Objectives. To investigate whether poor psychological status predicts short
er survival faster progress of disease and greater disability in patients w
ith ALS/MND (amyotrophic lateral sclerosis/motor neurone disease).
Design. A prospective study of mood as a predictor of 6-month outcome in a
consecutive cohort of patients with ALS/MND.
Methods. A cohort of 38 consecutive patients completed mood, self-esteem we
ll-being and disability measures at the time of diagnosis and 6 weeks later
. Survival and disability were assessed at 6 months.
Results. The 10 patients who died had poorer overall mood at the 6-week int
erviews. Low mood early in disease also predicted greater disability at 6 m
onths. The poor outcomes of patients with poor psychological well-being wer
e not due to confounding associations between mood and disease severity
Conclusions. The data confirm McDonald, Weidenfeld, Hillel, Carpenter & Wai
ter's (1994) finding that poor psychological status predicts poor survival
in ALS/MND. This study also extend their findings by (a) recruiting patient
s at the point of diagnosis and therefore controlling for effects due to th
e duration of disease, and (6) demonstrating that mood also predicts diseas
e progression and disability The findings are unlikely to be due to simple
spurious association of the psychological status measures with recognized i
ndices of disease or of expected survival. Explanations for the results can
be considered in the context of other findings of mood predicting outcomes
of life-threatening disease and the possible value of psychological interv
entions may be considered.