BackgroundDepression is a common nonmotor complication in Parkinson's disease (PD). However, few studies have evaluated the efficacy of first‐line psychological therapies for depression in this patient population.ObjectivesThis randomized controlled trial evaluated the efficacy of interpersonal psychotherapy (IPT), an empirically validated intervention for depression that focuses on the bidirectional relationship between mood disturbance and interpersonal and social stressors. A secondary aim was to assess maintenance of treatment gains at 6‐month follow‐up.MethodsParticipants with PD stages I to III and a comorbid depressive disorder were randomly assigned to 12 sessions of IPT (n = 32) or supportive therapy (ST) (n = 31), our active control intervention. The primary outcome was the Hamilton Depression Rating Scale (HAM‐D) administered blindly by telephone. Secondary outcomes included self‐report depression and anxiety, quality of life, clinician‐rated motor symptom, interpersonal relationships, and attachment style.ResultsIPT compared to ST resulted in a greater reduction in posttreatment HAM‐D scores (least square mean difference = −3.77, 95% confidence interval [CI]: −6.19 to −1.34, P = 0.003) and was associated with a greater odds of meeting remission (odds ratio = 3.23, 95% CI: 1.10–9.51, P = 0.034). The advantage of IPT over ST on HAM‐D scores and remission rates was not sustained at the 6‐month follow‐up. Both treatments improved self‐report depression, anxiety, quality of life, and aspects of interpersonal functioning.ConclusionsThis trial demonstrates the benefits of acute treatment with IPT in reducing depressive symptoms in PD. Clinicians should consider psychotherapy, alone or in combination with medication, as an important treatment option for PD depression. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

中文翻译：

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治疗帕金森病抑郁症的人际心理治疗：一项随机对照试验的结果


背景抑郁症是帕金森病 （PD） 中常见的非运动并发症。然而，很少有研究评估一线心理疗法对该患者群体抑郁症的疗效。目的这项随机对照试验评估了人际心理疗法 （IPT） 的疗效，这是一种经过实证验证的抑郁症干预措施，侧重于情绪障碍与人际和社会压力源之间的双向关系。次要目标是评估 6 个月随访时治疗收益的维持情况。方法将 PD I 至 III 期合并抑郁障碍的参与者随机分配到 12 次 IPT （n = 32） 或支持疗法 （ST） （n = 31），这是我们的主动对照干预。主要结局是通过电话盲法给药的汉密尔顿抑郁量表 （HAM-D）。次要结局包括自我报告的抑郁和焦虑、生活质量、临床医生评定的运动症状、人际关系和依恋类型。结果与 ST 相比，IPT 导致治疗后 HAM-D 评分降低更大 （最小二乘均数差 = -3.77,95% 置信区间 [CI]：-6.19 至 -1.34，P = 0.003），并且与达到缓解的几率更高相关 （比值比 = 3.23,95% CI：1.10-9.51，P = 0.034）。在 6 个月的随访中，IPT 在 HAM-D 评分和缓解率方面优于 ST 的优势并未持续。两种治疗方法都改善了自我报告的抑郁、焦虑、生活质量和人际功能的各个方面。结论该试验证明了 IPT 急性治疗对减轻 PD 抑郁症状的益处。 临床医生应考虑单独使用心理治疗或与药物治疗联合使用，作为 PD 抑郁的重要治疗选择。© 2024 作者。由 Wiley Periodicals LLC 代表国际帕金森和运动障碍协会出版的《运动障碍》。