Effect of a Telephone-administered Cognitive Behavioral Therapy for the Management of Depression, Anxiety, and Chronic Illness Anticipated Stigma in Parkinson's Disease

Eun Sook Bae; Dong Moon Yeum

doi:10.7475/kjan.2015.27.2.223

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Effect of a Telephone-administered Cognitive Behavioral Therapy for the Management of Depression, Anxiety, and Chronic Illness Anticipated Stigma in Parkinson's Disease

Eun Sook Bae¹, Dong Moon Yeum²

Korean Journal of Adult Nursing 2015;27(2):223-232.
Published online: April 30, 2015

DOI: https://doi.org/10.7475/kjan.2015.27.2.223

¹Department of Nursing Science, Dong-Eui University, Busan

²Department of Social Welfare, International University of Korea, Jinju, Korea

Corresponding author: Bae, Eun Sook Department of Nursing, Dong-Eui University, 995 Eomgwang-ro, Busanjin-gu, Busan 614-714, Korea. Tel: +82-51-890-2861, Fax: +82-505-182-6876, E-mail: baesukkr3966@deu.ac.kr

• Received: February 24, 2015 • Accepted: April 11, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
Parkinson's disease (PD) has a high incidence of psychiatric comorbidity, specifically depression and anxiety. This study examined the effectiveness of group cognitive behavioral therapy (CBT) in treating depression and anxiety.
Methods
The study included 42 participants, aged between 52 and 77 years, who were diagnosed with idiopathic Parkinson's disease (IPD) and reported suffering from depression and anxiety. Patients were attending a department of outpatient neurology at D University Schools of Medicine in B Metropolitan city. A structured telephone-administered cognitive behavioral therapy was conducted for eight weeks. A repeated measure ANOVA was used to analyze results at pretest, post-test, and four weeks follow up.
Results
According to service method, there were significant differences between the two groups in depression, anxiety and stigma was significant difference between time (p<.05). Analysis of the interaction between time and service method revealed significant differences in depression and anxiety (p<.05).
Conclusion
The results suggest that telephone-administered cognitive behavioral therapy may be effective and may provide opportunity to adapt to individual needs for treating depression and anxiety in patients with Parkinson's disease.
Key Words: Parkinson's disease; Depression; Anxiety; Cognitive Behavioral Therapy (CBT)

Figure 1.

Research design of the study.

Table 1.

Homogeneity of Demographic Characteristics and Disease Characteristics between the Two Groups (N=42)

Variables	Categories	Exp. (n=19)	Cont. (n=23)	Fisher exact or t	p
Variables	Categories	n (%) or M±SD	n (%) or M±SD	Fisher exact or t	p
Gender	Female	15 (78.9)	17 (73.9)	0.145^†	1.000
Gender	Male	4 (21.1)	6 (26.1)	0.145^†	1.000
Age (year)		60.9±6.13	68.3±7.15	9.181	.080
	≤49	0 (0.0)	0 (0.0)
	50~59	7 (36.3)	3 (13.0)
	60~69	9 (47.4)	8 (34.7)
	≥70	3 (15.8)	12 (52.1)
Education level	No	0 (0.0)	5 (21.7)	5.052	.289
	Elementary	4 (21.1)	5 (21.7)
	Middle school	8 (42.1)	7 (30.4)
	High school	4 (21.1)	3 (13.0)
	college ≥	3 (15.8)	3 (13.0)
Marital state	Married (live spouse)	15 (78.9)	18 (78.3)	0.303	1.000
	Unmarried	0 (0.0)	0 (0.0)
	Divorce	2 (10.5)	2 (8.7)
	Separation	0 (0.0)	0 (0.0)
	Bereavement	2 (10.5)	3 (13.0)
Average monthly income (10,000 won)	≤50	10 (52.6)	9 (39.1)	5.122	.421
	≤100	3 (15.8)	4 (17.4)
	≤150	0 (0.0)	4 (17.4)
	≤200	2 (10.5)	1 (4.3)
	≤250	2 (10.5)	1 (4.3)
	≥251	2 (10.5)	4 (17.4)
Occupation	Yes	1 (5.3)	5 (21.7)	2.307	.197
Occupation	No	18 (94.7)	18 (78.3)	2.307	.197
Duration of illness (year)	≤1	1 (5.6)	3 (13.0)	2.294	.885
	≤3	7 (38.9)	5 (21.7)
	≤6	5 (27.8)	7 (30.4)
	≤9	2 (11.1)	4 (17.4)
	≤12	2 (11.1)	2 (8.7)
	12 ＞	1 (5.6)	2 (8.7)
Age of onset (year)	≤49	4 (16.7)	1 (4.3)	5.489	.514
	≤59	8 (44.4)	6 (26.1)
	≤69	6 (33.3)	10 (43.5)
	≥70	1 (5.6)	6 (26.1)
H & Y stage S & E ADL MMSE		2.39±0.49	2.37±0.53	0.159	.874
		82.11±8.55	79.05±12.21	0.908	.370
		28.53±1.26	26.78±2.45	2.970	.005

H & Y stage=Hoehn & Yahr stage; S & E ADL=Schwab & England activities of daily living; MMSE=mini-mental state examination; Exp.=experimental group, Cont.=control group;

^†by x²-test (p ＜.05),

Table 2.

Homogeneity Test of Study Variables between the Two Groups (N=42)

variables	Exp. (n=19)	Cont. (n=23)	t	p
variables	M±SD	M±SD	t	p
Depression	20.79±7.84	24.17±9.51	1.73	.222
Anxiety	53.42±8.30	54.96±8.50	2.24	.560
CIAS	58.58±17.41	60.65±19.13	2.82	.718

Exp.=experimental group, Cont.=control group; CIAS=chronic illness anticipated stigma.

Table 3.

Repeated Measure ANOVA of Depression, Anxiety and CIAS between the Two Groups (N=42)

Variables	Groups	Pretest	Posttest 1	Posttest 2	p for time differences		F (p)	Sources	F	p
Variables	Groups	M±SD	M±SD	M±SD	(Post 1/ Pre)	(Post 2/ Pre)	F (p)	Sources	F	p
Depression	Exp.	20.79±7.84	17.68±11.85	22.05±12.69	.067	.084	0.80 (.457)	Group	5.70	.022
	Cont.	24.17±9.51	29.83±13.47	28.14±13.72			1.27 (.288)	Time	1.05	.349
	p for group	.222	.004	.155				Time*Group	4.22	.022
	differences
Anxiety	Exp.	53.42±8.30	44.26±14.06	44.26±13.65	.003	.007	3.51 (.037)	Group	6.67	.014
	Cont.	54.96±8.51	56.52±11.10	53.43±13.63			0.34 (.712)	Time	4.30	.017
	p for group	.560	.003	.040				Time*Group	4.94	.010
	differences
CIAS	Exp.	58.58±17.41	45.11±16.80	42.95±15.48	.006	.001	4.96 (.011)	Group	2.55	.119
	Cont.	60.65±19.13	56.09±18.97	50.24±14.59			1.89 (.160)	Time	12.60	＜ .001
	p for group	.718	.056	.134				Time*Group	1.60	.208
	differences

CIAS=chronic illness anticipated stigma; Exp.=experimental group; Cont.=control group; Pre=Pretest; Post 1=Posttest 1: week after intervention trials ended; Post 2=Posttest 2: 4 weeks after intervention trials ended.

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12.Simpson J, McMillan H, Reeve D. Reformulating psycholo-gicaldifficulties inpeople withParkinson'sdisease: the potential of a social relational approach to disablism. Parkinson's Disease 2013;Article ID 608562:.1-8. http://dx.doi.org/10.1155/2013/608562.
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Effect of a Telephone-administered Cognitive Behavioral Therapy for the Management of Depression, Anxiety, and Chronic Illness Anticipated Stigma in Parkinson's Disease

Korean J Adult Nurs. 2015;27(2):223-232. Published online April 30, 2015

DOI: https://doi.org/10.7475/kjan.2015.27.2.223

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Effect of a Telephone-administered Cognitive Behavioral Therapy for the Management of Depression, Anxiety, and Chronic Illness Anticipated Stigma in Parkinson's Disease

Korean J Adult Nurs. 2015;27(2):223-232. Published online April 30, 2015

DOI: https://doi.org/10.7475/kjan.2015.27.2.223

Figure

Effect of a Telephone-administered Cognitive Behavioral Therapy for the Management of Depression, Anxiety, and Chronic Illness Anticipated Stigma in Parkinson's Disease

Figure 1. Research design of the study.

Figure 1.

Effect of a Telephone-administered Cognitive Behavioral Therapy for the Management of Depression, Anxiety, and Chronic Illness Anticipated Stigma in Parkinson's Disease

Table 1.

Homogeneity of Demographic Characteristics and Disease Characteristics between the Two Groups (N=42)

Variables	Categories	Exp. (n=19)	Cont. (n=23)	Fisher exact or t	p
Variables	Categories	n (%) or M±SD	n (%) or M±SD	Fisher exact or t	p
Gender	Female	15 (78.9)	17 (73.9)	0.145^†	1.000
Gender	Male	4 (21.1)	6 (26.1)	0.145^†	1.000
Age (year)		60.9±6.13	68.3±7.15	9.181	.080
	≤49	0 (0.0)	0 (0.0)
	50~59	7 (36.3)	3 (13.0)
	60~69	9 (47.4)	8 (34.7)
	≥70	3 (15.8)	12 (52.1)
Education level	No	0 (0.0)	5 (21.7)	5.052	.289
	Elementary	4 (21.1)	5 (21.7)
	Middle school	8 (42.1)	7 (30.4)
	High school	4 (21.1)	3 (13.0)
	college ≥	3 (15.8)	3 (13.0)
Marital state	Married (live spouse)	15 (78.9)	18 (78.3)	0.303	1.000
	Unmarried	0 (0.0)	0 (0.0)
	Divorce	2 (10.5)	2 (8.7)
	Separation	0 (0.0)	0 (0.0)
	Bereavement	2 (10.5)	3 (13.0)
Average monthly income (10,000 won)	≤50	10 (52.6)	9 (39.1)	5.122	.421
	≤100	3 (15.8)	4 (17.4)
	≤150	0 (0.0)	4 (17.4)
	≤200	2 (10.5)	1 (4.3)
	≤250	2 (10.5)	1 (4.3)
	≥251	2 (10.5)	4 (17.4)
Occupation	Yes	1 (5.3)	5 (21.7)	2.307	.197
Occupation	No	18 (94.7)	18 (78.3)	2.307	.197
Duration of illness (year)	≤1	1 (5.6)	3 (13.0)	2.294	.885
	≤3	7 (38.9)	5 (21.7)
	≤6	5 (27.8)	7 (30.4)
	≤9	2 (11.1)	4 (17.4)
	≤12	2 (11.1)	2 (8.7)
	12 ＞	1 (5.6)	2 (8.7)
Age of onset (year)	≤49	4 (16.7)	1 (4.3)	5.489	.514
	≤59	8 (44.4)	6 (26.1)
	≤69	6 (33.3)	10 (43.5)
	≥70	1 (5.6)	6 (26.1)
H & Y stage S & E ADL MMSE		2.39±0.49	2.37±0.53	0.159	.874
		82.11±8.55	79.05±12.21	0.908	.370
		28.53±1.26	26.78±2.45	2.970	.005

H & Y stage=Hoehn & Yahr stage; S & E ADL=Schwab & England activities of daily living; MMSE=mini-mental state examination; Exp.=experimental group, Cont.=control group;

^†by x²-test (p ＜.05),

Table 2.

Homogeneity Test of Study Variables between the Two Groups (N=42)

variables	Exp. (n=19)	Cont. (n=23)	t	p
variables	M±SD	M±SD	t	p
Depression	20.79±7.84	24.17±9.51	1.73	.222
Anxiety	53.42±8.30	54.96±8.50	2.24	.560
CIAS	58.58±17.41	60.65±19.13	2.82	.718

Exp.=experimental group, Cont.=control group; CIAS=chronic illness anticipated stigma.

Table 3.

Repeated Measure ANOVA of Depression, Anxiety and CIAS between the Two Groups (N=42)

Variables	Groups	Pretest	Posttest 1	Posttest 2	p for time differences		F (p)	Sources	F	p
Variables	Groups	M±SD	M±SD	M±SD	(Post 1/ Pre)	(Post 2/ Pre)	F (p)	Sources	F	p
Depression	Exp.	20.79±7.84	17.68±11.85	22.05±12.69	.067	.084	0.80 (.457)	Group	5.70	.022
	Cont.	24.17±9.51	29.83±13.47	28.14±13.72			1.27 (.288)	Time	1.05	.349
	p for group	.222	.004	.155				Time*Group	4.22	.022
	differences
Anxiety	Exp.	53.42±8.30	44.26±14.06	44.26±13.65	.003	.007	3.51 (.037)	Group	6.67	.014
	Cont.	54.96±8.51	56.52±11.10	53.43±13.63			0.34 (.712)	Time	4.30	.017
	p for group	.560	.003	.040				Time*Group	4.94	.010
	differences
CIAS	Exp.	58.58±17.41	45.11±16.80	42.95±15.48	.006	.001	4.96 (.011)	Group	2.55	.119
	Cont.	60.65±19.13	56.09±18.97	50.24±14.59			1.89 (.160)	Time	12.60	＜ .001
	p for group	.718	.056	.134				Time*Group	1.60	.208
	differences

Table 1. Homogeneity of Demographic Characteristics and Disease Characteristics between the Two Groups (N=42)

H & Y stage=Hoehn & Yahr stage; S & E ADL=Schwab & England activities of daily living; MMSE=mini-mental state examination; Exp.=experimental group, Cont.=control group;

†

by x²-test (p ＜.05),

Table 2. Homogeneity Test of Study Variables between the Two Groups (N=42)

Exp.=experimental group, Cont.=control group; CIAS=chronic illness anticipated stigma.

Table 3. Repeated Measure ANOVA of Depression, Anxiety and CIAS between the Two Groups (N=42)

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Effect of a Telephone-administered Cognitive Behavioral Therapy for the Management of Depression, Anxiety, and Chronic Illness Anticipated Stigma in Parkinson's Disease

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