Emotional feeling, coping strategies and apathy in amyotrophic lateral sclerosis

Abstract

Background: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative motor neuron disease causing a progressive muscle paralysis, usually leading to death from respiratory failure in 3-5 years. The main objective of this research was to explore positive and negative emotions, coping strategies, apathy, anxiety and depressive symptomatology in patients suffering from ALS. Methods: 169 ALS patients with an average age of 63 ± 11.6 years, hospitalized at the day care hospital in the ALS Center at the Salpêtrière and Dupuytren Hospital, have been included. The self-administered questionnaires HADS, EPN-31, CHIP, Marin’s apathy scale were assessed by all patients. For the statistical analyses, correlation of Spearman and Kolmogorov-Smirnov test were made. Findings: Half of the patients had depressive symptoms and 60% had anxiety symptoms. The patients experienced on average more negative than positive emotions. They preferentially used the emotional regulation followed by the seeking of well-being. The emotional regulation and the palliative coping were positively correlated with negative emotions, apathy, anxiety and depression, and appeared to be non-adaptative strategies to cope with this disease. The distraction and the cognitive avoidance coping were negatively correlated with anxiety, depression, apathy, and positively with positive emotions. These strategies seem to be protective factors against anxiety and depressive symptoms. Discussion: These results highlight the importance of identifying the presence of depressive and anxiety symptoms as well as apathy given the links between these dimensions and the use of any coping strategies appearing as non-adaptive.