Depression and Its Symptoms Can Be Severe in Friedreich’s Ataxia Patients, Study Says

Depression can be severe and clinically relevant among patients with Friedreich’s ataxia, and its symptoms are most often expressed as a lack of motivation and negative feelings toward self, a study reports.

The study, “Depressive symptoms in Friedreich ataxia,” were published in the International Journal of Clinical and Health Psychology.

Depression is often associated with neurodegenerative disorders, such as Parkinson’s disease and multiple sclerosis. It also is  reported in other types of cerebellar degenerative diseases, including spinocerebellar ataxias. Its “negative impact on quality of life” is widely recognized as a negative “influence on the disease course itself.”

However, very few studies have analyzed the prevalence of depression among people with Friedreich’s ataxia (FA) — the most common type of inheritable ataxia — a disease characterized by a gradual loss of muscle coordination and balance, difficulty walking, and speech impairment.

Researchers at the Universidad de La Laguna in Spain set out to examine the prevalence and characteristics of depressive symptoms and their relationship with disease characteristics and information processing in FA patients.

Their observational study followed 57 patients with confirmed diagnoses between the ages of 19 and 66. Depressive symptoms and speed of information processing were examined using the Beck Depression Inventory-II (BDI; a 21-item questionnaire) and a Choice Reaction time task (a measure of cognition and thinking speed), respectively.

Results showed BDI scores were significantly higher in FA patients compared to what would be expected among the general population, with 21% of patients scoring in the “moderate” and “severe” range categories that mark depression of a “clinically relevant” stage.

Somatic-motivational and cognitive-affective scores — reflecting a lack of motivation and negative feelings toward oneself, respectively — were also significantly higher in FA patients than in the general population. Scores for somatic-motivational status were drawn from questions that touched on loss of pleasure, energy, and interests (including in sex), feelings of worthlessness and fatigue, and difficulties in concentrating. Questions relating to cognitive-affective scores addressed feelings of sadness and guilt, self-criticalness and self-dislike, past failures, suicidal thoughts, and episodes of crying and irritability.

Apart from FA severity, other disease characteristics did not seem to relate with depression. Conversely, depressive symptoms seemed to be directly correlated with patients’ reaction times in the Choice Reaction test.

“The data show that both somatic-motivational and cognitive affective symptoms of depression are frequent in individuals with FRDA [Friedreich’s ataxia] … [and the] study suggests that FRDA patients should be regularly evaluated in terms of risks for developing depression so they can be offered appropriate support,” the researchers wrote.