Psychotherapy and pharmacotherapy interventions to reduce distress or improve well-being in people with amyotrophic lateral sclerosis: a systematic review
Open accessAbstract
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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There have been no adequately powered randomised controlled trials of psychological interventions for people with motor neuron disease, and none of ACT.
“There have been no adequately powered randomised controlled trials of psychological interventions for people with motor neuron disease, and none of ACT.”
There is a paucity of adequately powered randomised controlled trials of psychological interventions for people with motor neuron disease, meaning there is little clear evidence-based guidance on what psychological support should be provided.
“However, a paucity of adequately powered randomised controlled trials means there is little clear evidence-based guidance on what psychological support should be provided.”
Previous systematic reviews of psychological interventions to reduce psychological distress and improve psychological wellbeing in plwMND have highlighted limited research of varying quality.
“Previous systematic reviews of psychological interventions to reduce psychological distress and improve psychological wellbeing in plwMND have highlighted limited research of varying quality [19, 20].”
From Acceptance and Commitment Therapy for people living with motor neuron disease: an uncontrolled feasibility study (2023) · cites this paper as [19]
There is insufficient evidence to support the effectiveness of psychological interventions for psychological distress in people with motor neuron disease.
“Psychological interventions may be of benefit for those psychological distresses; however, there is insufficient evidence to support their effectiveness at present (7).”
From Needs and preferences for psychological interventions of people with motor neuron disease (2019) · cites this paper as [7]
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- Authors
- Gould, R. L., Coulson, M. C., Brown, R. G., Goldstein, L. H., Al-Chalabi, A., & Howard, R. J.
- Affiliations
- King's College London (GB)
- Middlesex University London (GB)
- Corresponding author
- Gould, Rebecca L.
- Venue
- Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
- Publisher
- Informa UK Limited
- Published
- 2015-08-27
- Volume
- 16
- Issue
- 5-6
- Pages
- 293-302
- ISSN
- 2167-8421 (ISSN-L)
- 2167-9223
- OpenAlex
- W2022939158
- Cited by
- 47
- References
- 38
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 4 · 2023: 11 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 6 · 2018: 2 · 2017: 4 · 2016: 1 · 2015: 1
- FWCI
- 0.35
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- cc-by
- Locations
- Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, other-oa)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Figshare (cc-by)
- Funders
- Medical Research Council (MR/L501529/1)
- Economic and Social Research Council (ES/L008238/1)
- Topics
- Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- amyotrophic lateral sclerosis, psychotherapy, pharmacotherapy, psychological distress, well-being, cognitive behavioral therapy, counseling, hypnosis, life review, end-of-life care
- MeSH terms
- Amyotrophic Lateral Sclerosis, Humans, Psychotherapy, Stress, Psychological, Randomized Controlled Trials as Topic, Databases, Bibliographic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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