Atassi Nazem, Cook Amanda, Pineda Cristiana M E, Yerramilli-Rao Padmaja, Pulley Darlene, Cudkowicz Merit
Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Amyotroph Lateral Scler. 2011 Mar;12(2):109-12. doi: 10.3109/17482968.2010.536839. Epub 2010 Nov 24.
Depression is an under-recognized comorbidity associated with amyotrophic lateral sclerosis (ALS). The goals of this study were to prospectively estimate the prevalence of depression and other ALS related symptoms and to study the impact of depression on enrollment in research studies. One hundred and twenty-seven people with ALS completed the ALS Depression Inventory (ADI-12) and answered questions about ALS related symptoms and research study enrollment preferences. Demographics, ALS symptoms, medications, functional status, and research enrollment were compared between depressed and non-depressed patients. Results showed that the prevalence of mild and severe depression was 29% and 6%, respectively. More than one-third of our ALS patients were receiving anti-depressants to treat depression, sialorrhea, and pseudobulbar affect. Depression prevalence was not correlated with disease duration or progression. Except for anxiety, none of the ALS related symptoms predicted depression. The presence of depression did not have an effect on the decision to enroll in research studies. In conclusion, major depression is less common in our ALS cohort than in the general population. The diagnosis of depression can be masked by some ALS related symptoms and it has no impact on enrollment in ALS clinical trials.
抑郁症是一种与肌萎缩侧索硬化症(ALS)相关但未得到充分认识的合并症。本研究的目的是前瞻性地评估抑郁症及其他与ALS相关症状的患病率,并研究抑郁症对参与研究的影响。127名ALS患者完成了ALS抑郁症量表(ADI - 12),并回答了有关ALS相关症状及参与研究偏好的问题。对抑郁和非抑郁患者的人口统计学特征、ALS症状、药物治疗、功能状态及参与研究情况进行了比较。结果显示,轻度和重度抑郁症的患病率分别为29%和6%。超过三分之一的ALS患者正在接受抗抑郁药治疗抑郁症、流涎和假性延髓情绪。抑郁症患病率与疾病持续时间或进展无关。除焦虑外,没有任何ALS相关症状可预测抑郁症。抑郁症的存在对参与研究的决定没有影响。总之,在我们的ALS队列中,重度抑郁症的发生率低于一般人群。抑郁症的诊断可能被一些ALS相关症状所掩盖,且对ALS临床试验的参与率没有影响。