Author(s): Schluter D.K.; Miele G.; Mills R.; Young C.A.
Source: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration; 2018; vol. 19 ; p. 193-194
Publication Date: 2018
Publication Type(s): Conference Abstract
Abstract:Background: Depression is strongly associated with quality of life and has been the focus of several studies in Motor Neurone Disease (MND). Relationships of depression with demographic and disease-related characteristics and physical impairment are however unclear, as is the impact of effective communication with clinical staff and support from family, friends and voluntary societies. Objective(s): To develop a profile of depression in a large MND cohort in the UK; to assess associations of depression with various demographic or disease-related characteristics, physical symptoms and functioning to identify factors that can highlight individuals at risk of experiencing depression; to assess associations of depression with different types of support to understand their potential role in ameliorating depression. Method(s): 636 individuals with MND were recruited into the ongoing Trajectories of Outcomes in Neurological Conditions (TONiC) study from MND clinics across the United Kingdom. Participants completed a questionnaire pack collecting data on demographics and several patient reported measures, including the modified Hospital Anxiety and Depression scale-MND, ALSFRS-R, Neuropathic Pain Scale, Neurological Fatigue Index, Dyspnoea-12, Symptom Inventory-ALS, WHODAS-2 and questions around received support. Rasch analysis was applied to ordinal scale scores to derive interval level data. Explanatory variables were grouped into ‘demographic and disease characteristics’, ‘physical symptoms, functioning and disability’, and ‘support’. Within these groups simple and multiple linear regression were used to assess associations between depression and any of the explanatory variables. Statistical significance was based on the likelihood ratio test statistic and a p-value50.1. Only complete data were used for the analysis within each group of variables, therefore the sample size differed between groups. Result(s): Using published cut-offs for possible and probable depression, only 45 individuals had probable depression, which was 7% of the study population. 22% had possible depression. There were no significant associations between demographics, disease duration, and onset type and depression. However, breathlessness, fatigue, pain, drooling, choking, fasciculations, cramps, head drop, emotional lability, physical functioning, disability and perceived health were all found to be associated with depression. In the multiple regression analysis disability, breathlessness, fasciculation, drooling, pain, motor function, bulbar function and perceived health remained significant. Support from family, friends and voluntary societies as well as communication with clinical staff and obtaining high quality information about MND were inversely associated with depression. Discussion and conclusions: Depression in people with MND is associated with treatable symptoms such as pain, drooling and breathlessness, as well as functioning and disability. Support from family and friends, clinical staff and voluntary societies should actively be considered as important for the psychological health of patients. Longitudinal studies are required to confirm causation between depression and asociated factors.