Mood as a predictor of disability and survival inpatients newly diagnosed with ALS/MND.

Objectives. To investigate whether poor psychological status predicts shorter survival, faster progress of disease and greater disability in patients with 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, wellbeing 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 interviews. Low mood early in disease also predicted greater disability at 6 months. The poor outcomes of patients with poor psychological well-being were not due to confounding associations between mood and disease severity. Conclusions. The data confirm McDonald, Weidenfeld, Hillel, Carpenter & Walter's (1994) finding that poor psychological status predicts poor survival in ALS/MND. This study also extend their findings by (a) recruiting patients at the point of diagnosis and therefore controlling for effects due to the duration of disease, and (b) demonstrating that mood also predicts disease progression and disability. The findings are unlikely to be due to simple spurious association of the psychological status measures with recognized indices 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 interventions may be considered.