CBT for the treatment of depression in Parkinson’s disease: a promising nonpharmacological approach

Dobkin, Roseanne D.; Menza, Matthew; Bienfait, Karina

doi:10.1586/14737175.8.1.27

Cited by 38 publications

(23 citation statements)

References 90 publications

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“…While pharmacological research is being explored, non-pharmacological interventions such as cognitive-behavioral psychotherapy focusing on behavioral activation that re-engages the patient slowly back into activities and interests could be investigated. CBT approaches have shown promise in the treatment of PD depression (Dobkin, Allen, & Menza, 2007; Dobkin, Menza, & Bienfait, 2008), and may also prove beneficial for treatment of apathy.…”

Section: Discussionmentioning

confidence: 99%

Apathy and Depression: Separate Factors in Parkinson's Disease

Kirsch-Darrow

Marsiske

Okun

et al. 2011

J Int Neuropsychol Soc

121

107

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The objective of this study was to test the hypothesis that apathy and depression are dissociable in Parkinson disease (PD) by conducting a confirmatory factor analysis (CFA) of items from two commonly used mood scales. A total of 161 non-demented PD patients (age = 64.1; ± 8.4 years) were administered the Apathy Scale and the Beck Depression Inventory-II. Items were hypothesized to load onto four factors: (1) an apathy factor representing loss of motivation, (2) dysphoric mood factor representing sadness and negativity, (3) loss of interest/pleasure factor representing the features common to both apathy and depression, and (4) a somatic factor representing bodily complaints. Results indicated a good fit for the overall CFA model, χ2 (128, N = 146) = 194.9; p<.01. RMSEA was .060 (p = .16). The four-factor model was significantly better than all alternative nested models at p < .001, including an overarching single factor model, representing “depression.” Results support the concept that apathy and depression are discrete constructs. We suggest a “factor based” scoring of the Apathy Scale and Beck Depression Inventory-II that disentangles symptoms related to apathy, depression, overlapping symptoms, and somatic complaints. Such scoring may be important in providing useful information regarding differential treatment options.

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Section: Discussionmentioning

confidence: 99%

Apathy and Depression: Separate Factors in Parkinson's Disease

Kirsch-Darrow

Marsiske

Okun

et al. 2011

J Int Neuropsychol Soc

121

107

View full text Add to dashboard Cite

show abstract

“…The CBT package employed in this trial was tailored to the unique needs of the Parkinson’s population and is described in detail elsewhere (19,39). In brief, specific modifications included a stronger emphasis on behavioral and anxiety management techniques than traditionally integrated into CBT protocols for depression, and the inclusion of a supplemental caregiver educational program.…”

Section: Methodsmentioning

confidence: 99%

Cognitive-Behavioral Therapy for Depression in Parkinson's Disease: A Randomized, Controlled Trial

Dobkin¹,

Menza²,

Allen³

et al. 2011

AJP

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259

244

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Objective Despite the negative effects of depression in Parkinson’s disease, there is currently no evidence-based standard of care. The purpose of this study was to examine the efficacy of individually-administered Cognitive Behavior Therapy (CBT) versus clinical monitoring (with no new treatment) for depression in this medical population. Methods Eighty depressed (DSM-IV criteria) patients with Parkinson’s disease participated in an NIH-sponsored randomized-controlled trial of CBT vs. clinical monitoring (1:1 ratio) in an academic medical center from April 2007 to July 2010. All patients concurrently continued under the care of their personal physicians on stable medication regimens. The Hamilton Depression Rating Scale (HAM-D 17) was the primary outcome. CBT was modified to meet the unique needs of the Parkinson’s population and provided for 10 weeks. Assessments were completed at baseline and 5 (midpoint), 10 (end of treatment), and 14 weeks (follow-up) post-randomization by blind raters. Results The CBT group reported greater reductions in depression (HAM-D 17) vs. clinical monitoring (P<.0001). At week 10, mean HAM-D change was 7.35 for CBT vs. 0.05 for clinical monitoring (P<.0001). CBT was also superior to clinical monitoring on several secondary outcomes (i.e., Beck Depression Inventory, anxiety, quality of life, coping, Parkinson’s disease symptom ratings). There were more treatment responders in the CBT group (56% vs. 8%, P<.0001). Conclusions CBT may be a viable approach for the treatment of depression in Parkinson’s disease. Further research is needed to replicate and extend these findings.

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“…Although cognitive-behavioral therapy (CBT) has been demonstrated to be effective for treating PG [6,25,26] and for the management of depressive symptomatology in PD [27,28], there is a lack of studies that focus on the use of CBT to treat PG in patients with PD. Testing nonpharmacological treatment for the management of impulse control disorders in PD is particularly important given that many PD patients with PG are reluctant or unable to decrease the dosage of their dopaminergic medication [29].…”

Section: Introductionmentioning

confidence: 99%

Cognitive-Behavioral Therapy for Pathological Gambling in Parkinson’s Disease: A Pilot Controlled Study

et al. 2012

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Objectives: The main objective of this study was to compare the clinical characteristics and differences in response to treatment of two groups of pathological gamblers: with comorbid Parkinson’s disease (PG + PD) and without (PG – PD). Methods: Clinical and psychopathological profiles and response to cognitive-behavioral treatment were assessed in 15 PG + PD and 45 PG – PD individuals consulting a specialized hospital Unit. Results: Statistically significant differences were observed between the two groups on a series of clinical variables. PG + PD patients were older and presented later onset of problematic gambling behaviors, lower alcohol consumption and higher bingo playing than PG – PD patients. No significant differences were noted in psychopathology except for lower measures of hostility in the PG + PD group. No statistical differences were detected between groups in terms of response to treatment. Conclusion: These results may provide guidance for obtaining accurate diagnostic information in pathological gamblers by properly identifying patients with specific needs that may be targeted with treatment.

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CBT for the treatment of depression in Parkinson’s disease: a promising nonpharmacological approach

Cited by 38 publications

References 90 publications

Apathy and Depression: Separate Factors in Parkinson's Disease

Apathy and Depression: Separate Factors in Parkinson's Disease

Cognitive-Behavioral Therapy for Depression in Parkinson's Disease: A Randomized, Controlled Trial

Cognitive-Behavioral Therapy for Pathological Gambling in Parkinson’s Disease: A Pilot Controlled Study

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