Abstract
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.
Keywords
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Article info
Publication history
Published online: May 03, 2021
Footnotes
The authors declare no conflicts of interest.
The authors declare no financial relationships to disclose.
Identification
Copyright
© 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
