Telephone-Based Cognitive-Behavioral Therapy for Depression in Parkinson Disease
Telephone-Based Cognitive-Behavioral Therapy for Depression in Parkinson Disease
复制标题
DOI：
10.1177/0891988711422529
复制
发表时间：
2011-12-01
影响因子：
2.6
通讯作者：
Mark, Margery H.
中科院分区：
文献类型：
--
作者：
Dobkin, Roseanne D.;Menza, Matthew;Mark, Margery H.
背景资料：尽管在最近的一项随机对照试验中发现面对面认知行为治疗（CBT）对帕金森病（dPD）抑郁症的治疗有益，但获得护理被认为是一个关键问题，需要解决，以改善PD非运动并发症的管理。本研究旨在探讨以电话为基础的认知行为治疗对dPD的可行性及效果。研究方法：2009年10月至2011年2月，21名患有PD的抑郁症患者参加了美国国立卫生研究院赞助的一项基于电话的CBT的非对照试点试验。汉密尔顿抑郁评定量表是主要结果。为PD患者提供了10周的治疗，修改为通过电话提供，并补充了4个单独的基于电话的护理人员教育课程。在基线和入组后5周（中点）、10周（治疗结束）和14周（随访）完成评估。结果：20例（95%）PD患者完成了研究治疗。基于电话的CBT与抑郁，焦虑，消极思想和应对的显着改善相关。从基线到第10周，平均汉密尔顿抑郁量表变化为7.91分（P <0.001，Cohen d = 1.21）。结论：基于电话的CBT可能是治疗dPD的一种可行且有用的方法，值得在随机对照试验中进一步探索。结果与迄今为止进行的少数dPD认知行为治疗研究中观察到的结果相当。
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.