The effects of cognitive behavioral and mindfulness-based therapies on psychological distress in patients with multiple sclerosis, Parkinson's disease and Huntington's disease: Two meta-analyses

Abstract

Psychological distress has a high impact on quality of life in patients with multiple sclerosis (MS), Parkinson's disease (PD), and Huntington's disease (HD). Studies have shown that cognitive behavioral therapy (CBT) and mindfulness-based therapies (MBTs) are successful in reducing psychological distress in patients with anxiety, depressive, and chronic somatic disorders. We aimed to investigate the effectiveness of these therapies in MS, PD, and HD patients. Methods: We performed a comprehensive literature search in PubMed, PsycINFO, Embase and the Cochrane Central Register of Controlled Trials up to March 2018. Randomized controlled trials (RCTs) investigating a CBT or MBT and reporting psychological outcome measures were included. Two separate meta-analyses were performed; one on studies comparing psychological therapy with a treatment as usual or waitlist condition and one on studies with active treatment control conditions. Results: The first meta-analysis (N = 12 studies, 8 in MS and 4 in PD populations) showed a significant effect size of g = 0.51 in reducing psychological distress. The second meta-analysis (N = 7 studies, in MS populations) showed a mean effect size of g = 0.36. No RCTs were found in HD populations. The overall quality of the included studies was low and considerable heterogeneity was found. No evidence was found for publication bias. Conclusion: CBT and MBTs have a small to moderate effect on reducing psychological distress in patients with PD and MS. However, more research with better methodological quality and larger study samples is warranted, especially in HD patient populations.

Anxiety in multiple sclerosis is related to depressive symptoms and cognitive complaints

“…A recent meta-analysis showed that cognitive behavioural therapy and mindfulness-based therapies are successful in reducing psychological distress in patients with MS, but effects are small to moderate; more high-quality treatment studies are warranted. 51 Some limitations of our study need to be mentioned. First, our study has a cross-sectional design, so we cannot draw conclusions about the direction of the effects.…”

“…We suggest it is not the disease-specific factors that contribute to anxiety, but how well patients adjust to the disease. A recent meta-analysis showed that cognitive behavioural therapy and mindfulness-based therapies are successful in reducing psychological distress in patients with MS, but effects are small to moderate; more high-quality treatment studies are warranted 51. More specifically, a greater reliance on emotion-focused coping strategies is related to poor psychosocial adjustment, depression and anxiety 49.…”

Comparative study between bone marrow mesenchymal stem cell and their conditioned medium in the treatment of rat model of Parkinsonism

“…Parkinsonism is one of the most common neurodegenerative disorders with motor and nonmotor symptoms (Ghielen et al, 2019). Stem cell‐based treatments are considered as the most promising approach that could be widely used in a large number of patients (Palmer, Coronel, Bernabeu‐Zornoza, & Liste, 2019).…”

Psychological Interventions for People with Huntington’s Disease: A Call to Arms

“…Areas not yet addressed in the literature Despite extensive evidence showing that obsessive-compulsive symptoms and perseverative behaviours are highly prevalent among premanifest and especially symptomatic pwHD [21,24], no psychological interventions have been carried out so far to address them specifically. However, based on a rich literature highlighting that both face to face and telephone-delivered CBT are effective at reducing obsessive-compulsive symptoms and perseverative behaviours in the general population [92,93]-as well as that they are feasible with other motor neurodegenerative diseases like multiple sclerosis and Parkinson's disease [94,95]-the adoption of such approach for premanifest and early-stage pwHD should be explored by future studies.…”