Cognitive-behavioral therapy for depression in Parkinson's disease: a randomized, controlled trial.
Cognitive-behavioral therapy for depression in Parkinson's disease: a randomized, controlled trial.
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DOI：
10.1176/appi.ajp.2011.10111669
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发表时间：
2011-10
期刊：
影响因子：
--
通讯作者：
Friedman J
中科院分区：
文献类型：
--
作者：
Dobkin RD;Menza M;Allen LA;Gara MA;Mark MH;Tiu J;Bienfait KL;Friedman J
尽管抑郁症对帕金森氏症有负面影响，但目前还没有基于证据的护理标准。这项研究的目的是检验单独实施认知行为疗法(CBT)与临床监测(没有新的治疗方法)在这一医学人群中对抑郁症的疗效。从2007年4月到2010年7月，80名符合DSM-IV标准的帕金森氏病抑郁患者参加了由美国国立卫生研究院赞助的CBT与临床监测(1：1比率)的随机对照试验。所有患者同时继续接受他们的私人医生的稳定用药方案的护理。主要结果为汉密尔顿抑郁量表(HAM-D17)。CBT经过修改，以满足帕金森氏症患者的独特需求，并提供10周。评估由盲评分者在基线和随机化后5周(中点)、10周(治疗结束)和14周(随访)完成。CBT组报告的抑郁症(HAM-D17)与临床监测(P<；.0001)相比有更大的降低。在第10周，CBT的平均HAM-D变化为7.35，而临床监测为0.05(P<；.0001)。CBT在几个次要结果(即Beck抑郁量表、焦虑、生活质量、应对、帕金森氏症症状评分)上也优于临床监测。CBT组有更多的治疗应答者(56%对8%，P<；.0001)。CBT可能是治疗帕金森氏病抑郁的一种可行方法。需要进一步的研究来复制和推广这些发现。
Despite the negative effects of depression in Parkinson’s disease, there is currently no evidence-based standard of care. The purpose of this study was to examine the efficacy of individually-administered Cognitive Behavior Therapy (CBT) versus clinical monitoring (with no new treatment) for depression in this medical population. Eighty depressed (DSM-IV criteria) patients with Parkinson’s disease participated in an NIH-sponsored randomized-controlled trial of CBT vs. clinical monitoring (1:1 ratio) in an academic medical center from April 2007 to July 2010. All patients concurrently continued under the care of their personal physicians on stable medication regimens. The Hamilton Depression Rating Scale (HAM-D 17) was the primary outcome. CBT was modified to meet the unique needs of the Parkinson’s population and provided for 10 weeks. Assessments were completed at baseline and 5 (midpoint), 10 (end of treatment), and 14 weeks (follow-up) post-randomization by blind raters. The CBT group reported greater reductions in depression (HAM-D 17) vs. clinical monitoring (P<.0001). At week 10, mean HAM-D change was 7.35 for CBT vs. 0.05 for clinical monitoring (P<.0001). CBT was also superior to clinical monitoring on several secondary outcomes (i.e., Beck Depression Inventory, anxiety, quality of life, coping, Parkinson’s disease symptom ratings). There were more treatment responders in the CBT group (56% vs. 8%, P<.0001). CBT may be a viable approach for the treatment of depression in Parkinson’s disease. Further research is needed to replicate and extend these findings.
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影响因子：
48
作者：
Barone, Paolo;Poewe, Werner;Weintraub, Daniel
通讯作者：
Weintraub, Daniel
影响因子：
6.6
作者：
da Silva, Ticyana Moralez;Munhoz, Renato Puppi;Ferraz, Anete Curte
通讯作者：
Ferraz, Anete Curte
影响因子：
8.6
作者：
Devos, David;Dujardin, Kathy;Defebvre, Luc
通讯作者：
Defebvre, Luc
影响因子：
2.8
作者：
Dobkin, Roseanne DeFronzo;Panzarella, Catherine;Gara, Michael
通讯作者：
Gara, Michael
影响因子：
3
作者：
Borkovec, TD;Sibrava, NJ
通讯作者：
Sibrava, NJ