C9orf72 and amyotrophic lateral sclerosis: Whereas a limited association of this gene mutation has been reported with bipolar disorder9 and schizophrenia,10 the C9orf72 expansion is estimated to be present in <10% of apparently sporadic ALS patients in Western populations.11 We therefore concur with the view that early psychiatric symptoms may reflect an inherent feature of ALS pathology beyond C9orf72‐related ALS‐FTD.5 More florid psychotic symptoms warrant further study, as they will impact on compliance with ALS‐related interventions such as gastrostomy and noninvasive ventilation, as well as on carer burden.12