Psychological interventions for patients with Parkinson’s disease: a systematic meta-review

Abstract

Background: Main objectives of (neuro)psychological treatment are improvement of cognition and affective disorders, as well as promotion of activities and participation. They are conducted in a multidisciplinary and multimodal setting. We aimed to review the evidence on therapeutic or educative interventions based on psychological principles for patients with Parkinson’s disease (PD). Methods: Electronic bibliographic databases (MEDLINE, PsycINFO, PSYNDEX, CINAHL) were systematically searched for systematic reviews and meta-analyses on psychological interventions for patients with PD (published January 2000-2016). Psychological interventions for non-motor outcomes were extracted, and the corresponding grade of evidence was assigned. Findings: We identified 12 meta-analyses and 23 narrative reviews out of 812 search results. In total, 13 different types of psychological (plus multidisciplinary) interventions (eg, psychotherapy, cueing, mind and body interventions) were applied to 9 different non-motor outcomes (eg, depression, quality of life, cognitive symptoms). Discussion: The available evidence on the effectiveness of psychological interventions for the treatment of symptoms in patients with PD is heterogeneous. Still, this meta-review shows that some interventions are effective for a variety of symptoms. Even though, statistically significant results are reported in many reviews present, these often lack clinical relevance. Further high-quality research is needed to confirm existing evidence, and to explore the potential of psychological interventions for patients with PD. The results of this meta-review will guide the development of practice guidelines for psychological interventions in the rehabilitation of patients with PD (this project is funded by the German Statutory Pension Insurance).