Abstract
Psychiatric Changes in Amyotrophic Lateral Sclerosis Patients and their Relatives
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One hundred eighteen amyotrophic lateral (ALS) sclerosis patient and 97 their family members were examined by psychiatrists. Assessment was performed by Hamilton depression score (HAM-D) for a ll and frontotemporal dementia score for patients. Psychiatric changes were revealed in 101 (85%) of ALS patients and in 51 (52.5 %) of family members that were significantly lower than in ALS patients, p<0.05). The average score by HAM-Din ALS patients with situation-mediated depression comprised. 17±4, with situation mediated anxiety disorder it was 15±5, and with situation mediated anxiety and depression disorder it was 21±6 (p>0.05 between groups). The average degree by HAM-D in family members comprised 12±4, with situation-mediated anxiety disorder it was 22±5 (р<0.05 in comparison with the latter estimate), and with situation-mediated anxiety and depression disorder it was 16±6.The spectrum of situation mediated psychiatric impairments were equally represented with subtle predominance of situation-mediated depression. Rare cases of coincidence of ALS with major psychiatric disorders were described. In 33 of ALS patients (28%) frontotemporal cognitive changes were seen, that reached the level of dementia in 4.2% of cases. Among family members only situation-mediated psychiatric disorders were revealed with marked predominance of anxiety disorder (28%, p<0.05). Habitual intoxications were seen in 49ALS patients (41.5%) and 80 family members (82.4%) (p<0.05). High prevalence of anxiety disorder leads to denial in cooperation with professional doctors (73-76%), denial of aggressive treatments (74.5%), appeal to scammers and irrelevant expenses (29.6% случаев). Dual patronage of ALS families is recommended by psychiatrists and narcologists in individual cases, what may increase number of life-sustaining treatments in ALS and the increase of life quality in ALS patients and family members.
Keywords: Psychiatric disorders, Amyotrophic lateral sclerosis, Frontotemporal dysfunction, Habitual intoxications
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