Phone-based CBT alleviates depression in Parkinson disease

  • Neurology
  • 1 Apr 2020

  • curated by Susan London
  • Clinical Essentials
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • For patients with Parkinson disease and depression, 10 weekly sessions of tailored telephone-based cognitive-behavioral therapy (CBT) targeting negative thoughts and engaging their caregivers reduced depression vs treatment as usual.

Why this matters

Key results

  • Compared with treatment as usual, telephone-based CBT significantly improved depression scores by end of the treatment: 6.53 points vs −0.27 points (P<.0001>
  • Benefit persisted over the 6-month follow-up (P<.0001>
  • Difference was driven by a reduction in negative thoughts seen only in the telephone-based CBT group.
  • Additional benefits with telephone-based CBT vs treatment as usual:
    • Reduced anxiety (P<.0001>
    • Better QoL (P=.007).

Study design

  • Randomized controlled trial, 72 patients with Parkinson disease and depressive disorder and without dementia (mean age, 65.22 years).
  • Patients had either tailored telephone-based CBT (weekly for 3 months then, optionally, monthly during 6-month follow-up) plus treatment as usual vs treatment as usual alone.
  • Main outcome: depression (Hamilton Depression Rating Scale score).
  • Funding: Michael J. Fox Foundation for Parkinson’s Research; Parkinson’s Alliance.

Limitations

  • Unknown generalizability to patients with more severe Parkinson disease, dementia.
  • Nonspecific factors, such as attention, may have influenced benefit.
  • Relative contribution of intervention components is unclear.