This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

The Role of Psychological Factors

Evelyn R. McDonald, MS; Sue A. Wiedenfeld, PhD; Al Hillel, MD; Catherine L. Carpenter, MPH; Rhoda A. Walter, MS

Arch Neurol. 1994;51(1):17-23.

Abstract
Objective
Examining the relationship between psychological status and survival in amyotrophic lateral sclerosis. Our hypothesis is that psychological distress is associated with greater mortality and shorter survival time than psychological well-being.

Design
Cross-sectional, longitudinal. The baseline evaluations used were disease severity and 10 psychometric tests. A psychological status score was derived from these tests. Survival status was monitored for 3.5 years. Interviewers were blinded to other interviews and data analysis.

Setting
Patient's residence.

Patients
The criteria for eligibility were diagnosis of amyotrophic lateral sclerosis by a neurologist, dementia or alcoholism absent, communication in English, and any severity or length of disease. It was a volunteer sample consisting of 144 patients from amyotrophic lateral sclerosis clinics or community-based amyotrophic lateral sclerosis support groups. In this sample 66% were men, 94% were white, mean age at diagnosis was 55 years, 79% were married, 60% had some college education, and 61% died during the study.

Interventions
None.

Main Outcome Measures
End points: mortality during study, survival time from intake to last follow-up.

Results
Comparison between high and low psychological score groups: 32% of high and 82% of low died; survival curves were significantly different. Controlling for confounding factors (length of illness, disease severity, age), patients with psychological distress had a greater risk of mortality (relative risk, 6.76; 95% confidence limits, 1.69 to 27.12) and greater likelihood of dying in any given time period (relative risk, 2.24; 95% confidence limits, 1.08 to 4.64) than those with psychological well-being.

Conclusion
Adjusting for confounding factors, psychological status is strongly related to outcome in amyotrophic lateral sclerosis. Further studies on psychological status should be done to confirm its prognostic value.

Author Affiliations
From The New Road Map Foundation (Mss McDonald and Walter), and Departments of Psychiatry and Behavioral Medicine (Dr Wiedenfeld) and Otolaryngology (Dr Hillel), University of Washington, Seattle; and Department of Epidemiology, UCLA School of Public Health, Los Angeles, Calif (Ms Carpenter).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Severity of Depressive Symptoms and Quality of Life in Patients with Amyotrophic Lateral Sclerosis
Kubler et al.
Neurorehabil Neural Repair 2005;19:182-193.
ABSTRACT  

A Comparative Study of Variables That Have an Impact on Noncancer End-of-Life Diagnoses
Dobratz
Clin Nurs Res 2004;13:309-325.
ABSTRACT  

Standard Equations Are Not Accurate in Assessing Resting Energy Expenditure in Patients With Amyotrophic Lateral Sclerosis
Sherman et al.
JPEN J Parenter Enteral Nutr 2004;28:442-446.
ABSTRACT | FULL TEXT  

A cross sectional study on determinants of quality of life in ALS
Chio et al.
J. Neurol. Neurosurg. Psychiatry 2004;75:1597-1601.
ABSTRACT | FULL TEXT  

Prognosis in amyotrophic lateral sclerosis: A population-based study
Chio et al.
Neurology 2003;61:1826-1827.
FULL TEXT  

Fatigue and depression are associated with poor quality of life in ALS
Iwasaki et al.
Neurology 2003;61:872-872.
FULL TEXT  

Effect of a multidisciplinary amyotrophic lateral sclerosis (ALS) clinic on ALS survival: a population based study, 1996-2000
Traynor et al.
J. Neurol. Neurosurg. Psychiatry 2003;74:1258-1261.
ABSTRACT | FULL TEXT  

Prognosis in amyotrophic lateral sclerosis: A population-based study
del Aguila et al.
Neurology 2003;60:813-819.
ABSTRACT | FULL TEXT  

Early symptom progression rate is related to ALS outcome: A prospective population-based study
Chio et al.
Neurology 2002;59:99-103.
ABSTRACT | FULL TEXT  

Factors correlated with hypermetabolism in patients with amyotrophic lateral sclerosis
Desport et al.
Am. J. Clin. Nutr. 2001;74:328-334.
ABSTRACT | FULL TEXT  

Resilience and Distress Among Amyotrophic Lateral Sclerosis Patients and Caregivers
Rabkin et al.
Psychosom. Med. 2000;62:271-279.
ABSTRACT | FULL TEXT  

Health professionals' responses to multiple sclerosis and motor neurone disease
Carter et al.
Palliat Med 1998;12:383-394.
ABSTRACT  

A self report measure of affective lability
Moore et al.
J. Neurol. Neurosurg. Psychiatry 1997;63:89-93.
ABSTRACT | FULL TEXT  

Communicating the diagnosis of motor neurone disease
Johnston et al.
Palliat Med 1996;10:23-34.
ABSTRACT  

Evaluation of the psychological status of ventilatory-supported patients with ALS/MND
McDonald et al.
Palliat Med 1996;10:35-41.
ABSTRACT  

Ventilator Dependency in ALS: Management, Disease Progression, and Issues of Coping
Bromberg et al.
Neurorehabil Neural Repair 1996;10:195-199.
ABSTRACT  

Survival in Amyotrophic Lateral Sclerosis
Honig
Arch Neurol 1995;52:126-126.
ABSTRACT  

Survival in Amyotrophic Lateral Sclerosis-Reply
McDonald and Hillel
Arch Neurol 1995;52:126-127.
ABSTRACT