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Telephone-Administered Cognitive Behavioral Therapy: A Case Study of Anxiety and Depression in Parkinson’s Disease

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Abstract

Parkinson’s disease (PD) is a chronic medical illness with a high incidence of psychiatric comorbidity, specifically depression and anxiety. Research on treatment of such psychiatric complications is scarce. Non-pharmaceutical treatment options are especially attractive. Cognitive behavioral therapy (CBT) is a psychotherapeutic treatment option that has been successful in other chronically medically ill populations with comorbid depression and anxiety. The current research had two aims. The first was to pilot the feasibility of screening and identifying PD patients with symptoms of anxiety and depression in a specialized outpatient clinic. The second aim was to pilot the feasibility of telephone-administered CBT for the treatment of depression and anxiety in persons with PD, which was done through a case series comparing telephone-administered CBT to a Support strategy. A fairly large portion (67.5%) of patients screened in the outpatient clinic were identified as having symptoms of anxiety and/or depression. Results also indicated that CBT delivered via the telephone is a useful approach for targeting psychiatric symptoms in this population. A case example is given to illustrate the clinical considerations associated with delivering therapy via telephone to persons with PD.

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References

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • Beck, A. T., & Steer, R. A. (1993). Beck Anxiety Inventory: Manual. San Antonio, TX: The Psychological Corporation: Harcourt Brace & Company.

    Google Scholar 

  • Beiske, A. G., Svennsson, E., Sandanger, I., Czujko, B., Pederson, E. D., Aarseth, J. H., et al. (2008). Depression and anxiety amongst multiple sclerosis patients. European Journal of Neurology, 15, 239–245. doi:10.1111/j.1468-1331.2007.02041.x.

    Article  PubMed  Google Scholar 

  • Bilich, L. L., Deane, F. P., Phipps, A. B., Barisic, M., & Gould, G. (2008). Effectiveness of bibliotherapy self-help for depression with varying levels of telephone helpline support. Clinical Psychology and Psychotherapy, 15, 61–74. doi:10.1002/cpp.562.

    Article  PubMed  Google Scholar 

  • Cantello, R., Aguggia, M., Gilli, M., Delsedime, M., Chiardo-Cutin, I., Riccio, A., et al. (1989). Major depression in Parkinson’s disease and the mood response to intravenous methylphenidate: Possible role of the ‘hedonic’ dopamine synapse. Journal of Neurology, Neurosurgery and Psychiatry, 52, 724–731. doi:10.1136/jnnp.52.6.724.

    Article  Google Scholar 

  • Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685–716. doi:10.1146/annurev.psych.52.1.685.

    Article  PubMed  Google Scholar 

  • Crum, R. M., Anthony, J. C., Bassett, S. S., & Folstein, M. F. (1993). Population-based norms for the Mini-Mental State Examination by age and educational level. JAMA, 269, 2386–2391. doi:10.1001/jama.269.18.2386.

    Article  PubMed  Google Scholar 

  • Cubo, E., Bernard, B., Leurgans, S., & Raman, R. (2000). Cognitive and motor function in patients with Parkinson’s disease with and without depression. Clinical Neuropharmacology, 23, 331–334. doi:10.1097/00002826-200011000-00006.

    Article  PubMed  Google Scholar 

  • Cummings, J. L., & Masterman, D. L. (1999). Depression in patients with Parkinson’s disease. International Journal of Geriatric Psychiatry, 14, 711–718. doi:10.1002/(SICI)1099-1166(199909)14:9<711::AID-GPS4>3.0.CO;2-1.

    Article  PubMed  Google Scholar 

  • Dbouk, N., Arguedas, M. R., & Sheikh, A. (2008). Assessment of the PHQ-9 as a screening tool for depression in patients with chronic hepatitis C. Digestive Diseases and Sciences, 53, 1100–1106. doi:10.1007/s10620-007-9985-z.

    Article  PubMed  Google Scholar 

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis-I Disorders: Patient edition (with psychotic screen) (SCID-I/P (with psychotic screen)) (Version 2.0). New York: Biometrics Research Department, New York State Psychiatric Institute.

    Google Scholar 

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198. doi:10.1016/0022-3956(75)90026-6.

    Article  PubMed  Google Scholar 

  • Gorenstein, E. E., Papp, L. A., & Kleber, M. S. (1999). Cognitive behavioral treatment of anxiety in later life. Cognitive and Behavioral Practice, 6, 305–320. doi:10.1016/S1077-7229(99)80050-9.

    Article  Google Scholar 

  • Jenkinson, C., Fitzpatrick, R., Peto, V., Greenhall, R., & Hyman, N. (1997). The Parkinson’s Disease Questionnaire (PDQ-39): Development and validation of a Parkinson’s disease summary index score. Age and Ageing, 26, 353–357. doi:10.1093/ageing/26.5.353.

    Article  PubMed  Google Scholar 

  • Kabacoff, R. I., Segal, D. L., Hersen, M., & Van Hasselt, V. B. (1997). Psychometric properties and diagnostic utility of the Beck Anxiety Inventory and the State-Trait Anxiety Inventory with older adult psychiatric outpatients. Journal of Anxiety Disorders, 11, 33–47. doi:10.1016/S0887-6185(96)00033-3.

    Article  PubMed  Google Scholar 

  • Keppel, G. (1991). Design and analysis: A researcher’s handbook (3rd ed.). Englewood Cliffs, NJ: Prentice-Hall, Inc.

    Google Scholar 

  • Kroenke, K., Jackson, J. L., & Chamberlin, J. (1997). Depressive and anxiety disorders in patients presenting with physical complaints: clinical predictors of outcome. American Journal of Medicine, 103, 339–347. doi:10.1016/S0002-9343(97)00241-6.

    Article  PubMed  Google Scholar 

  • Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613. doi:10.1046/j.1525-1497.2001.016009606.x.

    Article  PubMed  Google Scholar 

  • Kroenke, K., Spitzer, R. L., Williams, J. B., Linzer, M., Hahn, S. R., DeGruy, F. V., et al. (1994). Physical symptoms in primary care: Predictors of psychiatric disorders and functional impairment. Archives of Family Medicine, 3, 774–779. doi:10.1001/archfami.3.9.774.

    Article  PubMed  Google Scholar 

  • Kunik, M. E., Azzam, P. N., Souchek, J., Cully, J. A., Wray, N. P., Krishnan, L. L., et al. (2007). A practical screening tool for anxiety and depression in patients with chronic breathing disorders. Psychosomatics, 48, 16–21. doi:10.1176/appi.psy.48.1.16.

    Article  PubMed  Google Scholar 

  • Kunik, M. E., Braun, U., Stanley, M. A., Wristers, K., Molinari, V., Stoebner, D., et al. (2001). One session cognitive behavioural therapy for elderly patients with chronic obstructive pulmonary disease. Psychological Medicine, 31, 717–723. doi:10.1017/S0033291701003890.

    Article  PubMed  Google Scholar 

  • Kunik, M. E., Veazey, C., Cully, J. A., Souchek, J., Graham, D. P., Hopko, D., et al. (2008). COPD education and cognitive behavioral therapy group treatment for clinically significant symptoms of depression and anxiety in COPD patients: A randomized controlled trial. Psychological Medicine, 38, 385–396. doi:10.1017/S0033291707001687.

    Article  PubMed  Google Scholar 

  • Lenze, E. J., Mulsant, B. H., Shear, M. K., Houck, P., & Reynolds, C. F. (2002). Anxiety symptoms in elderly patient with depression: What is the best approach to treatment. Drugs and Aging, 19, 753–760. doi:10.2165/00002512-200219100-00004.

    Article  PubMed  Google Scholar 

  • Lenze, E. J., Mulsant, B. H., Shear, M. K., Schulberg, H. C., Dew, M. A., Begley, A. E., et al. (2000). Comorbid anxiety disorders in depressed elderly patients. American Journal of Psychiatry, 157, 722–728. doi:10.1176/appi.ajp.157.5.722.

    Article  PubMed  Google Scholar 

  • Leo, R. J. (1996). Movement disorders associated with the serotonin selective reuptake inhibitors. Journal of Clinical Psychiatry, 57, 449–454.

    PubMed  Google Scholar 

  • Ludman, E., Simon, G. E., Tutty, S., & Von Korff, M. (2007). A randomized trial of telephone psychotherapy and pharmacotherapy for depression: Continuation and durability of effects. Journal of Consulting and Clinical Psychology, 75, 257–266. doi:10.1037/0022-006X.75.2.257.

    Article  PubMed  Google Scholar 

  • Meara, J., Mitchelmore, E., & Hobson, H. (1999). Use of the GDS-15 geriatric depression scale as a screening instrument for depressive symptomatology in patients with Parkinson’s disease and their carers in the community. Age and Ageing, 28, 35–38. doi:10.1093/ageing/28.1.35.

    Article  PubMed  Google Scholar 

  • Menza, M. A., Robertson-Hoffman, D. E., & Bonapace, A. S. (1993). Parkinson’s disease and anxiety: Comorbidity with depression. Biological Psychiatry, 34, 465–470. doi:10.1016/0006-3223(93)90237-8.

    Article  PubMed  Google Scholar 

  • Mohr, D. C., Hart, S., Julian, L., Catledge, C., Honos-Webb, L., Vella, L., et al. (2005). Telephone-administered psychotherapy for depression. Archives of General Psychiatry, 62, 1007–1014. doi:10.1001/archpsyc.62.9.1007.

    Article  PubMed  Google Scholar 

  • Mohr, D. C., Lokosky, W., Bertagnoli, A., Goodkin, D. E., Van Der Wende, J., Dwyer, P., et al. (2000). Telephone-administered cognitive-behavioral therapy for the treatment of depressive symptoms in multiple sclerosis. Journal of Consulting and Clinical Psychology, 68, 356–361. doi:10.1037/0022-006X.68.2.356.

    Article  PubMed  Google Scholar 

  • Morin, C. M., Landreville, P., Colecchi, C., McDonald, K., Stone, J., & Ling, W. (1999). The Beck Anxiety Inventory: Psychometric properties with older adults. Journal of Clinical Geropsychology, 5, 19–29. doi:10.1023/A:1022986728576.

    Article  Google Scholar 

  • Murray, J. B. (1996). Depression in Parkinson’s disease. Journal of Psychology, 130, 659–667.

    PubMed  Google Scholar 

  • Oehlberg, K., Barg, F. K., Brown, G. K., Taraborelli, D., Stern, M. B., & Weintraub, D. (2008). Attitudes regarding the etiology and treatment of depression in Parkinson’s disease: A qualitative study. Journal of Geriatric Psychiatry and Neurology, 21, 123–132. doi:10.1177/0891988708316862.

    Article  PubMed  Google Scholar 

  • Oertel, W. H., Hoglinger, G. U., Caraceni, T., Girotti, F., Eichhorn, T., Spottke, A. E., et al. (2001). Depression in Parkinson’s disease: An update. Advances in Neurology, 86, 373–383.

    PubMed  Google Scholar 

  • Peto, V., Jenkinson, C., & Fitzpatrick, R. (1998). PDQ-39: A review of the development, validation and application of a Parkinson’s disease quality of life questionnaire and its associated measures. Journal of Neurology, 245(Suppl 1), S10–S14. doi:10.1007/PL00007730.

    Article  PubMed  Google Scholar 

  • Roundy, K., Cully, J. A., Stanley, M. A., Veazey, C., Souchek, J., Wray, N. P., et al. (2005). Are anxiety and depression addressed in primary care patients with chronic obstructive pulmonary disease? A chart review. Primary Care Companion to the Journal of Clinical Psychiatry, 7, 213–218.

    PubMed  Google Scholar 

  • Sherbourne, C. D., Jackson, C. A., Meredith, L. A., Camp, P., & Wells, K. (1996). Prevalence of comorbid anxiety disorders in primary care outpatients. Archives of Family Medicine, 5, 27–35. doi:10.1001/archfami.5.1.27.

    Article  PubMed  Google Scholar 

  • Sherbourne, C. D., & Wells, K. (1997). Course of depression in patients with comorbid anxiety disorders. Journal of Affective Disorders, 43, 245–250. doi:10.1016/S0165-0327(97)01442-0.

    Article  PubMed  Google Scholar 

  • Slaughter, J. R., Slaughter, K. A., Nichols, D., Holmes, S. E., & Martens, M. P. (2001). Prevalence, clinical manifestations, etiology, and treatment of depression in Parkinson’s disease. Journal of Neuropsychiatry and Clinical Neurosciences, 13, 187–196. doi:10.1176/appi.neuropsych.13.2.187.

    PubMed  Google Scholar 

  • Spitzer, R. L., Kroenke, K., & Williams, J. B. (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA, 282, 1737–1744. doi:10.1001/jama.282.18.1737.

    Article  PubMed  Google Scholar 

  • Stanley, M. A., Beck, J. G., Novy, D. M., Averill, P. M., Swann, A. C., Diefenbach, G. J., et al. (2003). Cognitive-behavioral treatment of late-life generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 71, 309–319. doi:10.1037/0022-006X.71.2.309.

    Article  PubMed  Google Scholar 

  • Stanley, M. A., Diefenbach, G. J., & Hopko, D. R. (2004). Cognitive behavioral treatment for older adults with generalized anxiety disorder. A therapist manual for primary care settings. Behavior Modification, 28, 73–117. doi:10.1177/0145445503259259.

    Article  PubMed  Google Scholar 

  • Stanley, M. A., Veazey, C., Hopko, D., Diefenbach, G., & Kunik, M. E. (2005). Anxiety and depression in chronic obstructive pulmonary disease (COPD): A new intervention and case report. Cognitive and Behavioral Practice, 12, 424–436. doi:10.1016/S1077-7229(05)80070-7.

    Article  Google Scholar 

  • Steer, R. A., Willman, M., Kay, P. A. J., & Beck, A. T. (1994). Differentiating elderly medical and psychiatric outpatients with the Beck Anxiety Inventory. Assessment, 1, 345–351.

    Google Scholar 

  • Veazey, C., Aki, S. O. E., Cook, K. F., Lai, E., & Kunik, M. E. (2005). Prevalence and treatment of depression in Parkinson’s disease. Journal of Neuropsychiatry and Clinical Neurosciences, 17, 310–323. doi:10.1176/appi.neuropsych.17.3.310.

    PubMed  Google Scholar 

  • Weintraub, D., Moberg, P. J., Duda, J. E., Katz, I. R., & Stern, M. B. (2003). Recognition and treatment of depression in Parkinson’s Disease. Journal of Geriatric Psychiatry and Neurology, 16, 178–183. doi:10.1177/0891988703256053.

    Article  PubMed  Google Scholar 

  • Wetherell, J. L., & Arean, P. A. (1997). Psychometric evaluation of the Beck Anxiety Inventory with older medical patients. Psychological Assessment, 9, 136–144. doi:10.1037/1040-3590.9.2.136.

    Article  Google Scholar 

  • Yeh, A. H., Taylor, S., Thordarson, D. S., & Corcoran, K. M. (2003). Efficacy of telephone-administered cognitive behaviour therapy for obsessive-compulsive spectrum disorders: Case studies. Cognitive Behaviour Therapy, 32, 75–81. doi:10.1080/16506070302323.

    Article  PubMed  Google Scholar 

  • Zung, W. K., Magruder-Habib, K., Velez, R., & Alling, W. (1990). The comorbidity of anxiety and depression in general medical patients: A longitudinal study. Journal of Clinical Psychiatry, 51, 77–80.

    PubMed  Google Scholar 

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Acknowledgments

This work was supported in part by the Houston VA HSR&D Center of Excellence (Houston Center for Quality of Care & Utilization Studies; HFP-90-020).

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Authors and Affiliations

  1. Department of Psychology, University of Louisiana at Lafayette, P.O. Box 43131, Lafayette, LA, 70504-3131, USA

    Connie Veazey

  2. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA

    Karon F. Cook

  3. Houston Center for Quality of Care and Utilization Studies, Health Services Research and Development Service, Houston, TX, USA

    Melinda Stanley & Mark E. Kunik

  4. Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA

    Melinda Stanley, Eugene C. Lai & Mark E. Kunik

  5. Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA

    Melinda Stanley & Mark E. Kunik

  6. Veterans Affairs South Central Mental Illness Research, Education, & Clinical Center, Houston, TX, USA

    Melinda Stanley & Mark E. Kunik

  7. Department of Neurology, Baylor College of Medicine, Houston, TX, USA

    Eugene C. Lai

  8. Houston VA Parkinson’s Disease Research, Education, & Clinical Center, Houston, TX, USA

    Eugene C. Lai

  9. Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Mark E. Kunik

Authors
  1. Connie Veazey
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  2. Karon F. Cook
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  3. Melinda Stanley
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  4. Eugene C. Lai
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  5. Mark E. Kunik
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Corresponding author

Correspondence to Connie Veazey.

Additional information

This study was conducted at the Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX. The first author was previously affiliated with the Houston Center for Quality of Care and Utilization Studies.

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Veazey, C., Cook, K.F., Stanley, M. et al. Telephone-Administered Cognitive Behavioral Therapy: A Case Study of Anxiety and Depression in Parkinson’s Disease. J Clin Psychol Med Settings 16, 243–253 (2009). https://doi.org/10.1007/s10880-009-9167-6

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  • DOI: https://doi.org/10.1007/s10880-009-9167-6

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