Abstract
BackgroundThe aim of this study was to evaluate the efficacy of a group Cognitive Behavioural Therapy (CBT) treatment for depression and anxiety in Parkinson’s disease (PD).MethodsA waitlist-controlled trial design was used. Eighteen adults with PD and a comorbid DSM-IV-TR diagnosis of depression and/or anxiety were randomised to either Intervention (8-week group CBT treatment) or Waitlist (8-week clinical monitoring preceding treatment). The Depression, Anxiety, Stress Scale-21 (DASS-21) was the primary outcome. Assessments were completed at Time 1 (pretreatment), Time 2 (posttreatment/post-waitlist) and 1-month and 6-month follow-ups.ResultsAt Time 2, participants who received CBT reported greater reductions in depression (Mchange = -2.45) than Waitlist participants (Mchange = .29) and this effect was large, d = 1.12, p = .011. Large secondary effects on anxiety were also observed for CBT participants, d = .89, p = .025. All treatment gains were maintained and continued to improve during the follow-up period. At 6-month follow-up, significant and large effects were observed for both depression (d = 2.07) and anxiety (d = 2.26).ConclusionsGroup CBT appears to be an efficacious treatment approach for depression and anxiety in PD however further controlled trials with larger numbers of participants are required.Trial registrationAustralian New Zealand Clinical Trials Registry (Trial ID: ACTRN12610000455066)
Highlights
The aim of this study was to evaluate the efficacy of a group Cognitive Behavioural Therapy (CBT) treatment for depression and anxiety in Parkinson’s disease (PD)
At the end of the eight-week treatment period, participants who received CBT experienced statistically significant and large improvements in depression (d = 1.12) and anxiety (d = .89) relative to waitlist participants. These results are consistent with posttreatment effect sizes recently reported by Dobkin and colleagues [10] for individual CBT for depression in PD (Ham-D, d = 1.57; BDI, d = 1.1; anxiety; Ham-A, d = .98) and together add strong support to the growing body of evidence for the efficacy of CBT for depression and anxiety in PD
This finding contributes to a growing number of studies demonstrating simultaneous reductions in depressive and/or anxiety symptomatology and negative cognitions following CBT treatment in PD [13,14,19] further research is required to establish the mechanisms of change in CBT
Summary
The aim of this study was to evaluate the efficacy of a group Cognitive Behavioural Therapy (CBT) treatment for depression and anxiety in Parkinson’s disease (PD). In the first randomised controlled trial (RCT) of individual CBT for the treatment of depression with 80 individuals with PD [10], statistically significant and large effects on both depression (d = 1.59) and anxiety (d = .98) were observed following a 10-week CBT programme and maintained at one-month follow-up. While there have been a number of recent large groupbased didactic programmes featuring CBT techniques in PD [21,22,23], there have only been two studies of group CBT for clinical depression and/or anxiety in PD; one case study [17] and one case series [15], for a collective sample of five participants
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