Telephone-based cognitive-behavioral therapy for depression in Parkinson disease.
BACKGROUND
Although face-to-face cognitive-behavioral therapy (CBT) was found to be beneficial for the treatment of depression in Parkinson disease (dPD) in a recent randomized-controlled trial, access to care was identified as a critical issue that needs to be addressed in order to improve the management of this nonmotor complication in PD. The purpose of this study was to examine the feasibility and effect of telephone-based CBT for dPD.


METHODS
Twenty-one depressed people with PD participated in a National Institutes of Health-sponsored uncontrolled pilot trial of telephone-based CBT in an academic medical center from October 2009 to February 2011. The Hamilton Depression Rating Scale was the primary outcome. Treatment was provided to people with PD for 10 weeks, modified for delivery over the phone, and supplemented with 4 separate phone-based caregiver educational sessions. Assessments were completed at baseline and 5 (midpoint), 10 (end-of-treatment), and 14 weeks (follow-up) post-enrollment.


RESULTS
Twenty (95%) people with PD completed the study treatment. Phone-based CBT was associated with significant improvements in depression, anxiety, negative thoughts, and coping. Mean Hamilton Depression Rating Scale change from baseline to week 10 was 7.91 points (P < .001, Cohen d = 1.21).


CONCLUSIONS
Telephone-based CBT may be a feasible and helpful approach for treating dPD and warrants further exploration in randomized-controlled trials. Results were comparable to those observed in the few in-person cognitive-behavioral treatment studies for dPD conducted to date.
Department of Psychiatry, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Piscataway, NJ 08854, USA. dobkinro@umdnj.edu
Roseanne D
RD
Dobkin
Matthew
M
Menza
Lesley A
LA
Allen
Jade
J
Tiu
Jill
J
Friedman
Karina L
KL
Bienfait
Michael A
MA
Gara
Margery H
MH
Mark
D000046:Academic Medical Centers / Q000379:methods; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000295:instrumentation / Q000379:methods*; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000523:psychology*; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D017216:Telemedicine / Q000706:statistics & numerical data*; D013689:Telephone / Q000706:statistics & numerical data