Numerous practice guidelines have recommended cognitive behavioral therapy (CBT) and psychodynamic therapy as a treatment of choice for depression in Parkinson’s disease (PD). However, no recent meta-analysis has examined the effects of brief psychotherapy (which includes both CBT and psychodynamic therapy) for adult depression in PD. We decided to conduct such a systematic review and meta-analysis. We included randomized controlled trials (RCTs) examining the effects of brief psychotherapy compared with control groups, other support nursing, or pharmacotherapy. The quality of included studies was strictly evaluated. Twelve studies including 766 patients met all inclusion criteria. The result showed that brief psychotherapy could evidently improve the HAMD (p < 0.00001) and Moca scale (p = 0.006). There was no statistical significance in PDQ-39 scale (p = 0.31). In the subgroup analysis by types of brief psychotherapy, the efficacy of psychodynamic psychotherapy was better than CBT (SMD = −2.02 vs SMD = −0.90) for the outcome measure according to HAMD scale. Meanwhile, we found brief psychotherapy in China was more effective than in US (SMD = −1.54 vs SMD = −1.23), and in low quality studies was more efficacious than in high quality studies (SMD = −1.50 vs SMD = −1.33). Time of brief psychotherapy treatment above 6 weeks was superior to studies with less than 6 weeks treatment. We found brief psychotherapy is probable effective in the management of depression in PD patients. But one reason to undermine the validity of findings is high clinical heterogeneity and low methodological quality of the included trials.

A systematic review and meta-analysis of cognitive behavioral and psychodynamic therapy for depression in Parkinson’s disease patients

Objective To explore the effect of psychological intervention on depression and cognitive impairment in patient with Parkinson's Disease(PD).Methods Sixty PD patients with depression and cognitive impairment were randomly divided into control group and experimental group.Patients in control group received normal nursing care while those in experimental group normal nursing plus positive psychological intervention.The scores of depression and cognitive function assessing by Hamilton Depression Scale(HAMD) and Montreal Cognitive Assessment(MoCA) after 8 weeks intervention were compared.Results Depressive symptoms and cognitive impairment were found in all patients with PD.The HAMD scores descend in both the groups after 8 weeks,but scores descended more in experimental group(P0.01).The MoCA scores in experimental group increased significantly(P0.05) which indicated patients' cognitive function were improved while the total MoCA scores in control group didn't change much(P0.05).Conclusion Psychological intervention based on positive psychology can improve the depression and cognitive impairment of patients with PD.

Chen Xia

Papers

Effect of Positive Psychological Intervention on Depression and Cognitive Impairment in Patient with Parkinson's Disease