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Cognitive Behavioral Group Therapy Can Help Treat Parkinson’s Patients’ Depression, Study Finds

Group cognitive therapy study

Cognitive behavioral group therapy reduced Parkinson’s patients’ depression and anxiety, an Italian study reports.

Parkinson’s patients experience both movement and non-movement symptoms, including depression, anxiety, apathy, fatigue, pain, and impulse control disorders.

Cognitive behavioral therapy, or CBT, is a well-established strategy for reducing depression and apathy. But evidence supporting its use in Parkinson’s patients has dealt mostly with individual rather than group therapy. Groups give patients with a similar disorder a chance to interact with each other and share information and experiences.

Although the  limited research on group CBT in Parkinson’s has demonstrated that it can help treat patients’ psychiatric and neurological symptoms, no study used a control group to help validate the findings.

So a team of researchers conducted a study comparing the benefits of group CBT with that of a psychoeducational approach to treating Parkinson’s. The psychoeducational approach has proved beneficial in treating other neuropsychiatric disorders.

The study, “Cognitive behavioral group therapy versus psychoeducational intervention in Parkinson’s disease,” was published in the journal Neuropsychiatric Disease and Treatment, 

Researchers said the study’s main goal was to see if cognitive behavioral group therapy could improve Parkinson’s patients’ psychiatric, movement and non-movement symptoms.

The research team assigned 20 Parkinson’s patients diagnosed with a psychiatric disorder but showing no evidence of cognitive impairment to either a 12-week cognitive behavioral therapy group or a psychoeducational protocol.

Researchers used the Unified Parkinson’s Disease Rating Scale and the non-motor symptoms scale as measures of neurological symptoms. They assessed the severity of psychiatric symptoms with three scales. The team evaluated patients before the start of the trial and at the end of the 12-week treatment.

A psychiatrist and neurologist conducted the once-a-week, 90-minute group CBT sessions. The therapists were trained in using practical skills to change mood-related thoughts, behaviors, and movement symptoms. Researchers also looked at whether patients avoided social situations, engaged in family conflict, lacked assertiveness, had trouble with problem-solving, and what coping strategies they had.

The psychoeducational group met every two weeks. A different psychiatrist and neurologist than the ones in the CBT group conducted the therapy.

Sessions focused on information and explanations about Parkinson’s disease and possible implications for the patients’ lives. The four main topics were illness awareness, sticking with treatment, early detection of movement and non-movement symptoms, and achieving lifestyle continuity. Each session included an initial presentation, an exercise and a group discussion. Disease management and side effects were also covered.

The results showed that group CBT was an effective treatment for depression and anxiety in all of the Parkinson’s patients who completed the study. It also reduced the severity of patients’ other non-movement symptoms, such as apathy. In contrast, the psychoeducational protocol did not change patients’ symptoms, researchers said.

Because both groups had similar disease severity at the start of the study, the researchers said it was unlikely that differences in severity confounded the results.

This study demonstrated that group CBT did a better job of improving Parkinson’s patients’ psychiatric symptoms than psychoeducational treatment. But the research had its limitations. One was that the number and duration of psychoeducational sessions did not match those of the CBT sessions. Other limitations were the relatively small number of patients studied and the fact that the main measure of participants’ psychiatric condition was patient self-reports.

Nonetheless, the study suggested that group CBT should be considered along with standard drug therapy for treating the mental health symptoms of people with chronic and disabling illnesses, particularly depression and anxiety.

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Source: Parkinson's News Today

Transcranial Magnetic Stimulation Ineffective for Depression in Parkinson’s, Study Reports

depression and Parkinson's

Repetitive transcranial magnetic stimulation (TMS) does not appear to treat depressive symptoms in patients with Parkinson’s disease, although it may improve motor symptoms, an analysis of nine clinical trials found.

But the study included relatively few patients, so the researchers, with Guangxi University of Science and Technology in China, said that their conclusions warrant further exploration in long-term studies.

The study, titled “Effectiveness of high-frequency repetitive transcranial magnetic stimulation in patients with depression and Parkinson’s disease: a meta-analysis of randomized, controlled clinical trials,” was published in the journal Neuropsychiatric Disease and Treatment.

Depression is common in Parkinson’s disease, with up to half of patients experiencing low mood. Treating it is particularly important for Parkinson’s patients, because depression has been linked to disease progression. Doctors often opt for selective serotonin inhibitors (SSRIs) to treat the condition, but those antidepressants can have side effects that worsen motor problems. Data also shows that SSRI’s are no more effective for depression in Parkinson’s disease than placebo.

TMS is an alternative to traditional pharmacologic treatments for depression, and it uses electromagnetic currents to non-invasively stimulate select brain regions. Several studies showed that it was effective against depression in other patients, so researchers considered it as an option for Parkinson’s disease.

The nine trials analyzed in this study, which included a total of 332 Parkinson’s patients, used different methods: some compared TMS to a sham procedure, while some compared it to SSRI treatment.

The analysis showed that the procedure was no better than sham or SSRI treatments in lowering depressive symptoms. However, it did ease patients’ motor symptoms, more than both the sham and antidepressant treatments.

Though an analysis of multiple trials is considered a high standard of evidence, researchers cautioned against over-interpreting these findings, because the included trials were all small.

“Given this limitation, this review should be viewed with care when applying results to clinical practice,” they wrote.

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Source: Parkinson's News Today

What Causes Anxiety in Parkinson’s Disease?

Anxiety is a state of mind which can give the sufferer feelings of agitation and nervousness. Moods can often be foreboding and difficult to snap out of. People who live with Parkinson’s disease may also suffer from anxiety for several reasons.

MORE: The five stages of Parkinson’s disease

According to the National Parkinsons Foundation, chemical changes occurring in the brain due to Parkinson’s disease can trigger mood disorders such as anxiety and depression. People living with Parkinson’s often have extremely low levels of the chemical GABA, which has been linked to the onset of anxiety and depression. If this is the case, then medication can help rebalance the brain’s chemicals and reduce anxiety.

Intermittent bouts of anxiety can occur due to the effects of motor changes, which can often be extreme and result in severe anxiety attacks.

As well as biological factors, psychological factors can also play a role in the onset of anxiety for Parkinson’s disease patients. The effects of coping with a chronic disease can often have an adverse effect on a person’s mental health. In addition, patients may experience anxiety attacks when their medication has worn off and is no longer working.

MORE: How does Parkinson’s disease affect the brain?

Parkinsons’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

 

The post What Causes Anxiety in Parkinson’s Disease? appeared first on Parkinson’s News Today.

Source: Parkinson's News Today

10 Complications of Parkinson’s Disease

As well as the symptoms usually associated with Parkinson’s disease like rigidity and tremors, those living with the condition may also experience other complications. According to the Mayo Clinic, these complications may include:

Cognitive Problems
Cognitive problems tend to occur in the later stages of the disease, where thinking and reasoning may become impaired. Currently, there is no medication available to treat this complication.

Depression and Anxiety
It’s common for people living with Parkinson’s disease to suffer from emotional changes such as depression or anxiety. Speak to your doctor if you’re finding it hard to cope emotionally as medication or counseling may help.

Difficulty in Swallowing
As Parkinson’s disease progresses, some patients may find they experience swallowing difficulties. This may also lead to an excess of saliva in the mouth and drooling.

MORE: 11 Facts About Parkinson’s Disease You May Not Know

Sleep Disorders
Sleep disorders are extremely common in people with Parkinson’s disease. Common complaints include difficulty falling asleep, waking to go to the bathroom, restless leg syndrome, REM sleep behavior disorder and sleep apnea.

Bladder and Bowel Problems
Difficulty in controlling urination or starting urination is a common complication of Parkinson’s disease. In addition, many may find that they suffer from constipation.

Sudden Changes in Blood Pressure
Dizziness when standing up is due to a sudden drop in blood pressure.

MORE: Lifestyle Changes That Can Improve Quality of Life for Parkinson’s Patients

Loss of Sense of Smell
Many Parkinson’s disease patients report a decline in their sense of smell or being unable to distinguish between different smells.

Fatigue
Fatigue can affect many Parkinson’s disease patients, often without any known cause.

Pain
Pain experienced by Parkinson’s disease patients can be in specific areas or a general pain felt all over the body.

Lower Sex Drive
A lower sex drive or sexual dysfunction is a complication of Parkinson’s disease for many people and may be due to other symptoms such as fatigue, pain or depression.

MORE: 10 Complications of Parkinson’s Disease

Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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Source: Parkinson's News Today