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Predictors of response to a cognitive behavioral intervention for impulse control behaviors in Parkinson's disease
Author(s) -
Okai David,
AskeyJones Sally,
Samuel Michael,
David Anthony S.,
Brown Richard G.
Publication year - 2014
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.26108
Subject(s) - psychology , levodopa , clinical global impression , parkinson's disease , impulse control disorder , dopamine agonist , cognition , randomized controlled trial , anxiety , clinical trial , social anxiety , clinical psychology , psychiatry , disease , medicine , dopamine , dopaminergic , pathological , placebo , alternative medicine , pathology , neuroscience
Background Limited trial evidence suggests that cognitive‐behavioral therapy (CBT) may be effective in managing impulse control behavior (ICBs) in Parkinson's disease. Aims To examine predictors of outcome in trial, participants (N = 42) receiving treatment immediately or after a waiting time. Methods Dependent variables were Clinical Global Impression of Change (CGI‐C) and the Neuropsychiatric Inventory (NPI). Baseline demographic and clinical variables were independent variables. Results Better CGI‐C was predicted by fewer ICBs, taking a dopamine agonist, lower levodopa ( l ‐dopa) equivalent dose (LEDD), higher social functioning, and lower NPI severity before treatment. Improvement on the NPI was predicted by lower LEDD, lower anxiety, lower baseline global clinical severity, and higher social functioning. Conclusions Patients with lower burden of ICBs and other psychiatric symptomatology, better social functioning, and lower dose of antiparkinsonian medication may benefit more from CBT. However, we cannot yet identify individual patients with sufficient confidence at this stage to target treatment. © 2014 International Parkinson and Movement Disorder Society