A systematic review and meta-analysis of cognitive behavioral and psychodynamic therapy for depression in Parkinson’s disease patients

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• 作者：Cheng-Long Xie ; Xiao-Dan Wang ; Jie Chen ; Hua-Zhen Lin ; Yi-He Chen…
• 关键词：Cognitive behavioral therapy ; Psychosocial treatments ; Parkinson’s disease ; Depression ; Systematic review ; Meta ; analysis
• 刊名：Neurological Sciences
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：36
• 期：6
• 页码：833-843
• 全文大小：1,357 KB
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• 作者单位：Cheng-Long Xie (1) (2)
  Xiao-Dan Wang (3)
  Jie Chen (1)
  Hua-Zhen Lin (1)
  Yi-He Chen (4)
  Jia-Lin Pan (4)
  Wen-Wen Wang (1)
  
  1. The Center of Traditional Chinese Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027, China
  2. Department of Neurology, Xinhua Hospital Affiliated to the Medical School of Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
  3. Department of Neurology, Ruijin Hospital North Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 201801, China
  4. The Center of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027, China
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Neurology
  Neuroradiology
  Neurosurgery
  Psychiatry
  
• 出版者：Springer Milan
• ISSN：1590-3478

文摘

Numerous practice guidelines have recommended cognitive behavioral therapy (CBT) and psychodynamic therapy as a treatment of choice for depression in Parkinson’s disease (PD). However, no recent meta-analysis has examined the effects of brief psychotherapy (which includes both CBT and psychodynamic therapy) for adult depression in PD. We decided to conduct such a systematic review and meta-analysis. We included randomized controlled trials (RCTs) examining the effects of brief psychotherapy compared with control groups, other support nursing, or pharmacotherapy. The quality of included studies was strictly evaluated. Twelve studies including 766 patients met all inclusion criteria. The result showed that brief psychotherapy could evidently improve the HAMD (p?<?0.00001) and Moca scale (p?=?0.006). There was no statistical significance in PDQ-39 scale (p?=?0.31). In the subgroup analysis by types of brief psychotherapy, the efficacy of psychodynamic psychotherapy was better than CBT (SMD?=??.02 vs SMD?=??.90) for the outcome measure according to HAMD scale. Meanwhile, we found brief psychotherapy in China was more effective than in US (SMD?=??.54 vs SMD?=??.23), and in low quality studies was more efficacious than in high quality studies (SMD?=??.50 vs SMD?=??.33). Time of brief psychotherapy treatment above 6?weeks was superior to studies with less than 6?weeks treatment. We found brief psychotherapy is probable effective in the management of depression in PD patients. But one reason to undermine the validity of findings is high clinical heterogeneity and low methodological quality of the included trials.