Interpersonal Psychotherapy for the Treatment of Depression in Parkinson's Disease: Results of a Randomized Controlled Trial.

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY

Movement Disorders Pub Date : 2024-11-20 DOI:10.1002/mds.30061

Diana Koszycki, Monica Taljaard, Jacques Bradwejn, Caroline Lee, Giorgio A Tasca, David A Grimes

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Abstract

Background: Depression is a common nonmotor complication in Parkinson's disease (PD). However, few studies have evaluated the efficacy of first-line psychological therapies for depression in this patient population.

Objectives: This randomized controlled trial evaluated the efficacy of interpersonal psychotherapy (IPT), an empirically validated intervention for depression that focuses on the bidirectional relationship between mood disturbance and interpersonal and social stressors. A secondary aim was to assess maintenance of treatment gains at 6-month follow-up.

Methods: Participants with PD stages I to III and a comorbid depressive disorder were randomly assigned to 12 sessions of IPT (n = 32) or supportive therapy (ST) (n = 31), our active control intervention. The primary outcome was the Hamilton Depression Rating Scale (HAM-D) administered blindly by telephone. Secondary outcomes included self-report depression and anxiety, quality of life, clinician-rated motor symptom, interpersonal relationships, and attachment style.

Results: IPT compared to ST resulted in a greater reduction in posttreatment HAM-D scores (least square mean difference = -3.77, 95% confidence interval [CI]: -6.19 to -1.34, P = 0.003) and was associated with a greater odds of meeting remission (odds ratio = 3.23, 95% CI: 1.10-9.51, P = 0.034). The advantage of IPT over ST on HAM-D scores and remission rates was not sustained at the 6-month follow-up. Both treatments improved self-report depression, anxiety, quality of life, and aspects of interpersonal functioning.

Conclusions: This trial demonstrates the benefits of acute treatment with IPT in reducing depressive symptoms in PD. Clinicians should consider psychotherapy, alone or in combination with medication, as an important treatment option for PD depression. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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治疗帕金森病抑郁症的人际心理疗法：随机对照试验结果。

背景：抑郁症是帕金森病（PD）常见的非运动并发症。然而，很少有研究评估一线心理疗法对这一患者群体抑郁症的疗效：这项随机对照试验评估了人际心理疗法（IPT）的疗效，该疗法是一种经过经验验证的抑郁症干预措施，主要针对情绪障碍与人际和社会压力之间的双向关系。次要目的是评估随访6个月后治疗效果的维持情况：方法：患有帕金森病 I 至 III 期且合并抑郁障碍的参与者被随机分配到 12 个疗程的 IPT（32 人）或支持疗法（ST）（31 人）（我们的主动对照干预）中。主要结果是通过电话盲法进行的汉密尔顿抑郁量表（HAM-D）测量。次要结果包括自我报告的抑郁和焦虑、生活质量、临床医生评定的运动症状、人际关系和依恋方式：IPT与ST相比，治疗后HAM-D评分降低幅度更大（最小平方均差=-3.77，95%置信区间[CI]：-6.19至-1.34，P=0.003），且达到缓解的几率更大（几率比=3.23，95%置信区间：1.10至9.51，P=0.034）。在 6 个月的随访中，IPT 在 HAM-D 评分和缓解率方面的优势并未持续。两种治疗方法都改善了自我报告的抑郁、焦虑、生活质量和人际交往功能：这项试验表明，使用IPT进行急性治疗可减轻帕金森病患者的抑郁症状。临床医生应考虑将心理治疗（单独或与药物治疗相结合）作为治疗帕金森病抑郁症的重要选择。© 2024 作者姓名运动障碍》由 Wiley Periodicals LLC 代表国际帕金森和运动障碍协会出版。

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.