Mindfulness-based Cognitive Therapy for People with Parkinson's Disease during the COVID-19 Pandemic

INTRODUCTION: Anxiety and depression are among the most common non-motor PD symptoms. People with PD have experienced additional stress and social isolation during the COVID-19 pandemic. Caregivers of people with PD may experience significant caregiver burden. MBCT can prevent the relapse of depression and improve anxiety symptoms. Few studies have explored its benefits for people with PD; none have included caregivers. This study aimed to investigate the feasibility and effectiveness of a mindfulness-based cognitive therapy (MBCT) intervention in reducing anxiety and/or depression in people with Parkinson's disease (PD) and their caregivers. The study was registered on ClinicalTrials.gov (NCT04469049) and it was conducted entirely online. METHODS: Peoplewith PD or parkinsonism and mild-to-moderate anxiety and/or depressive symptoms and caregivers of people with PD were recruited from neurology clinics, support groups, and online. 3 MBCT groups were conducted in Zoom from November 2020 to June 2021, using a previously adapted MBCT protocol, further modified for online delivery during the pandemic. Caregivers could also enter MBCT groups or complete pre- and post- surveys without joining groups. Data collected included demographic and clinical variables, pre- and post-MBCT behavioral measures (GAD-7, PHQ-9, Five Facet Mindfulness Questionnaire: FFMQ-15), home practice time, and satisfaction surveys. Descriptive statistics were used to summarize participant characteristics, home practice time, and satisfaction survey responses. Pre- and post-MBCT behavioral measure scores were compared using mixed-effect models. RESULTS: See attached tables. All 27 participants who entered MBCT groups completed the intervention, except for one man with PD (n = 22 people with PD/parkinsonism, n = 4 caregivers). Attendance and participant satisfaction were high. MBCT completers had significant anxiety (GAD-7) and depression (PHQ-9) score reductions and FFMQ-15 total and Observing and Non-reactivity subscale score increases (all p’s < 0.05). Completers with PD/parkinsonism and anxiety (n = 14) had a significant GAD-7 score reduction; those with PD/parkinsonism and depression (n = 13) had a significant PHQ-9 score reduction (both p’s < 0.05). Completers with PD/parkinsonism also had a significant FFMQ-15 Observing subscale score increase (p < 0.05). The caregiver sample was too small to be analyzed. CONCLUSIONS: Online MBCT is feasible and may be effective in reducing anxiety and/or depression in people with PD. Results should be replicated in studies with larger samples and control groups. Please note, this study built on the previous pilot trial presented in poster #1101 at the 2021 AAGP Virtual Annual Meeting. This was a different study and it also included caregivers. THIS RESEARCH WAS FUNDED BY: This study was supported by the Mount Zion Health Fund.