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A longer diagnostic interval is a risk for depression in amyotrophic lateral sclerosis
Method: Structured medical and psychiatric history questionnaires and a validated depression scale (Depression, Anxiety, Stress Scale–21) were completed by 27 ALS patients (60% female; 59% limb onset; age 65.11±SE 2.21) prior to their initial review at a multidisciplinary clinic. Physical function was assessed with the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS–R).
Results: At the time of initial assessment, 44% of patients had a previous psychiatric history, although the majority (62%) reported no symptoms of depression. The mean ALSFRS–R score was 37.78±SE 1.22, with an average diagnostic interval of 16.04±SE 2.39 months. Logistic regression analysis revealed that the length of the diagnostic interval alone predicted depressive symptoms (x2 (3, n = 26) = 9.21, Odds Ratio (OR) = 1.12, p , 0.05.
Significance of Results: The illness experiences of ALS patients rather than established mental health risk factors influence the manifestation of depressive symptoms in the early stages of the disease, with clinical implications for the assessment and treatment of psychological morbidity. Patients with lengthy diagnostic intervals may be prime targets for psychological assessment and intervention, especially in the absence of ALS-specific tests and biomarkers.
Publication titlePalliative and Supportive Care
Department/SchoolAustralian Institute of Health Service Management (AIHSM)
PublisherCambridge University Press
Place of publicationUnited Kingdom
Rights statementCopyright Cambridge University Press, 2014