Internet-based cognitive behavioral therapy for depression and anxiety in Parkinson's disease—a pilot study
Open accessAbstract
Background Parkinson's disease (PD) is often associated with depression and anxiety. The availability of evidence-based psychological interventions is low. Objective This pilot study investigates the feasibility and preliminary effect of internet-based cognitive behavioral therapy (ICBT) for depression and anxiety in PD. Methods 9 patients with PD with comorbid symptoms on the relevant subscale of Hospital Anxiety and Depression Scale (HADS), of either depression (HADS-D > 7) or anxiety (HADS-A > 7) received 12 weeks of ICBT, specially adapted for depression and anxiety in PD. Primary outcome was change in depression and anxiety symptoms, measured with HADS total score. Effects on non-motor symptoms, PD specific health and quality of life and insomnia were explored, plus the participant's involvement, satisfaction, and subjective evaluation of the treatment. Results Participants reported lower symptoms on HADS after ICBT (Cohen's d = 0.79, p < 0.05). However, levels of inactivity were rather high and questionnaires and comments from participants suggested that the treatment can be improved, for example by adding more therapist support. Conclusions The results suggest that ICBT could be a feasible way to alleviate depression and anxiety in PD. However, a somewhat simplified treatment and different ways to provide support to enhance adherence and outcome are warranted.
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One of the five telehealth-based psychological intervention studies for anxiety and depression in PD involved internet-administered CBT with supplementary telephone support.
“one involved internet-administered CBT (in the form of self-paced, online modules) with supplementary telephone support (Kraepelien et al., 2015”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Kraepelien et al., 2015
Kraepelien et al. (2015) conducted the first uncontrolled pilot study examining the efficacy and feasibility of internet-based cognitive-behavioral therapy with telephone support to treat anxiety and depression in Parkinson disease.
“conducted the first uncontrolled pilot study examining the efficacy and feasibility of internet-based CBT (ICBT) with telephone support (as needed) to treat anxiety and depression in PD.”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Kraepelien et al., 2015
In Kraepelien et al. (2015), patient feedback indicated a desire for greater therapist communication.
“patient feedback indicated a desire for greater therapist communication.”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Kraepelien et al., 2015
In Kraepelien et al. (2015), patients reported moderate overall service satisfaction, with high satisfaction for the telephone-based component.
“Patients reported moderate overall service satisfaction, with high satisfaction for the telephone-based component”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Kraepelien et al., 2015
Kraepelien et al. (2015) demonstrates reduced therapist requirements.
“this study demonstrates reduced therapist requirements.”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Kraepelien et al., 2015
In Kraepelien et al. (2015), the small sample and absence of a control group limit the evaluation of intervention efficacy.
“the small sample and the absence of a control group limit the evaluation of intervention efficacy.”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Kraepelien et al., 2015
In Kraepelien et al. (2015), no motivation or apathy measures were administered.
“no motivation or apathy measures were administered.”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Kraepelien et al., 2015
Concerns exist regarding a lack of available cognitive-behavioral-therapy-trained therapists to deliver treatment to all those who could benefit from it.
“concerns regarding a lack of available CBT-trained therapists to deliver treatment to all those who could benefit from it”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Kraepelien et al., 2015
In Kraepelien et al. (2015), a significant reduction in depression only was observed.
“A significant reduction in depression only was observed”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Kraepelien et al., 2015
In Kraepelien et al. (2015), one-third of patients prematurely ceased treatment.
“one-third of patients prematurely ceased treatment.”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Kraepelien et al., 2015
In Kraepelien et al. (2015), therapists spent less than 13 minutes in communication with each participant per week.
“therapists spent less than 13 minutes in communication with each participant per week.”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Kraepelien et al., 2015
In Kraepelien et al. (2015), many participants did not complete homework exercises.
“many participants did not complete homework exercises.”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Kraepelien et al., 2015
Dobkin et al. (2011b) and Kraepelien et al. (2015) handled missing data using intent-to-treat analysis.
“missing data were handled using intent-to-treat analysis by Dobkin et al. (2011b”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Kraepelien et al., 2015
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“On the other hand the levels of non-motor symptoms, measured with NMSQuest, were in the range of severe PD (Chaudhuri et al., 2006).”
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“Internet-based interventions have also been used successfully with other neurology patients in two smaller studies, one treating depression in epilepsy (n = 40) (Thompson et al., 2010) and one managing fatigue in multiple sclerosis (n = 40) (Moss-Morris et al., 2012).”
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Remote delivery of psychological interventions for Parkinson's disease.
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“, 2013), and one involved internet-administered CBT (in the form of self-paced, online modules) with supplementary telephone support (Kraepelien et al., 2015).”
BackgroundMethodInfluentialCognitive Behavioral Therapy for Anxiety in Parkinsonʼs Disease: A Randomized Controlled Trial
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Kraepelien, M., Schibbye, R., Månsson, K., Sundström, C., Riggare, S., Andersson, G., Lindefors, N., Svenningsson, P., & Kaldo, V. (2020) · Journal of Parkinson's Disease · doi:10.3233/jpd-191894 · Cited by 41 · see citing works
Self-citationPersonalized Telemedicine for Depression in Parkinson’s Disease: A Pilot Trial
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A Systematic Review of Psychotherapy Approaches for Anxiety in Parkinson's Disease.
Roper, A., Pacas Fronza, G., Dobkin, R. D., Beaudreau, S. A., Mitchell, L. K., Pachana, N. A., Thangavelu, K., & Dissanayaka, N. N. (2024) · Clinical Gerontologist · doi:10.1080/07317115.2022.2074814 · Cited by 19 · see citing works
- Authors
- Kraepelien, M., Svenningsson, P., Lindefors, N., & Kaldo, V.
- Affiliations
- Karolinska Institutet (SE)
- Corresponding author
- Kraepelien, Martin
- Venue
- Internet Interventions
- Publisher
- Elsevier BV
- Published
- 2015-03
- Volume
- 2
- Issue
- 1
- Pages
- 1-6
- ISSN
- 2214-7829 (ISSN-L)
- OpenAlex
- W2004139271
- Cited by
- 27
- References
- 15
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 5 · 2019: 2 · 2018: 6 · 2017: 1 · 2016: 2
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Internet Interventions (publishedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Parkinsonfonden
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- internet-based cognitive behavioral therapy, Parkinson's disease, depression, anxiety, feasibility, non-motor symptoms, quality of life, insomnia, medication adherence, therapist support
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