

Diagnostic properties of the Italian ECAS Carer Interview (ECAS-CI)

“…The ECAS-CI adds up and complements the currently available range of disease-specific/-nonspecific, behavioural tools that have been standardized in Italy within the ALS population, namely, the Emotional Lability Questionnaire (ELQ) [16], the Dimensional Apathy Scale [17], the State-and Trait-Anxiety Inventory-Form Y (STAI-Y) [18], the ALS Depression Inventory-12 (ADI-12) [19] and the Beaumont Behavioural Inventory (BBI) [15]. However, at variance with them, the ECAS-CI is less time-consuming, as well as embedded within a full, ALS-specific cognitive and behavioural screener, whose section that assesses cognition has been extensively examined for its clinimetrics and feasibility in Italy, i.e.…”

Spanish adaptation and validation of the ALS Depression Inventory-12 (ADI-12) in patients with Amyotrophic Lateral Sclerosis

“…In patients with ALS, depression tends to co-occur with anxiety disorders, among others, and diagnosis is often confused with apathy ( 16 ). A recent study conducted in Scotland found a prevalence of 19.7% of neuropsychiatric disorders in patients with ALS, of which 70% were mood disorders ( 17 ).…”