Abstract
Depression is a common complication of Parkinson's disease (PD) with considerable impact on patients' quality of life. However, at present the most appropriate treatment approach is unclear. There are limited data on antidepressant medications in PD-associated depression (dPD) and those available suggest limited efficacy and tolerability of these drugs. Cognitive behavioural therapy (CBT) has been shown to be an effective treatment of depressive disorders. Treatment of dPD with CBT may pose particular challenges, including possible different pathophysiology, physical and mental comorbidities, and barriers to treatment through disability, which do not allow simple transfer of these results to patients with dPD. However, a number of case reports, case series, and small pilot studies suggest that this is a promising treatment for patients with PD. We here summarise the published evidence on this treatment in dPD.
Highlights
Parkinson’s disease (PD) is diagnosed on the basis of the classic features of motor disturbance [1, 2], it is widely recognised that nonmotor symptoms are common, and occur across all stages of the disease [3]
We screened 1579 article abstracts in total; the search yielded a number of review articles and 15 studies of Cognitive behavioural therapy (CBT) for depression in PD patients
The study was limited to young PD patients, which were self-referred, which could have led to selection bias
Summary
Parkinson’s disease (PD) is diagnosed on the basis of the classic features of motor disturbance [1, 2], it is widely recognised that nonmotor symptoms are common, and occur across all stages of the disease [3]. Depressive disorders affect approximately 40% of patients with PD [4,5,6,7] They are linked to functional impairment, cognitive decline, and faster disease progression and are the main determinant for poor quality of life in PD [8,9,10,11,12]. They are associated with increased health care costs in the population, raising both direct and indirect costs [13, 14]. Evidence-based recommendations and consensus on the best treatment choice for this patient population are scarce [20]
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