Objective: To evaluate a low-threshold psychoeducative group-intervention for depression in idiopathic Parkinson’s disease (PD).

Background: Up to 40% of PD-patients suffer from clinically relevant depression (DPD). However, effectiveness of antidepressants seems to be limited and data on psychosocial interventions is sparse. Cognitive Behavioral Therapy is a promising treatment option, but further evidence is needed and barriers for mental health care utilization remain high.

Methods: We designed a randomized-controlled rater-blinded trial to evaluate the intervention, providing information and exercises to obtain depressive symptom reduction. Nine weekly group meetings were conducted by a psychologist for groups of 4-6 patients. 26 patients were enrolled in three consecutive cycles and randomized into an intervention- (IG) and a waiting-list-control-group (WLC), parallelized by depression severity. Five former WLC-participants were later allocated to IG. Primary outcome measure was the MADRS, feasibility and patients’ perception of usefulness were evaluated. Data were collected at baseline, after the intervention (T2) and 6 months after T2 (T3).

Results: A total of twenty-six cases could be analyzed, whilst five patients were excluded. IG (N=13; 38% male) and WLC (N=13; 62% male) were comparable in age, age of onset, duration and severity of PD, and cognition. The intervention was feasible, rated as well-structured, helpful and participants reported a reduction of subjective strain. Exchange of experiences was often nominated as important aspect. However, no significant time-group-interaction could be found for MADRS total (IG: -4.2±2.9; WLC: -2.8±1.7 at T2; d_COHEN=0.23; p=.189). Excluding somatic items, a moderate but nonsignificant positive effect could be detected (IG: -3.1±2.1; WLC: -0.7±2.1; d_COHEN=0.61; p=.236) at T2. Decrease of sadness, lassitude and suicidal thoughts was stronger in the IG. Effects could not be maintained at T3. No predictors of treatment effect despite participation in a certain group-cycle could be identified. There was no change in self-rating-scales as GDS and PDQ-8.

Conclusions: A low-threshold psychoeducative group-intervention for DPD is feasible and perceived as useful by participants. It might reduce psychological symptoms of depression in a clinically relevant degree and provide emotional relief, but comprehensive individual CBT might be more effective.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/feasibility-and-effectiveness-of-a-low-threshold-psychoeducative-group-intervention-for-depression-in-parkinsons-disease/