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Psychotherapy and pharmacotherapy interventions to reduce distress or improve well-being in people with amyotrophic lateral sclerosis: A systematic review

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)293-302
Number of pages9
JournalAmyotrophic lateral sclerosis & frontotemporal degeneration
Issue number5-6
Accepted/In press10 May 2015
Published15 Jul 2015


  • Gould ALS systematic review v3 edits

    Gould_ALS_systematic_review_v3_edits.docx, 76.7 KB, application/vnd.openxmlformats-officedocument.wordprocessingml.document

    Uploaded date:30 Mar 2016

    Version:Accepted author manuscript

King's Authors


Our objective was to systematically review and critically evaluate the evidence for psychotherapy and pharmacotherapy interventions for reducing distress or improving well-being in people with amyotrophic lateral sclerosis (pwALS). Online bibliographic databases and clinical trial registers were searched and an assessment of study quality was conducted. Seven thousand two hundred and twenty-three studies were identified, of which five met inclusion criteria (four completed and one in progress). All studies examined psychotherapeutic interventions, and no studies investigated pharmacotherapy. Two studies adopted a randomized controlled trial design, one a controlled trial design and two a cohort design. Sample sizes were small in all studies (overall n = 145). The quality of completed studies was generally poor, with evidence that all were at potential risk of bias in numerous areas. Improvements in well-being were found with expressive disclosure (compared to no disclosure), cognitive behavioural therapy/counselling (compared to non-randomized pharmacotherapy) and hypnosis in the short term only, while no improvements were seen with a life review intervention. In conclusion, there is currently insufficient evidence to recommend the use of specific psychotherapy interventions for reducing distress or improving well-being in pwALS, and no evidence to support pharmacotherapy interventions. Research is urgently needed to address these significant gaps in the literature.

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