title: Depression in amyotrophic lateral sclerosis.
abstract: To examine the relative risk of depression among patients with amyotrophic lateral sclerosis (ALS), both in terms of depression diagnosis and use of antidepressant drugs, before and after diagnosis.
  
  
  
  We conducted a nested case-control study including 1,752 patients with ALS diagnosed from July 2005 to December 2010 and 8,760 controls based on the Swedish national health and population registers, to assess the associations of depression diagnosis and use of antidepressant drugs with a subsequent risk of ALS. We further followed the patients with ALS after diagnosis to estimate the association of an ALS diagnosis with the subsequent risk of depression and use of antidepressant drugs.
  
  
  
  Before diagnosis, patients with ALS were at higher risk of receiving a clinical diagnosis of depression compared to controls (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.3-2.3), and the highest risk increase was noted during the year before diagnosis (OR 3.5, 95% CI 2.1-5.6). Patients with ALS also had a highly increased risk of depression within the first year after diagnosis (hazard ratio 7.9, 95% CI 4.4-14.3). Antidepressant use was more common in patients with ALS than in controls, especially during the year before (OR 5.8, 95% CI 4.5-7.5) and the year after (hazard ratio 16.1, 95% CI 11.5-22.6) diagnosis.
  
  
  
  Patients with ALS are at higher risk of depression diagnosis and use of antidepressant drugs both immediately before and after diagnosis.
authors.affiliation: From the Departments of Medical Epidemiology and Biostatistics (E.R., D.M., C.L., K.W., F.F.) and Clinical Neuroscience (C.I., K.W.), and Institute of Environmental Medicine (P.M.R.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurology (P.M.R.), Division of Clinical Neurophysiology, Oslo University Hospital, Oslo, Norway.
authors.forename: Elin
authors.initials: E
authors.lastname: Roos
authors.affiliation: From the Departments of Medical Epidemiology and Biostatistics (E.R., D.M., C.L., K.W., F.F.) and Clinical Neuroscience (C.I., K.W.), and Institute of Environmental Medicine (P.M.R.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurology (P.M.R.), Division of Clinical Neurophysiology, Oslo University Hospital, Oslo, Norway. Daniela.Mariosa@ki.se.
authors.forename: Daniela
authors.initials: D
authors.lastname: Mariosa
authors.affiliation: From the Departments of Medical Epidemiology and Biostatistics (E.R., D.M., C.L., K.W., F.F.) and Clinical Neuroscience (C.I., K.W.), and Institute of Environmental Medicine (P.M.R.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurology (P.M.R.), Division of Clinical Neurophysiology, Oslo University Hospital, Oslo, Norway.
authors.forename: Caroline
authors.initials: C
authors.lastname: Ingre
authors.affiliation: From the Departments of Medical Epidemiology and Biostatistics (E.R., D.M., C.L., K.W., F.F.) and Clinical Neuroscience (C.I., K.W.), and Institute of Environmental Medicine (P.M.R.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurology (P.M.R.), Division of Clinical Neurophysiology, Oslo University Hospital, Oslo, Norway.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Lundholm
authors.affiliation: From the Departments of Medical Epidemiology and Biostatistics (E.R., D.M., C.L., K.W., F.F.) and Clinical Neuroscience (C.I., K.W.), and Institute of Environmental Medicine (P.M.R.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurology (P.M.R.), Division of Clinical Neurophysiology, Oslo University Hospital, Oslo, Norway.
authors.forename: Karin
authors.initials: K
authors.lastname: Wirdefeldt
authors.affiliation: From the Departments of Medical Epidemiology and Biostatistics (E.R., D.M., C.L., K.W., F.F.) and Clinical Neuroscience (C.I., K.W.), and Institute of Environmental Medicine (P.M.R.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurology (P.M.R.), Division of Clinical Neurophysiology, Oslo University Hospital, Oslo, Norway.
authors.forename: Per M
authors.initials: PM
authors.lastname: Roos
authors.affiliation: From the Departments of Medical Epidemiology and Biostatistics (E.R., D.M., C.L., K.W., F.F.) and Clinical Neuroscience (C.I., K.W.), and Institute of Environmental Medicine (P.M.R.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurology (P.M.R.), Division of Clinical Neurophysiology, Oslo University Hospital, Oslo, Norway.
authors.forename: Fang
authors.initials: F
authors.lastname: Fang
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology; D000928:Antidepressive Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D015331:Cohort Studies; D003866:Depressive Disorder / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D012042:Registries; D012306:Risk; D012680:Sensitivity and Specificity; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents