Introduction and objective:
Amyotrophic lateral sclerosis (ALS) is a degenerative disease of the nervous system. The disease leads to severe disability and eventually death from respiratory failure. Currently, attention is paid to the presence of major depression as an early marker of brain degeneration. The aim of the study was to review the literature on the occurrence of depression in patients with ALS.

Review methods:
Literature from the PubMed/Medline database covering the years 2004–2021 was included.

Brief description of the state of knowledge:
ALS patients are more likely to be diagnosed with depression. Studies have shown that the severity of depressive symptoms was related to gender, employment, perceived health status and the type of ALS. The severity of depression correlated with faster disease progression and worse functional status. Moreover, there is a high prevalence of depression in patients with ALS and cognitive impairment, compared with patients without cognitive deficits. However, in other studies it was observed that depression was not related to the duration and clinical presentation of the disease, gender, age at its onset, and the functional status of patients. Also, the occurrence and severity of depression were not correlated with disease progression. There were also no significant correlations between the level of depression and cognitive functions. A review of the literature shows that depression in ALS has a significant impact on both the physical and psychological domains of the quality of life.

Depression in patients with ALS occurs with varying frequency. The results of research regarding the influence of various factors on the incidence of depression in ALS patients are inconclusive. Depression in ALS is associated with poorer quality of life and social withdrawal.

Hardiman O, Al­Chalabi A, Chio A, et al. Amyotrophic lateral sclero­sis. Nat Rev Dis Primers. 2017; 3: 17071. doi:
Grad LI, Rouleau GA, Ravits J, et al. Clinical spectrum of amyotrophic lateral sclerosis (ALS). Cold Spring Harb Perspect Med. 2017; 7(8): a024117. doi:
Hulisz D. Amyotrophic lateral sclerosis: disease state overview. Am J Manag Care. 2018; 24(15 Suppl): 320–326.
Oskarsson B, Gendron TF, Staff NP. Amyotrophic lateral sclerosis: an update for 2018. Mayo Clin Proc. 2018; 93(11): 1617–1628. doi: 10.1016/j.mayocp.2018.04.007.
Mejnartowicz JP. Stwardnienie zanikowe boczne jako choroba neuronu ruchowego. In: Kozubski W, editor. Terapia w chorobach układu ner­wowego. Warszawa: PZWL; 2016. p. 438–447.
Malhi GS, Mann JJ. Depression. Lancet. 2018; 392(10161): 2299–2312. doi:­....
Pełka­Wysiecka J, Samochowiec J. Depresja – czy faktycznie zróżnico­wana farmakoterapia?. Psychiatria 2014; 11, 3: 141–147.
Otte Ch, Gold SM, Penninx BW, et al. Major depressive disorder. Nat Rev Dis Primers. 2016; 2: 16065. doi:
Réus GZ, E Titus SE, Abelaira HM, et al. Neurochemical correlation between major depressive disorder and neurodegenerative diseases. Life Sci. 2016; 158: 121–129. doi:
Pużyński S, Wciórka J. Klasyfikacja zaburzeń psychicznych i zaburzeń zachowania w ICD­10. Opisy kliniczne i wskazówki diagnostyczne. Międzynarodowa Statystyczna Klasyfikacja Chorób i Problemów Zdro­wotnych. Rewizja dziesiąta. Kraków–Warszawa: UWM Vesalius i IPiN; 2000. p. 107–108.
Rao M. Depresja u osób cierpiących na choroby somatyczne. Psychiatria po Dyplomie. 2009; 6(1): 37–45.
Esser P, Metelmann M, Hartung T, et al. Psychosocial care for pa­tients with amyotrophic lateral sclerosis: a narrative review. Psychother Psychosom Med Psychol. 2019; 69(9–10): 372–381. doi:­0806....
Galin S, Heruti I, Barak N, et al. Hope and self­efficacy are associated with better satisfaction with life in people with ALS. Amyotroph Lateral Scler Frontotemporal Degener. 2018; 19(7–8): 611–618. doi:
Heidari ME, Nadali J, Parouhan A, et al. Prevalence of depression among amyotrophic lateral sclerosis (ALS) patients: a systematic review and meta­analysis. J Affect Disord. 2021; 287: 182–190. doi:
Carvalho TL, de Almeida LM, Lorega CM, et al. Depression and anxie­ty in individuals with amyotrophic lateral sclerosis: a systematic re­view. Trends Psychiatry Psychother. 2016; 38(1): 1–5. doi:­6....
Pisa FE, Logroscino G, Casetta A, et al. The use of antidepressant me­dication before and after the diagnosis of amyotrophic lateral sclerosis: a population­based cohort study. Neuroepidemiology. 2015; 44(2): 91–98. doi:
Pagnini F, Manzoni GM, Tagliaferri A, et al. Depression and disease progression in amyotrophic lateral sclerosis: a comprehensive meta­­regression analysis. J Health Psychol. 2015; 20(8): 1107–1128. doi:
Wicks P, Abrahams S, Masi D, et al. Prevalence of depression in a 12­month consecutive sample of patients with ALS. Eur J Neurol. 2007; 14(9): 993–1001. doi:
Cragg JJ, Seals R, Cashman N, et al. Journal Club: Depression before and after diagnosis with amyotrophic lateral sclerosis. Neurology. 2016; 87(21): 257–259. doi:
Turner MR, Goldacre R, Talbot K, et al. Psychiatric disorders prior to amyotrophic lateral sclerosis. Ann Neurol. 2016; 80(6): 935–938. doi:
Roos E, Mariosa D, Ingre C, et al. Depression in amyotrophic lateral scle­rosis. Neurology. 2016; 86(24): 2271–2277. doi:
Grabler MR, Weyen U, Juckel G, et al. Death anxiety and depression in amyotrophic lateral sclerosis patients and their primary caregivers. Front Neurol. 2018; 9: 1035. doi:
Díaz JL, Sancho J, Barreto P, et al. Effect of a short­term psychological intervention on the anxiety and depression of amyotrophic lateral sclerosis patients. J Health Psychol. 2016; 21(7): 1426–1435. doi:
Atassi N, Cook A, Pineda CM, et al. Depression in amyotrophic lateral sclerosis. Amyotroph Lateral Scler. 2011; 12(2): 109–112. doi:
Prado LGR, Bicalho ICS, Vidigal­Lopes M, et al. Depression and anxiety in a case series of amyotrophic lateral sclerosis: frequency and associa­tion with clinical features. Einstein (Sao Paulo). 2017; 15(1): 58–60. doi:­....
De Marchi F, Sarnelli MF, Solara V, et al. Depression and risk of cognitive dysfunctions in amyotrophic lateral sclerosis. Acta Neurol Scand. 2019; 139(5): 438–445. doi:
Anca M, Sebastian A, Cristina R, et al. Predictors of depression in caucasian patients with amyotrophic lateral sclerosis in Romania. Brain Sci. 2020; 10(8): 470. doi:
Wei Q, Zheng Z, Guo X, et al. Association between depression and survival in Chinese amyotrophic lateral sclerosis patients. Neurol Sci. 2016; 37(4): 557–563. doi:
Chen D, Guo X, Zheng Z, et al. Depression and anxiety in amyotrophic lateral sclerosis: correlations between the distress of patients and care­givers. Muscle Nerve. 2015; 51(3): 353–357. doi:
Nazemi M, Raad MH, Arzoomanian CS, et al. Fatigue and depression in Iranian amyotrophic lateral sclerosis patients in Tehran in 2012. Elec­tron Physician. 2016; 8(3): 2194–2198. doi:
Hillemacher T, Grässel E, Tigges S, et al. Depression and bulbar invol­vement in amyotrophic lateral sclerosis. Amyotroph Lateral Scler Other Motor Neuron Disord. 2004; 5(4): 245–249. doi:
Caga J, Ramsey E, Hogden A, et al. A longer diagnostic interval is a risk for depression in amyotrophic lateral sclerosis. Palliat Support Care. 2015; 13(4): 1019–1024. doi:
Oh H, Sin MK, Schepp KG, et al. Depressive symptoms and functional impairment among amyotrophic lateral sclerosis patients in South Korea. Rehabil Nurs. 2012; 37(3): 136–144. doi:
Thakore NJ, Pioro EP. Depression in ALS in a large self­reporting co­ hort. Neurology. 2016; 86(11): 1031–1038. doi:
Cui F, Zhu W, Zhou Z, et al. Frequency and risk factor analysis of cog­nitive and anxiety­depressive disorders in patients with amyotrophic lateral sclerosis/motor neuron disease. Neuropsychiatr Dis Treat. 2015; 11: 2847–2854. doi:
McElhiney MC, Rabkin JG, Gordon PH, et al. Prevalence of fatigue and depression in ALS patients and change over time. J Neurol Neuro­surg Psychiatry. 2009; 80(10): 1146–1149. doi:
Carelli L, Solca F, Faini A, et al. The complex interplay between de­pression/anxiety and executive functioning: insights from the ECAS in a large ALS population. Front Psychol. 2018; 9: 450. doi:
Watanabe Y, Raaphorst J, Izumi Y, et al. Cognitive and behavioral status in Japanese ALS patients: a multicenter study. J Neurol. 2020; 267(5): 1321–1330. doi:
Wei Q, Chen X, Cao B, et al. Associations between neuropsychiatric symptoms and cognition in Chinese patients with amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener. 2016; 17(5–6): 358–365. doi:
Thakore NJ, Pioro EP. Laughter, crying and sadness in ALS. J Neu­rol Neurosurg Psychiatry. 2017; 88(10): 825–831. doi:­2....
Alejos M, Vázquez­Bourgon J, Santurtún M, et al. Do patients diag­nosed with a neurological disease present increased risk of suicide? Neurologia. 2020; S0213­4853(20)30129­8. doi:
Silva­Moraes MH, Bispo­Torres AC, Barouh JL, et al. Suicidal beha­vior in individuals with amyotrophic lateral sclerosis: a systematic review. J Affect Disord. 2020; 277: 688–696. doi:
Rabkin JG, Goetz R, Factor­Litvak P, et al. ALS COSMOS Study Group. Depression and wish to die in a multicenter cohort of ALS patients. Amyotroph Lateral Scler Frontotemporal Degener. 2015; 16(3–4): 265–273. doi:
Gourie­Devi M, Gupta R, Sharma V, et al. An insight into death wish among patients with amyotrophic lateral sclerosis in India using „Wish­­to­Die Questionnaire”. Neurol India. 2017; 65(1): 46–51. doi:­3....
Rabkin J, Goetz R, Murphy JM, et al. ALS COSMOS Study Group. Cognitive impairment, behavioral impairment, depression, and wish to die in an ALS cohort. Neurology. 2016; 87(13): 1320–1328. doi:
Beeldman E, Raaphorst J, Klein Twennaar M, et al. The cognitive profile of ALS: a systematic review and meta­analysis update. J Neurol Neurosurg Psychiatry. 2016; 87(6): 611–619. doi:­2....
Unglik J, Bungener C, Delgadillo D, et al. Emotional feeling in patients suffering from amyotrophic lateral sclerosis. Geriatr Psychol Neu­ropsychiatr Vieil. 2018; 16(4): 414–422. doi:
Caga J, Hsieh S, Highton­Williamson E, et al. Apathy and its impact on patient outcome in amyotrophic lateral sclerosis. J Neurol. 2018; 265(1): 187–193. doi:
Caga J, Turner MR, Hsieh S, et al. Apathy is associated with poor prognosis in amyotrophic lateral sclerosis. Eur J Neurol. 2016; 23(5): 891–897. doi:
Diaz­Abad M, Buczyner JR, Venza BR, et al. Poor sleep quality in patients with amyotrophic lateral sclerosis at the time of diagnosis. J Clin Neuromuscul Dis. 2018; 20(2): 60–68. doi:
Hübner J, Hübner I, Kroczka S. Mood disorders and cognitive impair­ment in the course of increasing disability in patients suffering from amyotrophic lateral sclerosis. Psychiatr Pol. 2020; 54(2): 289–302. doi:
Jakobsson Larsson B, Ozanne AG, Nordin K, et al. A prospective study of quality of life in amyotrophic lateral sclerosis patients. Acta Neurol Scand. 2017; 136(6): 631–638. doi:
Vázquez Medrano CR, Aho­Özhan HEA, Weiland U, et al. Disease progression but not physical state per se determines mental wellbeing in ALS. J Neurol. 2020; 267(12): 3593–3601. doi:
Körner S, Kollewe K, Abdulla S, et al. Interaction of physical function, quality of life and depression in amyotrophic lateral sclerosis: characte­rization of a large patient cohort. BMC Neurol. 2015; 15: 84. doi:
Pizzimenti A, Aragona M, Onesti E, et al. Depression, pain and quality of life in patients with amyotrophic lateral sclerosis: a cross­sectional study. Funct Neurol. 2013; 28(2): 115–119. doi:
Chiò A, Mora G, Lauria G. Pain in amyotrophic lateral sclerosis. Lan­cet Neurol. 2017; 16(2): 144–157. doi:­... ­1.
Edge R, Mills R, Tennant A, et al. TONiC study group. Do pain, anxiety and depression influence quality of life for people with amyotrophic lateral sclerosis/motor neuron disease? A national study reconciling previous conflicting literature. J Neurol. 2020; 267(3): 607–615. doi:
Kübler A, Winter S, Ludolph AC, et al. Severity of depressive symp­toms and quality of life in patients with amyotrophic lateral sclerosis. Neurorehabil Neural Repair. 2005; 19(3): 182–193. doi:
Paganoni S, McDonnell E, Schoenfeld D, et al. Functional decline is associated with hopelessness in amyotrophic lateral sclerosis (ALS). J Neurol Neurophysiol. 2017; 8(2): 423. doi:­9....
Grehl T, Rupp M, Budde P, et al. Depression and QOL in patients with ALS: how do self­ratings and ratings by relatives differ? Qual Life Res. 2011; 20(4): 569–574. doi: ­010­9781­7.
Sandstedt P, Johansson S, Ytterberg Ch, et al. Predictors of health­related quality of life in people with amyotrophic lateral sclerosis. J Neurol Sci. 2016; 370: 269–273. doi:
Schlüter DK, Tennant A, Mills R, et al. Risk factors for social withdrawal in amyotrophic lateral sclerosis/motor neurone disease. Amyotroph Lateral Scler Frontotemporal Degener. 2018; 19(7–8): 591–598. doi:
Journals System - logo
Scroll to top