Internet-based cognitive behavioral therapy for depression and anxiety in Parkinson's disease — A pilot study

Abstract Background Parkinson's disease (PD) is often associated with depression and anxiety. The availability of evidence-based psychological interventions is low. Objective This pilot study investigates the feasibility and preliminary effect of internet-based cognitive behavioral therapy (ICBT) for depression and anxiety in PD. Methods 9 patients with PD with comorbid symptoms on the relevant subscale of Hospital Anxiety and Depression Scale (HADS), of either depression (HADS-D>7) or anxiety (HADS-A>7) received 12weeks of ICBT, specially adapted for depression and anxiety in PD. Primary outcome was change in depression and anxiety symptoms, measured with HADS total score. Effects on non-motor symptoms, PD specific health and quality of life and insomnia were explored, plus the participant's involvement, satisfaction, and subjective evaluation of the treatment. Results Participants reported lower symptoms on HADS after ICBT (Cohen's d =0.79, p Conclusions The results suggest that ICBT could be a feasible way to alleviate depression and anxiety in PD. However, a somewhat simplified treatment and different ways to provide support to enhance adherence and outcome are warranted.

[1]  J. Larsen,et al.  Sleep Disorders in Patients with Parkinson’s Disease , 2001, CNS drugs.

[2]  M. Mark,et al.  Predictors of treatment response to cognitive-behavioral therapy for depression in Parkinson's disease. , 2012, Journal of consulting and clinical psychology.

[3]  T. T. Haug,et al.  The validity of the Hospital Anxiety and Depression Scale. An updated literature review. , 2002, Journal of psychosomatic research.

[4]  G. Andersson,et al.  Effectiveness of Internet‐based cognitive behaviour therapy for panic disorder in routine psychiatric care , 2013, Acta psychiatrica Scandinavica.

[5]  M. Mark,et al.  Telephone-Based Cognitive–Behavioral Therapy for Depression in Parkinson Disease , 2011, Journal of geriatric psychiatry and neurology.

[6]  V. Kaldo,et al.  Similarities and differences between practitioners of psychotherapy in Sweden: A comparison of attitudes between psychodynamic, cognitive, cognitive–behavioral, and integrative therapists. , 2009 .

[7]  Paolo Barone,et al.  International multicenter pilot study of the first comprehensive self‐completed nonmotor symptoms questionnaire for Parkinson's disease: The NMSQuest study , 2006, Movement disorders : official journal of the Movement Disorder Society.

[8]  C. Marsden,et al.  Recent Developments in Parkinson's Disease , 1986 .

[9]  Marcel Zeelenberg,et al.  Data analysis 2 , 2016 .

[10]  M. Sajatovic,et al.  Psychosocial Interventions for Depression and Anxiety in Parkinson's Disease , 2012, Journal of geriatric psychiatry and neurology.

[11]  Y. Cho,et al.  Sleep Disorders in Patients with Parkinson's Disease , 2014 .

[12]  Gerhard Andersson,et al.  Internet administration of the Hospital Anxiety and Depression Scale in a sample of tinnitus patients. , 2003, Journal of psychosomatic research.

[13]  Gerhard Andersson,et al.  Internet versus group cognitive-behavioral treatment of distress associated with tinnitus: a randomized controlled trial. , 2008, Behavior therapy.

[14]  R. Snaith,et al.  The hospital anxiety and depression scale. , 2013, Acta psychiatrica Scandinavica.

[15]  R. Fitzpatrick,et al.  The PDQ-8: Development and validation of a short-form parkinson's disease questionnaire , 1997 .

[16]  N. Lindefors,et al.  Cognitive behavior therapy via the Internet: a systematic review of applications, clinical efficacy and cost–effectiveness , 2012, Expert review of pharmacoeconomics & outcomes research.

[17]  R. Fitzpatrick,et al.  The Parkinson's Disease Questionnaire (PDQ-39): development and validation of a Parkinson's disease summary index score. , 1997, Age and ageing.

[18]  M. Mark,et al.  Cognitive-behavioral therapy for depression in Parkinson's disease: a randomized, controlled trial. , 2011, The American journal of psychiatry.

[19]  V. Preedy,et al.  Unified Parkinson's Disease Rating Scale , 2010 .

[20]  C. Morin,et al.  Validation of the Insomnia Severity Index as an outcome measure for insomnia research. , 2001, Sleep medicine.

[21]  Nancy J. Thompson,et al.  Distance delivery of mindfulness-based cognitive therapy for depression: Project UPLIFT , 2010, Epilepsy & Behavior.

[22]  J Li,et al.  Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies , 2010, Psychological Medicine.

[23]  R. Zwick,et al.  The client satisfaction questionnaire. Psychometric properties and correlations with service utilization and psychotherapy outcome. , 1982, Evaluation and program planning.

[24]  John Hardy,et al.  Parkinson's disease , 2009, The Lancet.

[25]  G. Wills,et al.  A pilot randomised controlled trial of an Internet-based cognitive behavioural therapy self-management programme (MS Invigor8) for multiple sclerosis fatigue. , 2012, Behaviour research and therapy.

[26]  Matthew Menza,et al.  Barriers to Mental Health Care Utilization in Parkinson’s Disease , 2013, Journal of geriatric psychiatry and neurology.

[27]  G. Andersson,et al.  Effectiveness of Internet-based cognitive behaviour therapy for depression in routine psychiatric care. , 2014, Journal of affective disorders.

[28]  G. Andersson,et al.  Development of a New Approach to Guided Self-Help via the Internet: The Swedish Experience , 2008 .

[29]  Dag Aarsland,et al.  Depression in Parkinson disease—epidemiology, mechanisms and management , 2011, Nature Reviews Neurology.

[30]  K. Cook,et al.  Telephone-Administered Cognitive Behavioral Therapy: A Case Study of Anxiety and Depression in Parkinson’s Disease , 2009, Journal of Clinical Psychology in Medical Settings.

[31]  C. Clarke,et al.  Systematic review of levodopa dose equivalency reporting in Parkinson's disease , 2010, Movement disorders : official journal of the Movement Disorder Society.

[32]  S. Fahn Members of the UPDRS Development Committee. Unified Parkinson's Disease Rating Scale , 1987 .

[33]  Bernard Ravina,et al.  The montreal cognitive assessment as a screening tool for cognitive impairment in Parkinson's disease , 2008, Movement disorders : official journal of the Movement Disorder Society.

[34]  P. Svanborg,et al.  Determinants of self‐rating and expert rating concordance in psychiatric out‐patients, using the affective subscales of the CPRS , 1996, Acta psychiatrica Scandinavica.