TY - JOUR
T1 - Psychotherapy for the Treatment of Anxiety and Depression in Patients with Parkinson Disease
T2 - A Meta-Analysis of Randomized Controlled Trials
AU - Hong, Chien Tai
AU - Tan, Shennie
AU - Huang, Tsai Wei
N1 - Funding Information:
We are grateful for the assistance of the staff members at Shuang Ho Hospital (109SHHR-3) for their support with the editing and publication of this article.
Publisher Copyright:
© 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine
PY - 2021/11
Y1 - 2021/11
N2 - Objective: Anxiety and depression are major psychiatric nonmotor symptoms (NMSs) of Parkinson disease (PD). Although several studies have investigated the effects of psychotherapeutic interventions, particularly cognitive-behavioral therapy (CBT), for alleviating anxiety and depression in patients with PD, the findings have been inconclusive because of the small sample size and the lack of a unified protocol for such treatments. Thus, the present meta-analysis of randomized controlled trials (RCTs) was conducted to assess the effect of psychotherapy on PD-related anxiety and depression. Design: Systematic review and meta-analysis. Setting and Participants: Relevant RCTs were extracted from PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library databases. This study was registered in PROSPERO under the number CRD 42020165052. Measures: The primary and secondary outcomes were changes in the anxiety score and depressive symptoms, respectively. Results: Fourteen RCTs including 507 patients with PD were analyzed. The interventions were classified as CBT and non-CBT. CBT significantly reduced anxiety at the end of the study (standardized mean difference = −0.85, 95% confidence interval = −1.12 to −0.58, P <.001, I2 = 0%), whereas non-CBT did not. Greater heterogeneity in the effects of non-CBT treatment was observed. CBT was significantly beneficial for depression (standardized mean difference = −0.83, 95% confidence interval = −1.26 to −0.40, P <.001, I2 = 55%). Despite the greater heterogeneity in the effects, non-CBT interventions were also effective in alleviating depressive symptoms. Conclusion and Implications: CBT is effective for the management of anxiety and depression in patients with PD. Routine treatment for patients with this condition is strongly recommended.
AB - Objective: Anxiety and depression are major psychiatric nonmotor symptoms (NMSs) of Parkinson disease (PD). Although several studies have investigated the effects of psychotherapeutic interventions, particularly cognitive-behavioral therapy (CBT), for alleviating anxiety and depression in patients with PD, the findings have been inconclusive because of the small sample size and the lack of a unified protocol for such treatments. Thus, the present meta-analysis of randomized controlled trials (RCTs) was conducted to assess the effect of psychotherapy on PD-related anxiety and depression. Design: Systematic review and meta-analysis. Setting and Participants: Relevant RCTs were extracted from PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library databases. This study was registered in PROSPERO under the number CRD 42020165052. Measures: The primary and secondary outcomes were changes in the anxiety score and depressive symptoms, respectively. Results: Fourteen RCTs including 507 patients with PD were analyzed. The interventions were classified as CBT and non-CBT. CBT significantly reduced anxiety at the end of the study (standardized mean difference = −0.85, 95% confidence interval = −1.12 to −0.58, P <.001, I2 = 0%), whereas non-CBT did not. Greater heterogeneity in the effects of non-CBT treatment was observed. CBT was significantly beneficial for depression (standardized mean difference = −0.83, 95% confidence interval = −1.26 to −0.40, P <.001, I2 = 55%). Despite the greater heterogeneity in the effects, non-CBT interventions were also effective in alleviating depressive symptoms. Conclusion and Implications: CBT is effective for the management of anxiety and depression in patients with PD. Routine treatment for patients with this condition is strongly recommended.
KW - anxiety
KW - depression
KW - meta-analysis
KW - Parkinson disease
KW - psychotherapy
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U2 - 10.1016/j.jamda.2021.03.031
DO - 10.1016/j.jamda.2021.03.031
M3 - Article
C2 - 33957132
AN - SCOPUS:85105520536
SN - 1525-8610
VL - 22
SP - 2289-2295.e2
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 11
ER -
