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Neurodegenerative disorders are progressive diseases that cause irreversible damage and loss to neurons in specific brain areas. Examples of these disorders include Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), and Amyotrophic Lateral Sclerosis (ALS). These disorders share characteristics such as proteinopathies, selective neuronal vulnerability, and a complex interplay between genetic and environmental factors. The primary therapeutic goal for these conditions is...
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Depression in amyotrophic lateral sclerosis.

Elin Roos1, Daniela Mariosa2, Caroline Ingre1

  • 1From 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.

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Summary

Patients with amyotrophic lateral sclerosis (ALS) show increased depression risk and antidepressant use before and after diagnosis. This highlights the importance of monitoring mental health in ALS patients throughout their journey.

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Area of Science:

  • Neurology
  • Psychiatry
  • Epidemiology

Background:

  • Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease.
  • Depression is a common comorbidity in neurological disorders.
  • Understanding the temporal relationship between ALS and depression is crucial for patient care.

Purpose of the Study:

  • To investigate the risk of depression diagnosis and antidepressant use in patients with ALS.
  • To compare these risks before and after an ALS diagnosis.

Main Methods:

  • A nested case-control study utilized Swedish national health and population registers.
  • 1,752 ALS patients were compared with 8,760 controls.
  • The study assessed depression diagnosis and antidepressant use pre- and post-ALS diagnosis.

Main Results:

  • Patients with ALS had a higher risk of depression diagnosis before diagnosis (OR 1.7), peaking in the year prior (OR 3.5).
  • A significantly increased risk of depression was observed within the first year post-diagnosis (HR 7.9).
  • Antidepressant use was substantially higher in ALS patients, particularly in the year before (OR 5.8) and after diagnosis (HR 16.1).

Conclusions:

  • Patients with ALS face elevated risks of depression diagnosis and antidepressant use.
  • These risks are present both immediately preceding and following an ALS diagnosis.
  • This underscores the need for proactive mental health support for individuals with ALS.