Correspondence
Depression and Quality of Life in Patients With Amyotrophic Lateral Sclerosis: Special Motivation
Dtsch Arztebl Int 2008; 105(47): 825. DOI: 10.3238/arztebl.2008.0825b


We know from palliative medicine and hospice work that comprehensive explanations about the disease and its progression, therapeutic options or the lack therefore, and holistic care can reduce fears and improve quality of life. The fact that lacking representativeness was mentioned and the numbers of participants were low makes me question some of the conclusions. The study subjects must have been unusually motivated (readiness to participate in the study, dependence on ALS outpatient clinics) patients, who benefited from the comprehensive care that is recommended in the conclusion. Unfortunately, no information was provided about age, social networks, or subjects' philosophy of life. I think it is not justified to conclude "a satisfactory quality of life even if they are severely physically impaired, [...]"is possible in any stage of ASL. This statement includes patients undergoing invasive ventilation. It also suggests that high quality information might increase patients' willingness to undergo therapeutic measures "including invasive ventilation". This is overstating the case, in view of the very small number of patients receiving invasive ventilation (n=4). Using the study results as instruments in the controversy about the validity or scope of advance directives (as has happened in the press) seems inappropriate. DOI: 10.3238/arztebl.2008.0825b
Dr. med. Jürgen Bickhardt
Uhlandstr. 19
85435 Erding, Germany