HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Polish Data Supplement Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Related articles in Neurology Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rabkin, J. G. Articles by Mitsumoto, H. Search for Related Content PubMed PubMed Citation Articles by Rabkin, J. G. Articles by Mitsumoto, H.

Prevalence of depressive disorders and change over time in late-stage ALS

From the New York State Psychiatric Institute, New York, NY.

Address correspondence and reprint requests to Dr. J. Rabkin, New York State Psychiatric Institute, 1051 Riverside Dr., New York, NY 10032; e-mail: jgr1{at}Columbia.edu

Objective: To determine the prevalence of depressive disorders and symptoms in patients with late-stage ALS, to identify possible risk and protective factors associated with depression, and to determine whether depression increases as death approaches.

Methods: Semistructured interviews were conducted monthly with hospice-eligible patients with ALS and caregivers until the study endpoints of death or tracheostomy. Standardized measures were administered to assess depressive disorders and symptoms, hopelessness, spiritual beliefs, attitudes toward hastened death, quality of life, and related constructs.

Results: Sixty-three percent of eligible patients were enrolled. Of the 80 participants, 17 were seen only once; the number of monthly assessments for the others ranged from 2 to 18. For the 53 patients who died, median interval between last assessment and death was 30 days. At study baseline, 81% had no depressive disorder, 10% had minor depression, and 9% had symptoms consistent with major depression. Diagnoses of depression were made on 16% of 369 monthly assessments. Fifty-seven percent of patients never had a depression diagnosis at any visit, and 8% were depressed at all visits. There was no trend toward increasing depression as death approached. Presumed protective factors including spiritual beliefs, spouse as care partner, financial situation, depression in caregiver, and hospice participation did not distinguish between those who were depressed and those who were not.

Conclusions: Results of multiple measures of depression and distress converged to indicate that major depression in people with late-stage ALS is rare, although transient depressive symptoms may occur, and depression does not generally increase as death approaches.

Commentary, see page 1

Editorial, see page 9

See also page 68

Received December 21, 2004. Accepted in final form March 4, 2005.

Related articles in Neurology:

July 12 Highlights and Commentary: ALS, depression, and desire for a hastened death: (How) are they related?

Neurology 2005 65: 1. [Full Text]  

Wish to die in end-stage ALS

S. M. Albert, J. G. Rabkin, M. L. Del Bene, T. Tider, I. O'Sullivan, L. P. Rowland, and H. Mitsumoto
Neurology 2005 65: 68-74. [Abstract] [Full Text]  

Exit strategies in ALS: An influence of depression or despair?

Richard K. Olney and Catherine Lomen-Hoerth
Neurology 2005 65: 9-10. [Full Text]  

This article has been cited by other articles:

				H. Schmolck, D. Mosnik, and P. Schulz Rating the approachability of faces in ALS Neurology, December 11, 2007; 69(24): 2232 - 2235. [Abstract] [Full Text] [PDF]

				H. Mitsumoto and J. G. Rabkin Palliative Care for Patients With Amyotrophic Lateral Sclerosis: "Prepare for the Worst and Hope for the Best" JAMA, July 11, 2007; 298(2): 207 - 216. [Abstract] [Full Text] [PDF]

				M. Gourie-Devi and S. M. Albert Wish to die in end-stage ALS Neurology, January 2, 2007; 68(1): 79 - 79. [Full Text] [PDF]

				L. H. Goldstein, L. Atkins, S. Landau, R. G. Brown, and P. N. Leigh Longitudinal predictors of psychological distress and self-esteem in people with ALS. Neurology, November 14, 2006; 67(9): 1652 - 1658. [Abstract] [Full Text] [PDF]

				R. K. Olney and C. Lomen-Hoerth Exit strategies in ALS: An influence of depression or despair? Neurology, July 12, 2005; 65(1): 9 - 10. [Full Text] [PDF]