Depression in amyotrophic lateral sclerosis

Abstract

Depression is an under-recognized comorbidity associated with amyotrophic lateral sclerosis (ALS). The goals of this study were to prospectively estimate the prevalence of depression and other ALS related symptoms and to study the impact of depression on enrollment in research studies. One hundred and twenty-seven people with ALS completed the ALS Depression Inventory (ADI-12) and answered questions about ALS related symptoms and research study enrollment preferences. Demographics, ALS symptoms, medications, functional status, and research enrollment were compared between depressed and non-depressed patients. Results showed that the prevalence of mild and severe depression was 29% and 6%, respectively. More than one-third of our ALS patients were receiving anti-depressants to treat depression, sialorrhea, and pseudobulbar affect. Depression prevalence was not correlated with disease duration or progression. Except for anxiety, none of the ALS related symptoms predicted depression. The presence of depression did not have an effect on the decision to enroll in research studies. In conclusion, major depression is less common in our ALS cohort than in the general population. The diagnosis of depression can be masked by some ALS related symptoms and it has no impact on enrollment in ALS clinical trials.

Key words::

• ALS
• depression
• management
• symptomatic
• enrollment

Acknowledgements

We would like to thank the participants in this study and DiGiovanni MGH ALS research fund. This work was conducted with support from NIH-T32NS0498005 and the Scholars in Clinical Science Program (SCSP) of Harvard Catalyst, the Harvard Clinical and Translational Science Center and financial contributions from Harvard University and its affiliated academic health centers.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.