title: Depression and bulbar involvement in amyotrophic lateral sclerosis.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry and Psychotherapy, Centre of Neuromuscular Diseases, University of Erlangen-Nuremberg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hillemacher
authors.forename: Elmar
authors.initials: E
authors.lastname: Grässel
authors.forename: Sebastian
authors.initials: S
authors.lastname: Tigges
authors.forename: Stefan
authors.initials: S
authors.lastname: Bleich
authors.forename: Bernhard
authors.initials: B
authors.lastname: Neundörfer
authors.forename: Johannes
authors.initials: J
authors.lastname: Kornhuber
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Hecht
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires