认知行为疗法减轻帕金森病患者抑郁或焦虑的Meta分析
|
摘要
背景抑郁、焦虑等症状是帕金森患者常见的精神症状,在患者所有症状中排名前5名。不仅导致患者不同程度的功能损害,还严重影响患者的生命质量。但传统药物治疗不良反应多、易成瘾,心理疗法不良反应少且节省经济成本。认知行为疗法(CBT)是被众多心理疗法中应用较广泛的一种,大量研究证实其应用于帕金森患者效果显著。目的系统评价CBT减轻帕金森患者抑郁、焦虑症状,改善生活质量的效果。方法计算机检索PubMed、EMBase、Web of Science、Cochrane Library、Science Direct、中国知网、维普网、万方数据知识服务平台、中国生物医学文献数据库(CBM)等数据库,检索时限为建库至2018年5月,收集有关CBT治疗帕金森患者抑郁、焦虑症状的随机对照试验,并对文献进行筛选、质量评价和资料提取,采用RevMan 5.3进行Meta分析。结果共纳入9篇文献,总样本量401例,Meta分析结果显示,试验组抑郁评分[标准化均数差(SMD)=-1.15,95%CI(-2.18,-0.13),P=0.03]、焦虑评分[SMD=-0.80,95%CI(-1.40,-0.21),P=0.008]、心理一般健康状况评分[SMD=-1.27,95%CI(-1.96,-0.59),P=0.000 3]较对照组降低;试验组与对照组生活质量评分比较,差异无统计学意义(P>0.05)。亚组分析显示,CBT对改善帕金森病患者治疗后即刻抑郁评分、焦虑评分效果不佳(P>0.05),但可明显改善随访时评价的抑郁评分、焦虑评分(P<0.05)。结论 CBT有助于帕金森病患者抑郁、焦虑症状的恢复,尤其是治疗结束长期随访的效果,但短期治疗后的效果以及在提升生活质量方面仍需进一步的临床研究证实其干预有效性。
Background Depression,anxiety and other symptoms are common psychiatric symptoms in patients with Parkinson's disease,ranking the top 5 among all the symptoms.Depression and anxiety not only cause different degrees of functional damage,but also seriously affect patients' quality of life.However,traditional medicines have many side effects and are addictive,while psychotherapies have fewer adverse reactions and reduce economic costs.Cognitive behavioral therapy(CBT)is widely used,and a large number of studies have confirmed its effectiveness in patients with Parkinson's disease.Objective To systematically evaluate the effect of CBT on the symptoms of depression and anxiety and the quality of life in patients with Parkinson's disease(PD).Methods We searched the databases of PubMed,EMBase,Web of Science,Cochrane Library,Science Direct,CNKI,VIP,Wanfang Data Knowledge Service Platform and CBM.And randomized controlled trials(RCT)related to using CBT to relieve depression and anxiety in patients with PD included since the inception to May 2018 were collected.RCT were screened,data extraction was performed and qualities of eligible RCT were assessed.Meta-analysis was implemented with RevMan 5.3.Results Nine RCT with 401 patients were included.Meta-analyses of depression symptom score [SMD =-1.15,95%CI(-2.18,-0.13),P=0.03],anxiety symptom score [SMD=-0.80,95%CI(-1.40,-0.21),P=0.008] and general psychological health [SMD=-1.27,95%CI(-1.96,-0.59),P=0.000 3] after treatment showed the superiority of the experimental group over the control group.However,there was no significant difference in post-treatment quality of life between the groups(P>0.05).Subgroup analyses showed that CBT had a poor effect on depression and anxiety after treatment immediately(P>0.05).However,follow-up results showed that it significantly relieved the symptoms of depression and anxiety(P<0.05).Conclusion CBT helps to relieve the symptoms of depression and anxiety in PD.And long-term use of it can bring significant effect.However,its short-term effect and its effect on improving the quality of life need to be verified by further clinical studies.
Background Depression,anxiety and other symptoms are common psychiatric symptoms in patients with Parkinson's disease,ranking the top 5 among all the symptoms.Depression and anxiety not only cause different degrees of functional damage,but also seriously affect patients' quality of life.However,traditional medicines have many side effects and are addictive,while psychotherapies have fewer adverse reactions and reduce economic costs.Cognitive behavioral therapy(CBT)is widely used,and a large number of studies have confirmed its effectiveness in patients with Parkinson's disease.Objective To systematically evaluate the effect of CBT on the symptoms of depression and anxiety and the quality of life in patients with Parkinson's disease(PD).Methods We searched the databases of PubMed,EMBase,Web of Science,Cochrane Library,Science Direct,CNKI,VIP,Wanfang Data Knowledge Service Platform and CBM.And randomized controlled trials(RCT)related to using CBT to relieve depression and anxiety in patients with PD included since the inception to May 2018 were collected.RCT were screened,data extraction was performed and qualities of eligible RCT were assessed.Meta-analysis was implemented with RevMan 5.3.Results Nine RCT with 401 patients were included.Meta-analyses of depression symptom score [SMD =-1.15,95%CI(-2.18,-0.13),P=0.03],anxiety symptom score [SMD=-0.80,95%CI(-1.40,-0.21),P=0.008] and general psychological health [SMD=-1.27,95%CI(-1.96,-0.59),P=0.000 3] after treatment showed the superiority of the experimental group over the control group.However,there was no significant difference in post-treatment quality of life between the groups(P>0.05).Subgroup analyses showed that CBT had a poor effect on depression and anxiety after treatment immediately(P>0.05).However,follow-up results showed that it significantly relieved the symptoms of depression and anxiety(P<0.05).Conclusion CBT helps to relieve the symptoms of depression and anxiety in PD.And long-term use of it can bring significant effect.However,its short-term effect and its effect on improving the quality of life need to be verified by further clinical studies.
引文
[1]卢健军,潘梦秋,王玉周,等.早期帕金森病患者动态姿态平衡检查分析[J].中国神经精神疾病杂志,2014,40(10):612-615.DOI:10.3936/j.issn.1002-0152.2014.10.008.LU J J,PAN M Q,WANG Y Z,et al.Analysis of dynamic posture in patients with early Parkinson disease[J].Chinese Journal of Nervous and Mental Diseases,2014,40(10):612-615.DOI:10.3936/j.issn.1002-0152.2014.10.008.
[2]吴兴华,王志伟,戚晓昆.电生理检测在多系统萎缩与帕金森病诊断及鉴别诊断中的研究进展[J].中华老年心脑血管病杂志,2016,18(12):1337-1339.DOI:10.3969/j.issn.1009-0126.2016.12.031.WU X H,WANG Z W,QI X K.Advances in electrophysiological testing in the diagnosis and differential diagnosis of multiple system atrophy and Parkinson's disease[J].Chinese Journal of Geriatric Heart Brain and Vessel Diseases,2016,18(12):1337-1339.DOI:10.3969/j.issn.1009-0126.2016.12.031.
[3]姜立志,沈丽华,李作汉,等.帕金森病患者氧化应激与运动功能的相关性研究[J].中风与神经疾病杂志,2015,32(12):1092-1094.JIANG L Z,SHEN L H,LI Z H,et al.Study on the relationship of oxidative stress and motor function in Parkinson's disease[J].Journal of Apoplexy and Nervous Diseases,2015,32(12):1092-1094.
[4]CHEN H L,ZHAO E J,ZHANG W,et al.Meta-analyses on prevalence of selected Parkinson's nonmotor symptoms before and after diagnosis[J].Transl Neurodegener,2015,4(1):1-26.DOI:10.1186/2047-9158-4-1.
[5]PAKER N,BUGDAYCI D,GOKSENOGLU G,et al.Gait speed and related factors in Parkinson's disease[J].J Phys Ther Sci,2015,27(12):3675-3679.DOI:10.1589/jpts.27.3675.
[6]曾培灿,孙光裕,曾宪杰,等.盐酸帕罗西汀片对帕金森患者伴发抑郁症状的临床疗效[J].现代诊断与治疗,2015,26(14):3183-3184.ZENG P C,SUN G Y,ZENG X J,et al.Clinical efficacy of paroxetine hydrochloride tablets in patients with Parkinson's disease with depressive symptoms[J].Modern Diagnosis&Treatment,2015,26(14):3183-3184.
[7]李秀娟,陈辉.盐酸帕罗西汀片治疗帕金森病合并抑郁和焦虑症状临床研究[J].中国实用神经疾病杂志,2015,18(2):69-70.DOI:10.3969/j.issn.1673-5110.2015.02.039.LI X J,CHEN H.Clinical study of paroxetine hydrochloride tablets in the treatment of Parkinson's disease with depression and anxiety[J].Chinese Journal of Practical Nervous Diseases,2015,18(2):69-70.DOI:10.3969/j.issn.1673-5110.2015.02.039.
[8]陈梅玲,彭天婵.帕金森病的研究进展[J].华夏医学,2017,30(3):153-156.CHEN M L,PENG T C.The research progress on Parkinson's disease[J].Acta Medicinae Sinica,2017,30(3):153-156.
[9]房进平,冯涛.帕金森病焦虑的发病机制及研究进展[J].中华老年心脑血管病杂志,2016,18(7):774-776.DOI:10.3969/j.issn.1009-0126.2016.07.028.FANG J P,FENG T.The pathogenesis and research progress of Parkinson's disease anxiety[J].Chinese Journal of Geriatric Heart Brain and Vessel Diseases,2016,18(7):774-776.DOI:10.3969/j.issn.1009-0126.2016.07.028.
[10]COOPER K,GREGORY J D,WALKER I,et al.Cognitive behaviour therapy for health anxiety:a systematic review and metaanalysis-CORRIGENDUM[J].Behav Cogn Psychother,2017,45(6):673.DOI:10.1017/S1352465817000510.
[11]JOHNSON J A,RASH J A,CAMPBELL T S,et al.A systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for insomnia(CBT-I)in cancer survivors[J].SleepMedRev,2016,27(1):20-28.DOI:10.1016/j.smrv.2015.07.001.
[12]陈梦丽,王雨吟.认知行为疗法对缓解护士职业倦怠的研究进展[J].全科护理,2017,15(23):2854-2856.DOI:10.3969/j.issn.1674-4748.2017.23.015.CHEN M L,WANG Y Y.Research progress of cognitive behavioral therapy on relieving nurses'job burnout[J].Chinese General Practice Nursing,2017,15(23):2854-2856.DOI:10.3969/j.issn.1674-4748.2017.23.015.
[13]杜治军,昌军,谢艳.文拉法辛联合认知行为疗法治疗帕金森症合并抑郁患者的疗效分析[J].河北医药,2013,35(9):1328-1329.DOI:10.3969/j.issn.1002-7386.2013.09.022.DU Z J,CHANG J,XIE Y.Therapeutic effect of venlafaxine combined with cognitive behavioral therapy on patients with Parkinson's disease and depression[J].Hebei Medical Journal,2013,35(9):1328-1329.DOI:10.3969/j.issn.1002-7386.2013.09.022.
[14]TROEUNG L,EGAN S J,GASSON N.A waitlist-controlled trial of group cognitive behavioural therapy for depression and anxiety in Parkinson's disease[J].BMC Psychiatry,2014,14(1):19-30.DOI:10.1186/1471-244X-14-19.
[15]LI J,JIN M,WANG L,et al.MDS clinical diagnostic criteria for Parkinson's disease in China[J].J Neurol,2017,264(3):476-481.DOI:10.1007/s00415-016-8370-2.
[16]GHOGOMU E A,MAXWELL L J,BUCHBINDER R,et al.Updated method guidelines for Cochrane musculoskeletal group systematic reviews and metaanalyses[J].J Rheumatol,2014,41(2):194-205.DOI:10.3899/jrheum.121306.
[17]聂利珞.文拉法辛联合认知行为干预治疗帕金森症合并抑郁、认知功能障碍的临床疗效[J].中国医药科学,2015,5(6):165-167,170.NIE L L.Clinical efficacy of venlafaxine combined with cognitive behavioral intervention for Parkinson's disease with depression and cognitive dysfunction[J].China Medicine and Pharmacy,2015,5(6):165-167,170.
[18]VEAZEY C,COOK K F,STANLEY M,et al.Telephoneadministered cognitive behavioral therapy:a case study of anxiety and depression in Parkinson's disease[J].J Clin Psychol Med Settings,2009,16(3):243-253.DOI:10.1007/s10880-009-9167-6.
[19]CHLOND M,BERGMANN F,GüTHLIN C,et al.Patient education for patients with Parkinson's disease:a randomised controlled trial[J].Basal Ganglia,2016,6(1):25-30.DOI:10.1016/j.baga.2015.11.004.
[20]GHIELEN I,VAN WEGEN E E H,RUTTEN S,et al.Body awareness training in the treatment of wearing-off related anxiety in patients with Parkinson's disease:results from a pilot randomized controlled trial[J].J Psychosom Res,2017,103(9):1-8.DOI:10.1016/j.jpsychores.2017.09.008.
[21]LAWSON R A,MILLAR D,BROWN R G,et al.Guided selfhelp for the management of worry in Parkinson's disease:a pilot study[J].J Parkinsons Dis,2013,3(1):61-68.DOI:10.3233/JPD-120156.
[22]OKAI D,ASKEY-JONES S,SAMUEL M,et al.Trial of CBT for impulse control behaviors affecting Parkinson patients and their caregivers[J].Neurology,2013,80(9):792-799.DOI:10.1212/WNL.0b013e3182840678.
[23]PARíS A P,SALETA H G,DE LA CRUZ CRESPO MARAVER M,et al.Blind randomized controlled study of the efficacy of cognitive training in Parkinson's disease[J].Mov Disord,2011,26(7):1251-1258.DOI:10.1002/mds.23688.
[24]PE?A J,IBARRETXE-BILBAO N,GARCíA-GOROSTIAGA I,et al.Improving functional disability and cognition in Parkinson disease:randomized controlled trial[J].Neurology,2014,83(23):2167-2174.DOI:10.1212/WNL.0000000000001043.
[25]DOBKIN R D,MENZA M,ALLEN L A,et al.Cognitivebehavioral therapy for depression in Parkinson's disease:a randomized controlled trial[J].Am J Psychiatry,2011,168(10):1066-1074.DOI:10.1176/appi.ajp.2011.10111669.
[26]姜立至,沈丽华,李作汉,等.帕金森病患者氧化应激与运动功能的相关性研究[J].中风与神经疾病杂志,2015,32(12):1092-1094.JIANG L Z,SHEN L H,LI Z H,et al.Study on the relationship of oxidative stress and motor function in Parkinson's disease[J].Journal of Apoplexy and Nervous Diseases,2015,32(12):1092-1094.
[27]余映丽.社区帕金森患者社会支持状况调查及社会因素分析[J].中国实用医药,2015,10(17):287-289.DOI:10.14163/j.cnki.11-5547/r.2015.17.195.YU Y L.Investigation of social support status and analysis of social factors for community Parkinson's disease patients[J].China Practical Medical,2015,10(17):287-289.DOI:10.14163/j.cnki.11-5547/r.2015.17.195.
[28]汪军,崔晓,周翠侠,等.认知行为疗法临床应用研究进展[J].中国康复理论与实践,2013,19(9):834-838.DOI:10.3969/j.issn.1006-9771.2013.09.010.WANG J,CUI X,ZHOU C X,et al.Application of cognitive behavior therapy(review)[J].Chinese Journal of Rehabilitation Theory and Practice,2013,19(9):834-838.DOI:10.3969/j.issn.1006-9771.2013.09.010.
[29]MORIN C M,BLAIS F,SAVARD J.Are changes in beliefs and attitudes about sleep related to sleep improvements in the treatment of insomnia?[J].Behav Res Ther,2002,40(7):741-752.
[30]张峰菊,王晓雪,刘欣欣.重复经颅磁刺激联合认知行为疗法对帕金森病非运动症状的疗效[J].中国实用神经疾病杂志,2017,20(9):61-63.DOI:10.3969/j.issn.1673-5110.2017.09.024.ZHANG F J,WANG X X,LIU X X.Effect of repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy on non-motor symptoms of Parkinson's disease[J].Chinese Journal of Practical Nervous Diseases,2017,20(9):61-63.DOI:10.3969/j.issn.1673-5110.2017.09.024.
[31]蒋晓江,郝凤仪,陈南西,等.慢性失眠症的团体认知行为疗法[J].中国临床神经科学,2017,25(1):112-118.DOI:10.3969/j.issn.1008-0678.2017.01.019.JIANG X J,HAO F Y,CHEN N X,et al.Group cognitive behavioral therapy for chronic insomnia[J].Chinese Journal of Clinical Neurosciences,2017,25(1):112-118.DOI:10.3969/j.issn.1008-0678.2017.01.019.
[32]黄庆玲,乐发国,蒋成刚,等.团体认知行为疗法对失眠症的疗效分析[J].解放军医学杂志,2018,43(3):224-228.DOI:10.11855/j.issn.0577-7402.2018.03.08.HANG Q L,LE F G,JIANG C G,et al.The treatment effect of group cognitive behavioral therapy for insomnia[J].Medical Journal of Chinese People's Liberation Army,2018,43(3):224-228.DOI:10.11855/j.issn.0577-7402.2018.03.08.
[33]OKAJIMA I.Self-help intervention delivered via devices[J].Nihon Rinsho,2015,73(6):1006-1009.
[34]SCHIENLE A,ILLE R,WABNEGGER A.Experience of negative emotions in Parkinson's disease:an fMRI investigation[J].Neurosci Lett,2015,609(1):142-146.DOI:10.1016/j.neulet.2015.10.046.
[35]HUX,SONGX,YUANY,etal.Abnormalfunctional connectivity of the amygdala is associated with depression in Parkinson's disease[J].Mov Disord,2015,30(2):238-244.DOI:10.1002/mds.26087.
[36]PAESF,BACZYNSKIT,NOVAESF,etal.Repetitive transcranial magnetic stimulation(rTMS)to treat social anxiety disorder:case reports and a review of the literature[J].Clin Pract Epidemiol Ment Health,2013,9(1):180-188.DOI:10.2174/1745017901309010180.
[37]COUTO M I,MONTEIRO A,OLIVEIRA A,et al.Depression and anxiety following deep brain stimulation in Parkinson's disease:systematic review and meta-analysis[J].Acta Med Port,2014,27(3):372-382.
[2]吴兴华,王志伟,戚晓昆.电生理检测在多系统萎缩与帕金森病诊断及鉴别诊断中的研究进展[J].中华老年心脑血管病杂志,2016,18(12):1337-1339.DOI:10.3969/j.issn.1009-0126.2016.12.031.WU X H,WANG Z W,QI X K.Advances in electrophysiological testing in the diagnosis and differential diagnosis of multiple system atrophy and Parkinson's disease[J].Chinese Journal of Geriatric Heart Brain and Vessel Diseases,2016,18(12):1337-1339.DOI:10.3969/j.issn.1009-0126.2016.12.031.
[3]姜立志,沈丽华,李作汉,等.帕金森病患者氧化应激与运动功能的相关性研究[J].中风与神经疾病杂志,2015,32(12):1092-1094.JIANG L Z,SHEN L H,LI Z H,et al.Study on the relationship of oxidative stress and motor function in Parkinson's disease[J].Journal of Apoplexy and Nervous Diseases,2015,32(12):1092-1094.
[4]CHEN H L,ZHAO E J,ZHANG W,et al.Meta-analyses on prevalence of selected Parkinson's nonmotor symptoms before and after diagnosis[J].Transl Neurodegener,2015,4(1):1-26.DOI:10.1186/2047-9158-4-1.
[5]PAKER N,BUGDAYCI D,GOKSENOGLU G,et al.Gait speed and related factors in Parkinson's disease[J].J Phys Ther Sci,2015,27(12):3675-3679.DOI:10.1589/jpts.27.3675.
[6]曾培灿,孙光裕,曾宪杰,等.盐酸帕罗西汀片对帕金森患者伴发抑郁症状的临床疗效[J].现代诊断与治疗,2015,26(14):3183-3184.ZENG P C,SUN G Y,ZENG X J,et al.Clinical efficacy of paroxetine hydrochloride tablets in patients with Parkinson's disease with depressive symptoms[J].Modern Diagnosis&Treatment,2015,26(14):3183-3184.
[7]李秀娟,陈辉.盐酸帕罗西汀片治疗帕金森病合并抑郁和焦虑症状临床研究[J].中国实用神经疾病杂志,2015,18(2):69-70.DOI:10.3969/j.issn.1673-5110.2015.02.039.LI X J,CHEN H.Clinical study of paroxetine hydrochloride tablets in the treatment of Parkinson's disease with depression and anxiety[J].Chinese Journal of Practical Nervous Diseases,2015,18(2):69-70.DOI:10.3969/j.issn.1673-5110.2015.02.039.
[8]陈梅玲,彭天婵.帕金森病的研究进展[J].华夏医学,2017,30(3):153-156.CHEN M L,PENG T C.The research progress on Parkinson's disease[J].Acta Medicinae Sinica,2017,30(3):153-156.
[9]房进平,冯涛.帕金森病焦虑的发病机制及研究进展[J].中华老年心脑血管病杂志,2016,18(7):774-776.DOI:10.3969/j.issn.1009-0126.2016.07.028.FANG J P,FENG T.The pathogenesis and research progress of Parkinson's disease anxiety[J].Chinese Journal of Geriatric Heart Brain and Vessel Diseases,2016,18(7):774-776.DOI:10.3969/j.issn.1009-0126.2016.07.028.
[10]COOPER K,GREGORY J D,WALKER I,et al.Cognitive behaviour therapy for health anxiety:a systematic review and metaanalysis-CORRIGENDUM[J].Behav Cogn Psychother,2017,45(6):673.DOI:10.1017/S1352465817000510.
[11]JOHNSON J A,RASH J A,CAMPBELL T S,et al.A systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for insomnia(CBT-I)in cancer survivors[J].SleepMedRev,2016,27(1):20-28.DOI:10.1016/j.smrv.2015.07.001.
[12]陈梦丽,王雨吟.认知行为疗法对缓解护士职业倦怠的研究进展[J].全科护理,2017,15(23):2854-2856.DOI:10.3969/j.issn.1674-4748.2017.23.015.CHEN M L,WANG Y Y.Research progress of cognitive behavioral therapy on relieving nurses'job burnout[J].Chinese General Practice Nursing,2017,15(23):2854-2856.DOI:10.3969/j.issn.1674-4748.2017.23.015.
[13]杜治军,昌军,谢艳.文拉法辛联合认知行为疗法治疗帕金森症合并抑郁患者的疗效分析[J].河北医药,2013,35(9):1328-1329.DOI:10.3969/j.issn.1002-7386.2013.09.022.DU Z J,CHANG J,XIE Y.Therapeutic effect of venlafaxine combined with cognitive behavioral therapy on patients with Parkinson's disease and depression[J].Hebei Medical Journal,2013,35(9):1328-1329.DOI:10.3969/j.issn.1002-7386.2013.09.022.
[14]TROEUNG L,EGAN S J,GASSON N.A waitlist-controlled trial of group cognitive behavioural therapy for depression and anxiety in Parkinson's disease[J].BMC Psychiatry,2014,14(1):19-30.DOI:10.1186/1471-244X-14-19.
[15]LI J,JIN M,WANG L,et al.MDS clinical diagnostic criteria for Parkinson's disease in China[J].J Neurol,2017,264(3):476-481.DOI:10.1007/s00415-016-8370-2.
[16]GHOGOMU E A,MAXWELL L J,BUCHBINDER R,et al.Updated method guidelines for Cochrane musculoskeletal group systematic reviews and metaanalyses[J].J Rheumatol,2014,41(2):194-205.DOI:10.3899/jrheum.121306.
[17]聂利珞.文拉法辛联合认知行为干预治疗帕金森症合并抑郁、认知功能障碍的临床疗效[J].中国医药科学,2015,5(6):165-167,170.NIE L L.Clinical efficacy of venlafaxine combined with cognitive behavioral intervention for Parkinson's disease with depression and cognitive dysfunction[J].China Medicine and Pharmacy,2015,5(6):165-167,170.
[18]VEAZEY C,COOK K F,STANLEY M,et al.Telephoneadministered cognitive behavioral therapy:a case study of anxiety and depression in Parkinson's disease[J].J Clin Psychol Med Settings,2009,16(3):243-253.DOI:10.1007/s10880-009-9167-6.
[19]CHLOND M,BERGMANN F,GüTHLIN C,et al.Patient education for patients with Parkinson's disease:a randomised controlled trial[J].Basal Ganglia,2016,6(1):25-30.DOI:10.1016/j.baga.2015.11.004.
[20]GHIELEN I,VAN WEGEN E E H,RUTTEN S,et al.Body awareness training in the treatment of wearing-off related anxiety in patients with Parkinson's disease:results from a pilot randomized controlled trial[J].J Psychosom Res,2017,103(9):1-8.DOI:10.1016/j.jpsychores.2017.09.008.
[21]LAWSON R A,MILLAR D,BROWN R G,et al.Guided selfhelp for the management of worry in Parkinson's disease:a pilot study[J].J Parkinsons Dis,2013,3(1):61-68.DOI:10.3233/JPD-120156.
[22]OKAI D,ASKEY-JONES S,SAMUEL M,et al.Trial of CBT for impulse control behaviors affecting Parkinson patients and their caregivers[J].Neurology,2013,80(9):792-799.DOI:10.1212/WNL.0b013e3182840678.
[23]PARíS A P,SALETA H G,DE LA CRUZ CRESPO MARAVER M,et al.Blind randomized controlled study of the efficacy of cognitive training in Parkinson's disease[J].Mov Disord,2011,26(7):1251-1258.DOI:10.1002/mds.23688.
[24]PE?A J,IBARRETXE-BILBAO N,GARCíA-GOROSTIAGA I,et al.Improving functional disability and cognition in Parkinson disease:randomized controlled trial[J].Neurology,2014,83(23):2167-2174.DOI:10.1212/WNL.0000000000001043.
[25]DOBKIN R D,MENZA M,ALLEN L A,et al.Cognitivebehavioral therapy for depression in Parkinson's disease:a randomized controlled trial[J].Am J Psychiatry,2011,168(10):1066-1074.DOI:10.1176/appi.ajp.2011.10111669.
[26]姜立至,沈丽华,李作汉,等.帕金森病患者氧化应激与运动功能的相关性研究[J].中风与神经疾病杂志,2015,32(12):1092-1094.JIANG L Z,SHEN L H,LI Z H,et al.Study on the relationship of oxidative stress and motor function in Parkinson's disease[J].Journal of Apoplexy and Nervous Diseases,2015,32(12):1092-1094.
[27]余映丽.社区帕金森患者社会支持状况调查及社会因素分析[J].中国实用医药,2015,10(17):287-289.DOI:10.14163/j.cnki.11-5547/r.2015.17.195.YU Y L.Investigation of social support status and analysis of social factors for community Parkinson's disease patients[J].China Practical Medical,2015,10(17):287-289.DOI:10.14163/j.cnki.11-5547/r.2015.17.195.
[28]汪军,崔晓,周翠侠,等.认知行为疗法临床应用研究进展[J].中国康复理论与实践,2013,19(9):834-838.DOI:10.3969/j.issn.1006-9771.2013.09.010.WANG J,CUI X,ZHOU C X,et al.Application of cognitive behavior therapy(review)[J].Chinese Journal of Rehabilitation Theory and Practice,2013,19(9):834-838.DOI:10.3969/j.issn.1006-9771.2013.09.010.
[29]MORIN C M,BLAIS F,SAVARD J.Are changes in beliefs and attitudes about sleep related to sleep improvements in the treatment of insomnia?[J].Behav Res Ther,2002,40(7):741-752.
[30]张峰菊,王晓雪,刘欣欣.重复经颅磁刺激联合认知行为疗法对帕金森病非运动症状的疗效[J].中国实用神经疾病杂志,2017,20(9):61-63.DOI:10.3969/j.issn.1673-5110.2017.09.024.ZHANG F J,WANG X X,LIU X X.Effect of repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy on non-motor symptoms of Parkinson's disease[J].Chinese Journal of Practical Nervous Diseases,2017,20(9):61-63.DOI:10.3969/j.issn.1673-5110.2017.09.024.
[31]蒋晓江,郝凤仪,陈南西,等.慢性失眠症的团体认知行为疗法[J].中国临床神经科学,2017,25(1):112-118.DOI:10.3969/j.issn.1008-0678.2017.01.019.JIANG X J,HAO F Y,CHEN N X,et al.Group cognitive behavioral therapy for chronic insomnia[J].Chinese Journal of Clinical Neurosciences,2017,25(1):112-118.DOI:10.3969/j.issn.1008-0678.2017.01.019.
[32]黄庆玲,乐发国,蒋成刚,等.团体认知行为疗法对失眠症的疗效分析[J].解放军医学杂志,2018,43(3):224-228.DOI:10.11855/j.issn.0577-7402.2018.03.08.HANG Q L,LE F G,JIANG C G,et al.The treatment effect of group cognitive behavioral therapy for insomnia[J].Medical Journal of Chinese People's Liberation Army,2018,43(3):224-228.DOI:10.11855/j.issn.0577-7402.2018.03.08.
[33]OKAJIMA I.Self-help intervention delivered via devices[J].Nihon Rinsho,2015,73(6):1006-1009.
[34]SCHIENLE A,ILLE R,WABNEGGER A.Experience of negative emotions in Parkinson's disease:an fMRI investigation[J].Neurosci Lett,2015,609(1):142-146.DOI:10.1016/j.neulet.2015.10.046.
[35]HUX,SONGX,YUANY,etal.Abnormalfunctional connectivity of the amygdala is associated with depression in Parkinson's disease[J].Mov Disord,2015,30(2):238-244.DOI:10.1002/mds.26087.
[36]PAESF,BACZYNSKIT,NOVAESF,etal.Repetitive transcranial magnetic stimulation(rTMS)to treat social anxiety disorder:case reports and a review of the literature[J].Clin Pract Epidemiol Ment Health,2013,9(1):180-188.DOI:10.2174/1745017901309010180.
[37]COUTO M I,MONTEIRO A,OLIVEIRA A,et al.Depression and anxiety following deep brain stimulation in Parkinson's disease:systematic review and meta-analysis[J].Acta Med Port,2014,27(3):372-382.