Abstract：
BACKGROUND: Parkinson\'s disease (PD) patients often experience non-motor symptoms like depression and anxiety, significantly impacting their quality of life. With the limited effectiveness of pharmacological treatments, effective non-pharmacological interventions are needed. This systematic review and meta-analysis aimed to evaluate the efficacy of cognitive-behavioral therapy (CBT) in reducing depression and anxiety symptoms in PD patients.
METHODS: Randomized controlled trials (RCTs) exploring CBT\'s effectiveness for depression and anxiety in PD patients were included. Studies published until April 2023 were identified from PubMed, Web of Science, and Scopus. Methodological quality was assessed using the Risk of Bias-2 (ROB-2) tool. Statistical analysis involved calculating the standardized mean difference (SMD) and corresponding 95% confidence intervals (CIs) using Review Manager 5.4.1.
RESULTS: The systematic review included 12 studies involving 241 PD patients. CBT led to a substantial reduction in anxiety (SMD -0.95, 95% CI [-1.15 to -0.74], P < 0.00001) and depression (SMD -1.02, 95% CI [-1.39 to -0.65], P < 0.0001). Both traditional CBT and tele-CBT (administered over the phone or internet) were effective in treating depression and anxiety. Traditional CBT improved depression (SMD -1.16, 95% CI [-1.83 to -0.49], P < 0.00001), while tele-CBT showed comparable results (SMD -0.90, 95% CI [-1.31 to -0.48], P < 0.00001). For anxiety, both traditional CBT (SMD -0.94, 95% CI [-1.25 to -0.63], P < 0.00001) and tele-CBT (SMD -0.95, 95% CI [-1.22 to -0.67], P < 0.00001) significantly reduced symptoms. In conclusion, this systematic review and meta-analysis demonstrated the efficacy of CBT in reducing depression and anxiety in PD patients. Healthcare providers are encouraged to integrate CBT into their treatment protocols. However, additional high-quality studies with longer-term follow-up assessments are needed to further enhance understanding in this area.
UNASSIGNED: CRD42023424758.
METHODS: Randomized controlled trials (RCTs) exploring CBT\'s effectiveness for depression and anxiety in PD patients were included. Studies published until April 2023 were identified from PubMed, Web of Science, and Scopus. Methodological quality was assessed using the Risk of Bias-2 (ROB-2) tool. Statistical analysis involved calculating the standardized mean difference (SMD) and corresponding 95% confidence intervals (CIs) using Review Manager 5.4.1.
RESULTS: The systematic review included 12 studies involving 241 PD patients. CBT led to a substantial reduction in anxiety (SMD -0.95, 95% CI [-1.15 to -0.74], P < 0.00001) and depression (SMD -1.02, 95% CI [-1.39 to -0.65], P < 0.0001). Both traditional CBT and tele-CBT (administered over the phone or internet) were effective in treating depression and anxiety. Traditional CBT improved depression (SMD -1.16, 95% CI [-1.83 to -0.49], P < 0.00001), while tele-CBT showed comparable results (SMD -0.90, 95% CI [-1.31 to -0.48], P < 0.00001). For anxiety, both traditional CBT (SMD -0.94, 95% CI [-1.25 to -0.63], P < 0.00001) and tele-CBT (SMD -0.95, 95% CI [-1.22 to -0.67], P < 0.00001) significantly reduced symptoms. In conclusion, this systematic review and meta-analysis demonstrated the efficacy of CBT in reducing depression and anxiety in PD patients. Healthcare providers are encouraged to integrate CBT into their treatment protocols. However, additional high-quality studies with longer-term follow-up assessments are needed to further enhance understanding in this area.
UNASSIGNED: CRD42023424758.
摘要：
背景：帕金森病（PD）患者通常会出现抑郁和焦虑等非运动症状，显著影响他们的生活质量。由于药物治疗的有效性有限，需要有效的非药物干预措施。本系统综述和荟萃分析旨在评估认知行为疗法（CBT）在减轻PD患者抑郁和焦虑症状方面的功效。
方法：纳入探讨CBT对PD患者抑郁和焦虑的有效性的随机对照试验(RCTs)。直到2023年4月发表的研究都是从PubMed确定的，WebofScience,还有Scopus.使用偏差风险2（ROB-2）工具评估方法学质量。统计分析涉及使用ReviewManager5.4.1计算标准化平均差(SMD)和相应的95%置信区间(CI)。
结果：系统评价包括12项研究，涉及241例PD患者。CBT导致焦虑大幅减少(SMD-0.95，95%CI[-1.15至-0.74]，P<0.00001）和抑郁（SMD-1.02，95%CI[-1.39至-0.65]，P<0.0001)。传统的CBT和远程CBT（通过电话或互联网进行）均可有效治疗抑郁症和焦虑症。传统CBT改善抑郁症（SMD-1.16，95%CI[-1.83至-0.49]，P<0.00001),而远程CBT显示出可比的结果(SMD-0.90，95%CI[-1.31至-0.48]，P<0.00001)。对于焦虑，两者都是传统的CBT(SMD-0.94，95%CI[-1.25至-0.63]，P<0.00001）和远程CBT（SMD-0.95，95%CI[-1.22至-0.67]，P<0.00001)症状显著减轻。总之,本系统综述和荟萃分析证明了CBT在降低PD患者抑郁和焦虑方面的疗效.鼓励医疗保健提供者将CBT纳入其治疗方案。然而,需要更多的高质量研究和长期随访评估,以进一步增进对这一领域的了解.
■CRD42023424758。
方法：纳入探讨CBT对PD患者抑郁和焦虑的有效性的随机对照试验(RCTs)。直到2023年4月发表的研究都是从PubMed确定的，WebofScience,还有Scopus.使用偏差风险2（ROB-2）工具评估方法学质量。统计分析涉及使用ReviewManager5.4.1计算标准化平均差(SMD)和相应的95%置信区间(CI)。
结果：系统评价包括12项研究，涉及241例PD患者。CBT导致焦虑大幅减少(SMD-0.95，95%CI[-1.15至-0.74]，P<0.00001）和抑郁（SMD-1.02，95%CI[-1.39至-0.65]，P<0.0001)。传统的CBT和远程CBT（通过电话或互联网进行）均可有效治疗抑郁症和焦虑症。传统CBT改善抑郁症（SMD-1.16，95%CI[-1.83至-0.49]，P<0.00001),而远程CBT显示出可比的结果(SMD-0.90，95%CI[-1.31至-0.48]，P<0.00001)。对于焦虑，两者都是传统的CBT(SMD-0.94，95%CI[-1.25至-0.63]，P<0.00001）和远程CBT（SMD-0.95，95%CI[-1.22至-0.67]，P<0.00001)症状显著减轻。总之,本系统综述和荟萃分析证明了CBT在降低PD患者抑郁和焦虑方面的疗效.鼓励医疗保健提供者将CBT纳入其治疗方案。然而,需要更多的高质量研究和长期随访评估,以进一步增进对这一领域的了解.
■CRD42023424758。
