A Systematic Review of Third-Wave Therapies to Reduce Distress and Improve Wellbeing and Quality of Life in People with Parkinson's Disease.

Third-wave psychotherapies, particularly mindfulness-based interventions, show promise for reducing psychological distress and improving well-being and quality of life in people with Parkinson's disease, but evidence is limited. A systematic review of ten randomized controlled trials found that nine tested mindfulness-based approaches and one tested acceptance and commitment therapy. Methodological quality was moderate to high, but sample sizes were small, and only one trial was adequately powered. The largest trial reported significant benefits of Mindfulness Yoga for depression, anxiety, psychological well-being, and quality of life. Other findings were mixed. Pilot and feasibility studies indicated mindfulness interventions were well received. No conclusions could be drawn about non-mindfulness therapies due to insufficient data. Larger trials are needed to confirm clinical meaningfulness.

Study at a glance

Abstract

This systematic review assessed use of third-wave psychotherapies in reducing psychological distress and improving psychological well-being and quality of life in people with Parkinson's disease and critically evaluated intervention adaptations. A literature search, conducted across five databases identified randomized controlled trials (RCTs) evaluating third-wave psychotherapies for individuals with Parkinson's disease. Ten RCTs were identified of which nine evaluated mindfulness-based interventions, and one acceptance and commitment therapy. Methodological quality ranged from moderate to high, but sample sizes were small, and only one study was adequately powered. Five reported on Parkinson's specific adaptations. The trial with the largest sample size reported a significant effect of Mindfulness Yoga on depression and anxiety, psychological well-being and quality of life. Other findings were mixed across all outcomes. There was evidence of an effect of Mindfulness Yoga on our pre-defined outcomes. Pilot and feasibility trials showed that mindfulness-based interventions were well received and provided feedback on adaptations. There was a lack of data to draw conclusions regarding non-mindfulness-based therapies. Larger trials of mindfulness-based interventions are required to establish the clinical meaningfulness of treatment effects. Further research is needed to adapt and explore on non-mindfulness-based interventions such as acceptance and commitment therapy.