Neuromuscular Patients Dependent on Non Invasive Mechanical Ventilation: Psychological Factors Influencing Adherence to NIV

<bold>Background:</bold> NIV is associated with improvement of mobility and mortality in neuromuscular patients with chronic respiratory failure. Long-term NIV positively impacts the patient's quality of life and perception of disease status. Its effectiveness is likely related to the adherence to NIV. Several factors, patient- and not patient-related, may compromise adherence to NIV, such as physical, behavioural, familiar, and social issues. Few data are currently available on the role of psychological factors in influencing NIV adherence. <bold>Materials and methods:</bold> We evaluated the adherence to NIV in a group of 35 adult patients with neuromuscular diseases (Duchenne muscular dystrophy, myotonic dystrophy, and amyotrophic lateral sclerosis) in relation to their grade of depression assessed by the Beck Depression Inventory (BDI) questionnaire. Other data were collected, such as clinical features (age and sex), use of anxiolytic drugs, the presence of a family or professional caregiver, the quality of patient-physician relationship, the beginning of psychological support after BDI screening, and the family acceptance of NIV. NIV adherence was defined as the use of NIV for at least 4 h per night on 70% of nights in a month. <bold>Results:</bold> The overall rate of NIV adherence was 80 %. Based on the BDI questionnaire, patients who were non-adherent to NIV had a higher rate of depression, mainly observed in the oldest patients. The acceptance of NIV by the family and positive physician-patient interaction seem to favour NIV adherence. <bold>Conclusion:</bold> Depression can interfere with NIV adherence in patients with neuromuscular diseases.