Objective: From 2013 to the present, we have explored the feasibility of cognitive behavioral therapy (CBT) for Japanese Parkinson’s disease (PD) patients with depression and anxiety. Since the psychosocial intervention for such psychiatric conditions in PD is not common, we introduce the two CBT studies for depression and anxiety in Japanese PD patients.

Background: Depression and Anxiety is a highly comorbid with Parkinson’s disease (PD) (Broen et al., 2016). The psychiatric condition may decrease the patient’s ADL and QOL and influence the patient’s acceptability and satisfaction of the pharmacotherapy as well.

Method: We introduce two CBT studies conducted among Japanese PD patients. The first study (Shinmei et.al., 2016) is the single armed study for 6 sessions CBT among 19 Japanese PD outpatients with depression (GRID-Hamilton Rating Scale for Depression: GRID-HAMD). The second one is the exploratory study for anxiety (Hamilton Rating Scale for Anxiety: HAM-A) with 8 sessions of CBT among 7 PD patients.

Results: In the first study, we included 16 participants (mean age = 63.8 years, [SD] =9.9 years; mean Hohen–Yahr stage=1.7, [SD] = 0.8) completed CBT and the dropout rate was 16% (3/19). We observed significant reduction in the GRID-HAMD (14.3, [SD] =4.5 to 9.7 [SD] =4.3),p＜.001) at the post treatment period. In the second study, 7 patients (mean age =72.3 years, [SD] =11.1 years; mean Hohen–Yahr stage=1.7, [SD] =0.8)and we also found significant score reduction in the HAM-A (20.6, [SD] =6.2) to 9.4 [SD] =3.7), p＜.05) at the post treatment period and no dropout.

Conclusion: We observed significant reduction of depression and anxiety in Japanese PD inpatients and outpatients and the second study indicated lower dropout rate than the first study. For those anxious patients, fear for fall or off state may interfere their hospital visit and inpatient CBT seems to increase completion rate of the treatment. In the first study, we utilized original CBT workbook that each session has specific components but in the second study, the therapists delivered CBT more in the tailor-made manor. For the reason, PD patients’ claims for anxiety vary from general anxiety to specific disease related problem. In the future study, we will pursue the possibility of CBT as a treatment choice for enhancement of anxiety in off state and dopamine dysregulation syndrome (DDS).

References: 1. M.P. Broen, N.E. Narayen, M.L. Kuijf, N.N.W. Dissanayaka, A.F.G. Leentjens, Prevalence of anxiety in Parkinson’s disease: a systematic review, Mov. Dis- ord. 31 (8) (2016 Aug) 1125e1133, http://dx.doi.org/10.1002/mds.26643. 2. Shinmei, I, Kobayashi, K, Oe, Y, Takagishi, Y, Kanie, A, Ito, M, Takebayashi, Y, Murata, M, Horikoshi, M, Dobkin, R. D. Cognitive behavioral therapy for depression in Japanese Parkinson’s disease patients: a pilot study. Neuropsychiatric disease and treatment. 2016;12:1319-1331.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/pursuit-of-psychosocial-intervention-for-depression-and-anxiety-in-japanese-parkinsons-disease-patients-two-studies-of-cognitive-behavioral-therapy/