Effect of cognitive behavioral therapy on quality of life in patients with Parkinson's disease: a Meta-analysis

Abstract

Background

Depression, anxiety, impulse control disorders, insomnia are prevalent non-motor symptoms of Parkinson's disease, severely impairing the quality of life of patients. Cognitive behavioral therapy (CBT) is a common psychological intervention for various clinical psychological conditions, which can improve anxiety, insomnia and depression in patients with Parkinson's disease. However, the current research evidence on the effects of CBT in improving quality of life in patients with Parkinson's disease remains inconsistent.

Objective

To assess the effects of CBT on the quality of life among patients with Parkinson's disease, so as to provide references for the clinical application of CBT in this population.

Methods

On May 25, 2023, a systematic search was conducted across PubMed, PsycINFO, Embase, CNKI, Wanfang Database and VIP Database to identify randomized controlled trials investigating the impact of CBT on the quality of life in patients with Parkinson's disease. Literature screening, quality evaluation and data extraction were performed, focusing on variables related to quality of life, anxiety, and depression. Meta-analysis was performed using Stata 13.0 and RevMan 5.3.

Results

A total of 11 studies with 456 participants were included, comprising 241 in the CBT group and 215 in the control group. The CBT group exhibited significantly higher quality of life compared with the control group (SMD=0.47, 95%CI: 0.27~0.67, P<0.01). Anxiety and depression scores in CBT group were significantly lower than those in the control group (SMD=-0.63, 95% CI: -0.84~-0.43, P<0.01; SMD=-0.83, 95%CI: -1.15~-0.51, P<0.01). Among the 11 studies, 6 studies delivered CBT remotely and 5 studies implemented CBT face-to-face. Meta-analysis results revealed that remote CBT group yielded significantly higher quality of life (SMD=0.43, 95%CI: 0.17~0.70, P<0.01), and lower anxiety and depression scores (SMD=-0.62, 95%CI: -0.91~-0.34, P<0.01; SMD=-0.78, 95%CI: -1.34~-0.21, P<0.01) compared with the control group. Similarly, face-to-face CBT group showed better outcomes than the control group in terms of quality of life, anxiety and depression (SMD=0.51, 95%CI: 0.22~0.81, P<0.01; SMD=-0.64, 95%CI: -0.93~-0.35, P<0.01; SMD=-0.90, 95%CI: -1.20~-0.60, P<0.01).

Conclusion

CBT may contribute to alleviating anxiety and depression levels of patients with Parkinson's disease, and improving their quality of life.｛Funded by Shanghai 13th Five-Year Key Specialty Construction Project (number, shslczdzk04901); Nature Fund Project of Shanghai Science and Technology Commission (number, 22ZR1459300); Shanghai Municipal Health Commission Traditional Chinese Medical Science Non-drug Therapy Demonstration Center Project [number, ZY (2021-2023) -0204-03]｝.