Objective: Patients with amyotrophic lateral sclerosis (ALS) often develop depressive symptoms. Little is known of the factors that predict or influence depression in ALS patients.
Patients and methods: In 41 ALS patients we compared a self-rating depression scale with the ALS Functional Rating Scale (ALS-FRS), duration of disease, age, sex, education and participation in a self-help group.
Results: There was no significant relation between the total ALS-FRS score and the self-rating depression scale. In contrast, we found a significant correlation between the swallowing (r=-0.453; P=0.003) and breathing (r=-0.333; P=0.033) items of the ALS-FRS and the depressive scale. Depressive symptoms were negatively correlated with the duration of the disease (r=-0.377; P=0.016); there was no influence of age or sex.
Conclusion: We found no evidence for a direct association between the loss of physical ability in general and depression, but for a decrease of depressive symptoms in relation to the length of time since diagnosis. Therefore, depressive symptoms in ALS patients seem to occur mainly as a depressive reaction following the communication of the diagnosis. In addition, patients with bulbar and respiratory symptoms should carefully be screened for depressive symptoms.