Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Behavioral Impairment Linked to Depression in ALS

Neurology; ePub 2016 Aug 5; Rabkin, Goetz, et al

While no association was found between cognitive impairment and depression or any measure of distress in patients with amyotrophic lateral sclerosis (ALS), behavioral impairment was strongly associated with depressive symptoms and diagnoses, although seldom addressed by clinicians, a recent study found. Researchers evaluated a cohort of 247 patients and found:

• 79 (32%) had neither cognitive nor behavioral impairment, 100 (40%) had cognitive impairment, 23 (9%) had behavioral impairment, and 45 (18%) had comorbid cognitive and behavioral decline.

• Cognitive impairment, when present, was in the mild range for 90% and severe for 10%.

• 31 patients (12%) had a major or minor depressive disorder.

• Cognitive impairment was unrelated to all psychiatric/psychosocial measures.

• In contrast, patients with behavioral impairment reported more depressive symptoms, greater hopelessness, negative mood, and more negative feedback from spouse or caregiver; a wish to die was unrelated to either cognitive or behavioral impairment.

Citation:

Rabkin J, Goetz R, Murphy JM, Factor-Litvak P, Mitsumoto H. Cognitive impairment, behavioral impairment, depression, and wish to die in an ALS cohort. [Published online ahead of print August 5, 2016]. Neurology. doi:10.1212/WNL.0000000000003035.

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