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Pinto C, Geraghty AWA, McLoughlin C, Pagnini F, Yardley L, Dennison L. Experiences of psychological interventions in neurodegenerative diseases: a systematic review and thematic synthesis. Health Psychol Rev 2023; 17:416-438. [PMID: 35546326 DOI: 10.1080/17437199.2022.2073901] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/01/2022] [Indexed: 11/04/2022]
Abstract
Background: Psychological interventions for managing emotional distress in neurodegenerative diseases are needed, but progressive worsening of symptoms and increasing disability might pose difficulties with engagement. We aimed to synthesise the experiences of engaging with and using psychological interventions in neurodegenerative diseases and identify relevant barriers and facilitators. Methods: Systematic searches were conducted in six electronic databases and results were screened. We included qualitative and mixed methods studies reporting patient or caregivers' views or experiences of psychological interventions. Qualitative data were extracted and thematically synthesised. Results: 34 papers were included, covering a range of diseases and interventions. Engagement was facilitated by flexible intervention formats and tailoring to the specific needs of people with neurodegenerative diseases. Interventions were sometimes inaccessible or burdensome because of physical and cognitive symptoms, and the time and effort required for the intervention. Participants' levels of acceptance and readiness often differed and influenced engagement with the intervention. Across different interventions, participants experienced wide-ranging benefits including changes in insight, perspective, self-efficacy, emotions and relationships. Conclusion: Although people with neurodegenerative diseases and caregivers experience benefits from psychological interventions, burden-reducing adaptations and sensitive tailoring to the specific disease context is required to improve acceptability and engagement.
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Affiliation(s)
- Cathryn Pinto
- Department of Psychology, University of Southampton, Southampton, UK
| | - Adam W A Geraghty
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | | | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Lucy Yardley
- Department of Psychology, University of Southampton, Southampton, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Laura Dennison
- Department of Psychology, University of Southampton, Southampton, UK
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Wal P, Dwivedi J, Wal A, Vig H, Singh Y. Detailed insight into the pathophysiology and the behavioral complications associated with the Parkinson's disease and its medications. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2022. [DOI: 10.1186/s43094-022-00425-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The loss of dopamine neurons in the substantia nigra, as well as other mostly catecholaminergic neurons, causes many of the motor symptoms that define Parkinson's disease. Parkinson's disease is commonly thought of as a movement disorder, the significant prevalence of psychiatric complications such as cognitive impairment, and psychosis suggests it should be considered a neuropsychiatric illness, and all behavioral complications are linked to growing disability and the medication.
Main body
Apart from the disease-induced abnormalities, there are several other side effects of the disease and also from the medication used to prevent the disease. This article focuses on the pathogenesis of Parkinson’s disease and also the behavioral abnormalities caused by the disease and its medication. The study's data were gathered by searching several review articles and research papers from a variety of sources, including Elsevier, PubMed, Research Gate, Journal of Pharmaceutical Science, etc., from the year 1985 to 2021. Parkinson's disease is a neurodegenerative disease caused by a variety of complex processes. It is responsible not just for motor symptoms, but also for a variety of behavioral symptoms that can arise as a result of the disease and/or medication.
Conclusion
Only symptomatic drugs are available; thus, finding treatments that directly address the disease mechanisms causing Parkinson’s disease is essential. To alleviate the disease's burden on patients and their families, better treatments for the neuropsychiatric repercussions of Parkinson's disease are required.
Graphical Abstract
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Pourghayoomi E, Behzadipour S, Ramezani M, Joghataei MT, Shahidi GA. A new postural stability-indicator to predict the level of fear of falling in Parkinson's disease patients. Biomed Eng Online 2020; 19:64. [PMID: 32811522 PMCID: PMC7436981 DOI: 10.1186/s12938-020-00808-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/05/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. Seventy percent of Parkinson's disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error. OBJECTIVES In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients. METHODS Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTRis; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF-related behavior(s). RESULTS FTR1/2 (the ratio between FTR1 and FTR2) was strongly correlated with the FES-I (r = - 0.63, p < 0.001), Pull test (r = - 0.65, p < 0.001), Timed Up and Go test (r = - 0.57, p < 0.001), and Berg Balance Scale (r = 0.62, p < 0.001). The model of FTR1/2 was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83. CONCLUSIONS Using the proposed assessment technique, we can accurately predict the intensity of FoF in PD patients. Also, the FTR1/2 index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.
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Affiliation(s)
- Ehsan Pourghayoomi
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Behzadipour
- Mechanical Engineering Department, and Cross Appointed with Djawad Movafaghian Research Center in Neuro-rehabilitation Technologies, Sharif University of Technology, Tehran, Iran
| | - Mehdi Ramezani
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Taghi Joghataei
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Gholam Ali Shahidi
- Movement Disorders Clinic, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran.
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Assogna F, Pellicano C, Savini C, Macchiusi L, Pellicano GR, Alborghetti M, Caltagirone C, Spalletta G, Pontieri FE. Drug Choices and Advancements for Managing Depression in Parkinson's Disease. Curr Neuropharmacol 2019; 18:277-287. [PMID: 31622207 PMCID: PMC7327944 DOI: 10.2174/1570159x17666191016094857] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/27/2019] [Accepted: 10/15/2019] [Indexed: 12/21/2022] Open
Abstract
Depression is a frequent non-motor symptom of Parkinson’s disease (PD), and may even precede the onset of motor symptoms of parkinsonism. Beyond its negative influence on mood, depression in PD is frequently associated with other neuropsychiatric symptoms and with late-stage complications such as dementia. Despite its profound impact on the quality of life and cognitive functioning in PD, depression in PD is often under-recognized and poorly treated. Pathophysiological studies demonstrated that depression in PD is associated with global dysfunction of interactions between discrete brain areas rather than focal structural or functional abnormalities, and that it is sustained by pathological changes of several neurotransmitter/receptor complexes. In general, all traditional antidepressants and some dopamine agonists have been found to be safe and well-tolerated to treat depressive symptoms in PD, despite initial warning on worsening of parkinsonism. Available data suggest that the time-course of response differs among antidepressants. Efficacy results from clinical trials with antidepressant in PD are, however, rather uncertain,
although pooled analysis suggests a moderate benefit. Several issues may critically impact the
results of clinical trials with antidepressants in PD, including the correct psychiatric diagnosis, the overlap of symptoms between depression and PD, and the selection of appropriate end-points and rating scales.
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Affiliation(s)
| | - Clelia Pellicano
- Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306-00179 Roma, Italy.,Neurology Unit, "Belcolle" Hospital, Str. Sammartinese-01100 Viterbo, Italy
| | - Cinzia Savini
- Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306-00179 Roma, Italy
| | - Lucia Macchiusi
- Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306-00179 Roma, Italy
| | - Gaia R Pellicano
- Dipartimento di Psicologia Dinamica e Clinica, "Sapienza" Università di Roma, Via degli Apuli, 1-00185 Roma, Italy
| | - Marika Alborghetti
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso (NESMOS), "Sapienza" Universita di Roma, Via di Grottarossa, 1035-00189 Roma, Italy
| | | | | | - Francesco E Pontieri
- Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306-00179 Roma, Italy.,Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso (NESMOS), "Sapienza" Universita di Roma, Via di Grottarossa, 1035-00189 Roma, Italy
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The effects of cognitive behavioral and mindfulness-based therapies on psychological distress in patients with multiple sclerosis, Parkinson's disease and Huntington's disease: Two meta-analyses. J Psychosom Res 2019; 122:43-51. [PMID: 31126411 DOI: 10.1016/j.jpsychores.2019.05.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 05/07/2019] [Accepted: 05/08/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Psychological distress has a high impact on quality of life in patients with multiple sclerosis (MS), Parkinson's disease (PD), and Huntington's disease (HD). Studies have shown that cognitive behavioral therapy (CBT) and mindfulness-based therapies (MBTs) are successful in reducing psychological distress in patients with anxiety, depressive, and chronic somatic disorders. We aimed to investigate the effectiveness of these therapies in MS, PD, and HD patients. METHODS We performed a comprehensive literature search in PubMed, PsycINFO, Embase and the Cochrane Central Register of Controlled Trials up to March 2018. Randomized controlled trials (RCTs) investigating a CBT or MBT and reporting psychological outcome measures were included. Two separate meta-analyses were performed; one on studies comparing psychological therapy with a treatment as usual or waitlist condition and one on studies with active treatment control conditions. RESULTS The first meta-analysis (N = 12 studies, 8 in MS and 4 in PD populations) showed a significant effect size of g = 0.51 in reducing psychological distress. The second meta-analysis (N = 7 studies, in MS populations) showed a mean effect size of g = 0.36. No RCTs were found in HD populations. The overall quality of the included studies was low and considerable heterogeneity was found. No evidence was found for publication bias. CONCLUSION CBT and MBTs have a small to moderate effect on reducing psychological distress in patients with PD and MS. However, more research with better methodological quality and larger study samples is warranted, especially in HD patient populations.
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Koychev I, Okai D. Cognitive-behavioural therapy for non-motor symptoms of Parkinson's disease: a clinical review. EVIDENCE-BASED MENTAL HEALTH 2017; 20:15-20. [PMID: 28073810 PMCID: PMC10688422 DOI: 10.1136/eb-2016-102574] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 12/23/2016] [Indexed: 11/03/2022]
Abstract
Neuropsychiatric symptoms are common in Parkinson's disease (PD) and have a disproportionate impact on quality of life and carer burden. Pharmacological treatment is the main approach in dealing with these symptoms, but it is limited by variable efficacy and risk of drug interactions. Non-pharmacological approaches using the cognitive-behavioural therapy (CBT) model are viable alternatives and in this review paper we summarise the evidence of CBT for three of the most common psychiatric manifestations of PD: depression and anxiety, impulse-control disorders and insomnia. Most studies modified the usual CBT format to include modules accounting for problems specific to PD: activity scheduling around motoric function, motor symptoms as triggers of anxiety, fear of falling and preparation for disease progression as well as accommodation of materials for suspected executive dysfunction. We found a growing evidence base that CBT (modified to account for PD-specific problems) is effective in the treatment of PD psychiatric symptoms. Where controlled study design was used, moderate effect sizes are reported for the efficacy of CBT for depression, including with distance administration of CBT. The effects were sustained during follow-up which was between 1 and 6 months. In addition, there are some initial data on the effects of CBT on impulse-control disorders and insomnia. The studies were limited by their small and potentially unrepresentative samples and the quality of sample reporting (eg, concomitant antidepressant and dopaminergic therapy use). Additional well-designed and adequately powered studies are required to determine the utility of CBT in PD.
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Affiliation(s)
- Ivan Koychev
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - David Okai
- Psychological Medicine Service, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Bogosian A, Hurt CS, Vasconcelos E Sa D, Hindle JV, McCracken L, Cubi-Molla P. Distant delivery of a mindfulness-based intervention for people with Parkinson's disease: the study protocol of a randomised pilot trial. Pilot Feasibility Stud 2017; 3:4. [PMID: 28116120 PMCID: PMC5244573 DOI: 10.1186/s40814-016-0117-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 12/12/2016] [Indexed: 01/19/2023] Open
Abstract
Background Psychological difficulties, especially depression and anxiety, are the most prevalent non-motor symptoms in Parkinson’s disease. Pharmacological treatments for these conditions appear relatively ineffective in Parkinson’s disease. Mindfulness courses are increasingly popular and recognised as effective for managing emotional states, and there is growing evidence for the effectiveness of mindfulness courses for people with long-term medical conditions. With this exploratory pilot trial, we want to assess the feasibility of the procedures and processes, including recruitment, most appropriate outcome measure(s), acceptability of type and number of measures, potential nocebo effects, and potential effectiveness and cost-effectiveness of a specially adapted distance-delivered mindfulness-based intervention in people affected by Parkinson’s disease. Methods/Design This is a pilot two-arm randomised parallel group controlled trial. Sixty participants who meet eligibility criteria will be randomly assigned either to an 8-week mindfulness-based intervention group or a wait-list control group. The mindfulness intervention will include 1-h weekly sessions delivered by a health psychologist trained to facilitate mindfulness courses. Participants in both groups will complete standardised questionnaires assessing anxiety, depression, pain, insomnia, fatigue, and daily activities at four time points (baseline, 4, 8, and 20 weeks). The analysis will also consider potential mechanisms of change, such as acceptance, self-compassion, and tolerance of uncertainty, as well as health economic outcomes. Participants’ experiences of the mindfulness interventions will be explored via in-depth interviews. Discussion A mindfulness-based intervention for people with Parkinson’s delivered remotely, through Skype group videoconferences, may represent a viable, more accessible, intervention for people with mobility limitations and people who live in rural areas. The trial will provide important information about the feasibility, potential efficacy and cost-effectiveness, and acceptability of the intervention as well as mechanisms of psychosocial adjustment. The results of this pilot trial will help us design a phase III trial to assess efficacy of an online mindfulness-based intervention in Parkinson’s disease and evaluate significance. Trial registration ClinicalTrials.gov, NCT02683330
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Affiliation(s)
- A Bogosian
- Division of Health Services Research & Management, School of Health Sciences, City, University of London, EC1V 0HB London, UK
| | - C S Hurt
- Division of Health Services Research & Management, School of Health Sciences, City, University of London, EC1V 0HB London, UK
| | - D Vasconcelos E Sa
- Division of Health Services Research & Management, School of Health Sciences, City, University of London, EC1V 0HB London, UK
| | - J V Hindle
- School of Psychology, Bangor University, Bangor, UK
| | - L McCracken
- Health Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Chlond M, Bergmann F, Güthlin C, Schnoor H, Larisch A, Eggert K. Patient education for patients with Parkinson’s disease: A randomised controlled trial. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.baga.2015.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Troeung L, Egan SJ, Gasson N. A meta-analysis of randomised placebo-controlled treatment trials for depression and anxiety in Parkinson's disease. PLoS One 2013; 8:e79510. [PMID: 24236141 PMCID: PMC3827386 DOI: 10.1371/journal.pone.0079510] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 09/30/2013] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Psychopharmacotherapy currently constitutes the first-line treatment for depression and anxiety in Parkinson's disease (PD) however the efficacy of antidepressant treatments in PD is unclear. Several alternative treatments have been suggested as potentially more viable alternatives including dopamine agonists, repetitive transcranial magnetic stimulation, and cognitive behavioural therapy (CBT). METHOD A meta-analysis of randomised placebo-controlled trials for depression and/or anxiety in PD was conducted to systematically examine the efficacy of current treatments for depression and anxiety in PD. RESULTS Nine trials were included. There was only sufficient data to calculate a pooled effect for antidepressant therapies. The pooled effect of antidepressants for depression in PD was moderate but non-significant (d = .71, 95% CI = -1.33 to 3.08). The secondary effect of antidepressants on anxiety in PD was large but also non-significant (d = 1.13, 95% CI = -.67 to 2.94). Two single-trials of non-pharmacological treatments for depression in PD resulted in significant large effects; Omega-3 supplementation (d = .92, 95% CI = .15 to 1.69) and CBT (d = 1.57, 95% CI = 1.06 to 2.07), and warrant further exploration. CONCLUSIONS There remains a lack of controlled trials for both pharmacological and non-pharmacological treatments for depression and anxiety in PD which limits the conclusions which can be drawn. While the pooled effects of antidepressant therapies in PD were non-significant, the moderate to large magnitude of each pooled effect is promising. Non-pharmacological approaches show potential for depression in PD however more research is required.
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Affiliation(s)
- Lakkhina Troeung
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Sarah J. Egan
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Natalie Gasson
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia
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Cognitive behavioural therapy for depression in advanced Parkinson's disease: a case illustration. COGNITIVE BEHAVIOUR THERAPIST 2012. [DOI: 10.1017/s1754470x12000049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
AbstractParkinson's disease (PD) is associated with significant symptoms of depression. Cognitive behaviour therapy (CBT) has been shown to be effective for depression in PD. However, much of the previous research focuses on working with younger adults in the earlier stages of the disease, despite evidence for greater risk of depression when PD symptoms are more severe. This paper provides a case illustration of using CBT for depression with an 84-year-old man with advanced PD. The results of an assessment are described and a psychological formulation is presented. The specific adaptations made to the therapy and illustrations of the content of therapy are discussed. This intervention resulted in improvements in global mental health and moderate reductions in depression. However, there was no effect on anxiety. This case highlights the complexity of conducting CBT with this population, and further research is needed to determine the modifications necessary to make such interventions effective.
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Eccles FJR, Murray C, Simpson J. Perceptions of cause and control in people with Parkinson's disease. Disabil Rehabil 2011; 33:1409-20. [DOI: 10.3109/09638288.2010.533241] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Eccles FJR, Simpson J. A review of the demographic, clinical and psychosocial correlates of perceived control in three chronic motor illnesses. Disabil Rehabil 2011; 33:1065-88. [DOI: 10.3109/09638288.2010.525287] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mallick S. Palliative care in Parkinson's disease: role of cognitive behavior therapy. Indian J Palliat Care 2011; 15:51-6. [PMID: 20606856 PMCID: PMC2886210 DOI: 10.4103/0973-1075.53512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a chronic, progressive, neurodegenerative disorder that leads to the classic features of akinesia (encompassing hypokinesia and bradykinesia), tremor, rigidity and postural instability. Other non-motor complications include depression, fatigue, pain, and sleep disturbances. For the management of these complications, non-pharmacological techniques, such as Cognitive-behavioral therapy (CBT) can be used. This can focus on overt behavior and underlying cognitions and train the patient in coping strategies to obtain better symptom control. OBJECTIVES To review studies on CBT as palliative care in PD patients. MATERIALS AND METHODS A survey was conducted for all available English-language studies by means of a MEDLINE search. Keywords in the searches included Parkinson's disease, palliative care, and cognitive behavior therapy. All articles that reported the cognitive behavior therapy and palliative care in a group of PD patients regardless of the method used by the researchers were identified and analyzed. RESULT AND CONCLUSION CBT has a strong evidence base for its use and has proven to be an effective treatment in management of people with chronic pain, fatigue syndrome, depression and sleep disturbances, with efficacy that lasts beyond the duration of treatment. Although PD patients suffer from these complications, there are only a few studies on administration of CBT on them. Considering its effectiveness, CBT can be used as an option for palliative care for PD patients, directed toward improving the patient's functional status, clinical disability and quality of life. Further studies are required in this area.
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Affiliation(s)
- Samput Mallick
- Department of Psychiatry, R. G. Kar Medical College and Hospital, Kolkata, India
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Simpson J, Haines K, Lekwuwa G, Wardle J, Crawford T. Social support and psychological outcome in people with Parkinson's disease: Evidence for a specific pattern of associations. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2010; 45:585-90. [PMID: 17076966 DOI: 10.1348/014466506x96490] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this study was to explore the relationship between social support and psychological functioning in people with Parkinson's disease. METHOD 34 participants with idiopathic Parkinson's disease completed a comprehensive range of social support assessments and measures of depression, anxiety, stress, general psychological distress and positive affect. RESULTS A clear pattern of relationships emerged, with the less satisfaction with social support, the higher the depression, anxiety and stress scores. Conversely, positive affect was related to more quantitative assessments of social support, such as the number of close relationships. CONCLUSION The relationship between social support and psychological outcome in people with PD is complex. Furthermore, the complexity of this relationship should be addressed in any therapeutic attempts to relieve psychological distress and promote happiness.
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Todd D, Simpson J, Murray C. An interpretative phenomenological analysis of delusions in people with Parkinson's disease. Disabil Rehabil 2010; 32:1291-9. [PMID: 20088687 DOI: 10.3109/09638280903514705] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The aim of this qualitative study was to explore what delusional experiences mean for people with Parkinson's disease (PD) and to examine how psychosocial factors contribute to the development and maintenance of delusional beliefs. METHOD Eight participants were interviewed, and interpretative phenomenological analysis was used to identity themes within their accounts. Participants were either recruited from a hospital-based outpatient movement disorder clinic or from a PD support group in the north-west of England. RESULTS Four themes emerged from the analysis: (1) 'I got very frightened': The emotional experience associated with delusions; (2) 'Why the hell's that happening?': Sense of uncertainty and of losing control; (3) 'I feel like I'm disintegrating': Loss of identity and sense of self; (4) 'I've just tried to make the best of things': Acceptance and adjustment to experience of delusions. These interconnected themes in participants' accounts of delusional beliefs were reflected in their descriptions of living with, and adjusting to, PD. CONCLUSIONS The results of this study add to the evidence base indicating the urgent examination of psychological alternatives to conventional, medication-based approaches to alleviating the distress caused by delusions in people with PD.
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Affiliation(s)
- David Todd
- Division of Health Research, Department of Clinical Psychology, Lancaster University, Lancaster LA1 4YT, UK.
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Fitzpatrick L, Simpson J, Smith A. A qualitative analysis of mindfulness-based cognitive therapy (MBCT) in Parkinson's disease. Psychol Psychother 2010; 83:179-92. [PMID: 19843353 DOI: 10.1348/147608309x471514] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To analyse the experiences of participants with Parkinson's disease (PD), who participated in an 8-week mindfulness-based cognitive therapy (MBCT) course. DESIGN AND METHOD Interpretative phenomenological analysis guided the design and method used in this study. A total of twelve participants (seven men and five women) with PD were recruited prior to and following participation in an MBCT course and interviewed with a semi-structured interview schedule. One participant who opted out of the course was also interviewed. The researcher also participated in another MBCT course to enhance their understanding of the participants' experience, keeping a detailed diary as a means of acknowledging bias in the analysis process. Themes were summarized from transcripts and later classified into superordinate themes, which were compared across all cases. Transcripts were also read and analysed by a second author and participants were given the opportunity to comment upon emerging themes. RESULTS Major themes included (1) changing patterns of coping; (2) the role of mindfulness in consolidating existing coping skills in the context of loss; (3) group support in the context of loss and society that stigmatizes difference; and (4) the dualism of experience between Parkinson's and mindful meditation. CONCLUSIONS This study has indicated that MBCT could benefit people with PD and was an acceptable form of group intervention.
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Montel S, Bungener C. Coping et qualité de vie dans la sclérose en plaques et la maladie de Parkinson : une réflexion clinique. ANNALES MEDICO-PSYCHOLOGIQUES 2010. [DOI: 10.1016/j.amp.2008.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cognitive–Behavioral Therapy for Patients With Parkinson’s Disease and Comorbid Major Depressive Disorder. PSYCHOSOMATICS 2010. [DOI: 10.1016/s0033-3182(10)70672-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Aarsland D, Marsh L, Schrag A. Neuropsychiatric symptoms in Parkinson's disease. Mov Disord 2010; 24:2175-86. [PMID: 19768724 DOI: 10.1002/mds.22589] [Citation(s) in RCA: 326] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Neuropsychiatric symptoms are common in Parkinson's disease, even at the earliest stages, and have important consequences for quality of life and daily functioning, are associated with increased carer burden and increased risk for nursing home admission. In addition to cognitive impairment, a wide range of neuropsychiatric symptoms have been reported. In this article, the epidemiology, clinical course, diagnosis, and management of some of the most common neuropsychiatric symptoms in PD are discussed: depression, anxiety, apathy, fatigue, and psychotic symptoms. Although much is known regarding the prevalence and course of these symptoms, the empirical evidence for how to manage these symptoms is limited at best. There is thus an urgent need for systematic studies for the pharmacological and non-pharmacological management of these symptoms.
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Affiliation(s)
- Dag Aarsland
- The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway.
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20
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A'Campo L, Wekking E, Spliethoff-Kamminga N, Le Cessie S, Roos R. The benefits of a standardized patient education program for patients with Parkinson's disease and their caregivers. Parkinsonism Relat Disord 2010; 16:89-95. [DOI: 10.1016/j.parkreldis.2009.07.009] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2008] [Revised: 07/01/2009] [Accepted: 07/20/2009] [Indexed: 11/28/2022]
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Oehlberg K, Barg FK, Brown GK, Taraborelli D, Stern MB, Weintraub D. Attitudes regarding the etiology and treatment of depression in Parkinson's disease: a qualitative study. J Geriatr Psychiatry Neurol 2008; 21:123-32. [PMID: 18474721 PMCID: PMC2680384 DOI: 10.1177/0891988708316862] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Depression in Parkinson's disease (dPD) remains under recognized and under treated. As patients' beliefs may impact the reporting and treatment of depression, this study assessed the opinions of 38 dPD patients, approximately half with a self-reported poor response to antidepressant treatment, regarding the etiology and treatment of their depression using a semi-structured, audio-taped, qualitative interview. About half of the participants listed PD itself as a primary cause for their depressive symptoms, with most in this group citing psychosocial factors rather than PD-related neurobiological factors. Antidepressant therapy, psychotherapy, and self-initiated approaches were noted as preferred treatments for dPD. Many had concerns about antidepressant therapy, listing side-effects and medication dependency most frequently. About half raised concerns about psychotherapy with trust/discomfort, stigma, and transportation issues most frequently mentioned. This preliminary study suggests that many PD patients with clinically significant depressive symptoms attribute their depression to psychosocial factors and endorse nonpharmacologic treatment approaches.
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Affiliation(s)
| | - Frances K. Barg
- Department of Family Medicine and Community Health, University of Pennsylvania, Department of Anthropology, School of Arts and Sciences (FKB), University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | | | - Daniel Weintraub
- Department of Psychiatry, University of Pennsylvania, Department of Neurology, University of Pennsylvania, Parkinson's Disease, Philadelphia VA Medical Center, Mental Illness Research, Education, and Clinical Centers (PADRECC and MIRECC), Philadelphia VA Medical Center, Pennsylvania
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Dobkin RD, Menza M, Bienfait KL. CBT for the treatment of depression in Parkinson's disease: a promising nonpharmacological approach. Expert Rev Neurother 2008; 8:27-35. [PMID: 18088199 DOI: 10.1586/14737175.8.1.27] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Depression is very common in Parkinson's disease (PD) and linked with a faster progression of physical symptoms, greater cognitive decline and poorer quality of life. Nonpharmacological approaches, such as cognitive-behavioral therapy (CBT), for the treatment of depression in PD (dPD) have received little experimental attention despite strong demonstrated efficacy in other geriatric and medical populations. Depressed PD patients often differ from the depressed non-PD elderly in that they present with increased rates of both executive dysfunction and comorbid psychiatric diagnoses, may differ in their depressive symptom presentation and typically have caregivers who are highly involved in their treatment. Therefore, it is not possible to conclude that empirically validated treatments in the depressed aged will generalize to those with PD. In order to be most effective for PD patients, CBT should be tailored to their unique needs. Additional controlled research is needed to further explore the efficacy of CBT for dPD.
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Affiliation(s)
- Roseanne DeFronzo Dobkin
- Department of Psychiatry, UMDNJ/Robert Wood Johnson Medical School, 675 Hoes Lane, Room D-317, Piscataway, NJ 08854, USA.
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Jamieson DRS, Jamieson AE. Depression in patients with Parkinson's disease: identification and treatment. Br J Hosp Med (Lond) 2007; 68:485-8. [DOI: 10.12968/hmed.2007.68.9.27170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Recognizing depression in Parkinson's disease can be problematic but since it has such a significant impact on the quality of life in these patients and is easily treatable the value of therapeutic intervention should not be underestimated.
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Ferreri F, Agbokou C, Gauthier S. Recognition and management of neuropsychiatric complications in Parkinson's disease. CMAJ 2006; 175:1545-52. [PMID: 17146092 PMCID: PMC1660590 DOI: 10.1503/cmaj.060542] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Parkinson's disease is primarily considered a motor disease characterized by rest tremor, rigidity, bradykinesia and postural disturbances. However, neuropsychiatric complications, including mood and anxiety disorders, fatigue, apathy, psychosis, cognitive impairment, dementia, sleep disorders and addictions, frequently complicate the course of the illness. The pathophysiologic features of these complications are multifaceted and include neuropathophysiologic changes of a degenerative disease, exposure to antiparkinsonian treatments and emotional reactions to having a disabling chronic illness. Changes in mental status have profound implications for the well-being of patients with Parkinson's disease and of their caregivers. Treatment is often efficacious but becomes a challenge in advanced stages of Parkinson's disease. In this article, we review the key clinical features of neuropsychiatric complications in Parkinson's disease as well as what is known about their epidemiologic characteristics, risk factors, pathophysiologic features and management.
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Affiliation(s)
- Florian Ferreri
- Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging, Douglas Hospital, Verdun, Quebec, Canada
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