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. 2020 Mar;267(3):607-615.
doi: 10.1007/s00415-019-09615-3. Epub 2019 Nov 7.

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

Rhiannon Edge  1 , Roger Mills  2 , Alan Tennant  3 , Peter J Diggle  4 , Carolyn A Young  2   5 ; TONiC study group
Collaborators, Affiliations

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

Rhiannon Edge et al. J Neurol. 2020 Mar.

Erratum in

Abstract

Introduction: The importance of elucidating the relationships between pain, mood and quality of life (QoL) amongst people with amyotrophic lateral sclerosis/motor neuron disease is evident to clinicians, yet the literature is limited and inconsistent. We explored the relationships between pain, depression, anxiety and QoL to reconcile the previous contrasting findings and inform future research and clinical practice.

Methods: Patient-reported outcomes were obtained as part of the Trajectories of Outcomes in Neurological Conditions study. Mood and QoL scales underwent Rasch analysis. Correlation coefficients examined the strength of association between variables of interest. A bivariate regression model was developed to examine the effects of pain, depression and anxiety on joint psychological and physical QoL domains.

Results: Of 636 people with ALS, 69% reported pain, of these most had mild pain. Seven percent (7%) of participants exceeded published cutoffs for probable depression and 14% had probable anxiety. Pain, depression and anxiety all influence quality of life; depression has a significant effect on both physical and psychological domains of QoL, whereas pain affects physical QoL and anxiety psychological QoL.

Conclusions: These results show the importance of expressing quality of life in a conceptually appropriate way, as failing to take account of the multidimensional nature of QoL can result in important nuances being overlooked. Clinicians must be aware that pain, depression and anxiety all worsen QoL across their ranges, and not just when pain is severe or when anxiety or depression reach case level.

Keywords: Amyotrophic lateral sclerosis (ALS); Anxiety; Depression; Motor neuron disease (MND); Pain; Quality of life; TONiC study.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
A bar chart showing the responses to the pain numerical rating scale
Fig. 2
Fig. 2
Coefficient plot for the parameters of the bivariate model
See this image and copyright information in PMC

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