Longitudinal predictors of psychological distress and self-esteem in people with ALS

Objective: To identify predictors of psychological distress ( measured by anxiety and depression) and low self-esteem and to determine whether these change over time in people with ALS. Method: We interviewed 50 patients with ALS living with a spouse/partner; further interviews were held at median intervals of 6 and then 5 months. Although carers were interviewed, we report the patients' data. Patients completed measures about their social support and marital relationship; the functional impact of ALS; everyday cognitive, emotional, and behavioral changes; symptoms of anxiety and depression; and self-esteem. The ALS Severity Scale was also completed. Results: From the initial sample of 50, 26 patients were interviewed on all three occasions. At the first interview, negative social support and bulbar impairment were most predictive of psychological distress; pre-illness marital intimacy was the best predictor of patients' self-esteem. Over time, negative social support and pre-illness marital intimacy retained an ability to predict patients' affective state and self-esteem. Conclusions: Social factors are important in determining longer-term psychological well-being in people with ALS who are in the relatively early stages of the disease.