Physician-authored summaries and commentary on the most important medical research, provided by the NEJM Group, a division of the Massachusetts Medical Society.
© Massachusetts Medical SocietyJanuary/February 2025
Psychotherapy is a meaningful acute treatment for Parkinson depression.
Psychotherapy is a first-line psychological approach to treat depression in Parkinson’s disease (PD), but few studies have been conducted on the topic. This randomised trial included patients with stages I to III PD and comorbid depressive disorder. Patients were assigned to 12 sessions of interper sonal psychotherapy (n=32) or supportive therapy (n=31). The primary outcome was the Hamilton Depression Rating Scale.
Patients who received interpersonal psychotherapy had a significantly greater reduction in depression than those who received supportive therapy (least squares mean difference, −3.77). Additionally, the interpersonal psychotherapy group had a higher odds of achieving remission (odds ratio, 3.23). The advantage favouring interpersonal psychotherapy was not sustained at six months. The comparator in this study was an active treatment known to have beneficial effects, meaning that at six months there was likely continued effectiveness. Both interpersonal psychotherapy and supportive therapy improved self-reported depression, anxiety, quality of life and several aspects of interpersonal functioning.
Comment: In a world dominated by pharmacotherapy, it is refreshing to be reminded that psychotherapy has meaningful acute benefits for patients with PD. We know, however, that in the longer term in the setting of PD, use of antidepressant medications can be efficacious and will be used by most patients. Such treatment may serve to preserve depression remission.
Michael S. Okun, MD, Adelaide Lackner Professor and Chair of Neurology and Executive Director, Fixel Institute for Neurological Diseases, University of Florida McKnight Brain Institute, Gainesville, USA.
Koszycki D, et al. Interpersonal psychotherapy for the treatment of depression in Parkinson’s disease: results of a randomized controlled trial. Mov Disord 2024 Nov 20; e-pub (https://doi.org/10.1002/mds.30061).
This summary is taken from the following Journal Watch title: Neurology.