Attitudes Regarding the Etiology and Treatment of Depression in Parkinson's Disease: A Qualitative Study

Oehlberg, Katherine; Barg, Frances K.; Brown, Gregory K.; Taraborelli, Donna; Stern, Matthew B.; Weintraub, Daniel

doi:10.1177/0891988708316862

Cited by 47 publications

(46 citation statements)

References 22 publications

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“…Interest in tele-health approaches to mental health treatment was high and, in several instances, correlated with perceived barriers of mental health care utilization. Overall, the present findings are both consistent with and extend the published literature regarding barriers to health care utilization in other populations 10–15 , as well as prior research regarding the suboptimal detection and management of depression in PD 4–6 and patient treatment preferences for co-morbid psychiatric complications in PD 20 .…”

Section: Discussionsupporting

confidence: 89%

Barriers to Mental Health Care Utilization in Parkinson’s Disease

Dobkin¹,

Rubino²,

Friedman³

et al. 2013

J Geriatr Psychiatry Neurol

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Background Parkinson’s disease (PD) is frequently complicated by co-occurring psychiatric problems, such as depression and anxiety, that negatively affect the course and management of the illness. Yet, in the majority of cases, these psychiatric comorbidities are neither recognized nor treated to remission. The primary purpose of this study was to identify and describe barriers to mental health care utilization for people with PD. Secondary objectives included the assessment of attitudes and preferences regarding the need for mental health services in the PD community and the acceptability of tele-health interventions as a method for improving access and quality of care. Methods Seven hundred sixty-nine people with PD completed an anonymous cross-sectional questionnaire assessing barriers to mental health care utilization in this medical population. Respondents were drawn from a national sample. Results Commonly endorsed barriers to mental health care utilization in PD reflect the patients’ incomplete understanding of mental health problems, access issues, and illness-specific concerns, as well as the inadequate screening and detection of psychiatric complications by medical providers, and the need for more effective treatments in this medical population. Several demographic, medical, and psychiatric variables also influenced the likelihood of accessing mental health care. Interest in tele-health approaches to mental health treatment was high and, in several instances, correlated with perceived barriers to mental health care utilization. Conclusions People with PD may encounter a multitude of barriers that impede their pursuit of mental health care. Clinical implications are discussed and further research is needed to replicate and extend these findings.

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Section: Discussionsupporting

confidence: 89%

Barriers to Mental Health Care Utilization in Parkinson’s Disease

Dobkin¹,

Rubino²,

Friedman³

et al. 2013

J Geriatr Psychiatry Neurol

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“…There is now some evidence for the efficacy of SSRIs for PD depression as well as for SSNRIs, tricylic antidepressants, and the dopamine agonist pramipexole, which are “useful” or “possibly useful” for this indication. For nonpharmacological treatments, there is evidence for the efficacy of CBT, and many PD patients with depression may prefer psychotherapy . Some patients with PD depression may respond to rTMS .…”

Section: Discussionmentioning

confidence: 99%

Update on treatments for nonmotor symptoms of Parkinson's disease—an evidence‐based medicine review

et al. 2019

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Objective To update evidence‐based medicine recommendations for treating nonmotor symptoms in Parkinson's disease (PD). Background The International Parkinson and Movement Disorder Society Evidence‐Based Medicine Committee's recommendations for treatments of PD were first published in 2002, updated in 2011, and now updated again through December 31, 2016. Methods Level I studies testing pharmacological, surgical, or nonpharmacological interventions for the treatment of nonmotor symptoms in PD were reviewed. Criteria for inclusion and quality scoring were as previously reported. The disorders covered were a range of neuropsychiatric symptoms, autonomic dysfunction, disorders of sleep and wakefulness, pain, fatigue, impaired olfaction, and ophthalmologic dysfunction. Clinical efficacy, implications for clinical practice, and safety conclusions are reported. Results A total of 37 new studies qualified for review. There were no randomized controlled trials that met inclusion criteria for the treatment of anxiety disorders, rapid eye movement sleep behavior disorder, excessive sweating, impaired olfaction, or ophthalmologic dysfunction. We identified clinically useful or possibly useful interventions for the treatment of depression, apathy, impulse control and related disorders, dementia, psychosis, insomnia, daytime sleepiness, drooling, orthostatic hypotension, gastrointestinal dysfunction, urinary dysfunction, erectile dysfunction, fatigue, and pain. There were no clinically useful interventions identified to treat non‐dementia‐level cognitive impairment. Conclusions The evidence base for treating a range of nonmotor symptoms in PD has grown substantially in recent years. However, treatment options overall remain limited given the high prevalence and adverse impact of these disorders, so the development and testing of new treatments for nonmotor symptoms in PD remains a top priority. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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“…As a result of this and the countless other losses related to a diagnosis of PD, many patients suffer from depression [34,35]. They are continually bombarded with the demands of managing their disease-related symptoms, as well as the countless other demands in their lives (including their roles and relationships) [35].…”

Section: Social Supportmentioning

confidence: 99%