Emotions and amyotrophic lateral sclerosis: a psychopathological perspective

Emotions have not often been studied in amyotrophic lateral sclerosis (ALS). Most existing studies have assessed the psychopathological manifestations involved, essentially depression and less frequently anxiety. The results have shown that major depressive episodes and anxious episodes are not frequent in ALS patients, although moderate depressive or anxious symptoms are often observed, but less frequently than in other diseases like multiple sclerosis or Parkinson's disease. Depressive symptoms are not correlated to the duration or severity of the disease. This has led us to investigate the coping mechanisms involved in ALS. Results of previously published studies have shown that they did not differ from those observed in other somatic diseases, but ALS patients show more frequent concern with spirituality and religious preoccupations. It thus appears necessary to make a more detailed study of how ALS patients cope with the disease and its ominous consequences. Emotional processing difficulties may be a factor underlying quite diverse somatic and psychological disorders. The Baker's model propose five stages in emotional processing: emotional experience, emotional expression, labelling, linkage and awareness. Assessment of the emotional processing used by ALS patients should improve our comprehension of their adaptive functioning. The patients' caregivers play an essential role, and studies have shown that they often suffer themselves from depression and the burdens involved, and that the perceived social support has an impact on the quality of life and on the depression of the patients. Therefore, it seems important to assess the emotional processing not only of patients but also of their caregivers.