School of Psychology,The University of Queensland,Brisbane,Australia.
Int Psychogeriatr. 2018 Dec;30(12):1783-1795. doi: 10.1017/S1041610218000340. Epub 2018 May 11.
ABSTRACTObjective:Over two-thirds of Parkinson's disease (PD) patients experience comorbid neuropsychiatric symptoms, which adversely impact their quality of life and often require intervention. There is a preference for non-pharmacological, psychological approaches in addressing these symptoms. Given mobility limitations, travel burden, and cost, accessibility to psychological treatment can be problematic in this population. There has been a recent shift toward delivering care via telehealth in PD. Accordingly, this review aimed to examine remotely delivered psychological interventions for PD patients.Results:Most of the telehealth studies for PD involved Cognitive Behavioral Therapy (CBT) based anxiety and depression telephone interventions with relatively short (one month) follow-up periods.Conclusion:Although a preliminary work indicates efficacy, future studies should demonstrate the non-inferiority of these telehealth programs compared to face-to-face delivery, and examine the long-term outcomes of remotely delivered therapy. Video-conferencing (VC) appears to be a promising modality to overcome noted limitations of telephone delivery, and has demonstrated efficacy for PD speech programs. Further research should be conducted evaluating telehealth VC modalities for delivery of psychotherapy including CBT, as well as mindfulness-based therapy and acceptance and commitment therapy for remote treatment of depression and anxiety in PD.
摘要
超过三分之二的帕金森病 (PD) 患者伴有神经精神共病症状,这些症状对他们的生活质量产生负面影响,往往需要干预。对于这些症状,人们更倾向于采用非药物的心理方法。考虑到行动不便、旅行负担和费用问题,PD 患者获得心理治疗的机会有限。最近,PD 的治疗方式已经向远程医疗转变。因此,本综述旨在探讨针对 PD 患者的远程心理干预措施。
PD 的大多数远程医疗研究涉及基于认知行为疗法 (CBT) 的电话干预,用于治疗焦虑和抑郁,随访期相对较短(一个月)。
尽管初步研究表明这些干预措施有效,但未来的研究应证明这些远程医疗计划与面对面治疗相比不劣效,并检查远程治疗的长期结果。视频会议 (VC) 似乎是克服电话治疗局限性的一种很有前途的方式,并且已经证明对 PD 语音治疗有效。应进一步开展研究,评估远程医疗 VC 模式在提供心理治疗方面的应用,包括 CBT 以及正念疗法和接受与承诺疗法,以远程治疗 PD 患者的抑郁和焦虑。