title: Depression and anxiety in individuals with amyotrophic lateral sclerosis: a systematic review.
abstract: BACKGROUND
  Studies assessing symptoms of depression and anxiety in individuals with amyotrophic lateral sclerosis (ALS) have reported contradictory results. The objective of this systematic review is to identify the prevalence of these mood disorders in the literature.
  
  
  METHODS
  We searched the PubMed, HighWire, MEDLINE, SciELO, LILACS and ScienceDirect databases. Literature was selected for review in two stages, according to eligibility criteria. The first stage involved searching databases and checking titles and abstracts. The second step consisted of reading complete articles and excluding those that did not meet the inclusion criteria. The inclusion criteria were articles written in Portuguese, English or Spanish, published in the last five years and involving people with ALS diagnosed according to the El Escorial criteria.
  
  
  RESULTS
  The database searches returned a total of 1,135 titles and abstracts and then 1,117 of these were excluded. Eighteen articles were selected for review. The 12-item Amyotrophic Lateral Sclerosis Depression Inventory (ADI-12) was the only instrument designed specifically to assess depression in ALS, but it was only used in three studies. No instruments specifically designed for anxiety in ALS were used. A large number of studies found presence and slight increase of anxiety disorders. There was considerable large variation in the results related to depressive disorders, ranging from moderate depression to an absence of symptoms.
  
  
  CONCLUSIONS
  Patients with ALS may exhibit symptoms of depression and anxiety at different levels, but there is a need for studies using specific instruments with larger samples in order to ascertain the prevalence of symptoms in ALS and the factors associated with it.
authors.affiliation: Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco, Recife, PE, Brazil.
authors.forename: Tatiana Lins
authors.initials: TL
authors.lastname: Carvalho
authors.affiliation: Universidade Federal de Pernambuco, Recife, PE, Brazil.
authors.forename: Lilian Maria Sanguinett
authors.initials: LM
authors.lastname: de Almeida
authors.affiliation: Universidade Federal de Pernambuco, Recife, PE, Brazil.
authors.forename: Camila Maria Araújo
authors.initials: CM
authors.lastname: Lorega
authors.affiliation: Universidade Federal de Pernambuco, Recife, PE, Brazil.
authors.forename: Mirella Francyne Oliveira
authors.initials: MF
authors.lastname: Barata
authors.affiliation: Centro de Referência para Atenção ao Paciente Portador de Doença Desmielinizante, Recife, PE, Brazil.
authors.forename: Maria Lúcia Brito
authors.initials: ML
authors.lastname: Ferreira
authors.affiliation: Departamento de Neurologia, Faculdade de Ciências Médicas, UPE, Recife, PE, Brazil.
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: de Brito-Marques
authors.affiliation: Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco, Recife, PE, Brazil.
authors.forename: Carolina da Cunha
authors.initials: Cda C
authors.lastname: Correia
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology* / Q000523:psychology*; D001007:Anxiety / Q000453:epidemiology*; D003863:Depression / Q000453:epidemiology*; D006801:Humans