Brunel University

04/11/2024 | News release | Distributed by Public on 04/11/2024 02:41

New study shows psychotherapy can reduce anxiety and depression in Parkinson's patients

Today is World Parkinson's Day, which aims to raise awareness of the condition and support those living with it. People with Parkinson's disease often display symptoms such as anxiety, stress and depression, and a new study from Brunel University London investigated whether compassionate mind training - a form of mindfulness - could enhance the well being and quality of life of people with the disease.

Compassionate mind training (CMT) is a mindfulness-based psychotherapy that aims to cultivate self-compassion - the ability to show compassion towards oneself during difficult times - as well as compassion towards others and the ability to receive compassion from others. Studies have shown that CMT is effective at improving compassion levels, as well as reducing depression, anxiety and stress in several medical conditions.

Reports suggest that self-compassion might serve as a protective factor against the detrimental impact of stigma - the experience of devaluation, discrimination or embarrassment that is self-perceived or other-perceived - which is often felt by people with Parkinson's disease (PD).

Dr Elena Makovac, a Senior Lecturer in Clinical Psychology at Brunel University London, co-led the new study in collaboration with Dr Lucia Ricciardi from St George's University of London, and researchers from UCL and King's College. The research was the first to use CMT as an intervention in people with PD and aimed to assess the feasibility of an online CMT programme to support people with the disease.

As well as investigating the effectiveness of CMT in improving the quality of life of people with PD, the study, published in the European Journal of Neurology, also evaluated its impact on physiological measures linked to emotional resilience, namely heart rate variability (HRV) - the variability of intervals between consecutive heartbeats.

"Recent studies have confirmed that CMT increases heart rate variability, and a higher HRV is linked to better well being," explained Dr Makovac. "In contrast, a reduction in HRV is usually observed during emotional or mental stress."

Higher HRV levels have also been linked to other physical benefits such as a higher pain threshold and lower levels of inflammation.

The clinical study involved participants with PD in Italy, who attended six online CMT group sessions. Each weekly session lasted for around two hours and was led by a psychotherapist.

Before beginning the CMT programme, participants completed a questionnaire that assessed their feelings of depression, anxiety and self-compassion over the last month.

Around half of the participants also had their HRV measured before starting the programme, and it was taken in three different conditions. "In the first condition, patients were tested at rest, when sitting quietly and breathing," explained Dr Ricciardi.

"In the second condition, patients participated in a 'triggering interview', where clinicians asked them triggering questions such as, 'How is life for you now that you are living with Parkinson's?' The specific questions aimed to elicit personal experiences and emotional reactions concerning the diagnosis, and participants then had 5 minutes to respond before their HRV measurement was taken."

In the third condition, participants engaged in a three-minute deep breathing exercise that was designed to improve their focus and induce relaxation before their HRV was recorded.

"Our analysis showed that the triggering interview resulted in the lowest HRV measurements when compared to the resting level results, which indicates a measurable physiological response to an emotionally stressful situation," explained Dr Makovac.

Following the six-week intervention, participants completed an additional questionnaire, and HRV levels were measured again in the participating patients.

"Our results found that CMT improves quality of life scores of participants, in particular in the domain of self-perceived stigma," said Dr Makovac.

"The data showed that self-perceived stigma before the intervention was associated with lower HRV, and the levels increased after the intervention," she added.

"Interestingly, participants who exhibited a minimal decline in HRV when placed under stress during the pre-intervention triggering interview, indicating a more robust physiological response to stress, experienced a greater alleviation of anxiety and depression following the CMT intervention. This implies that the physiological response to stress may serve as a predictive factor for identifying those who stand to benefit most from CMT."

The study explains why enriching self-compassion through CMT can be effective in improving quality of life in general and self-perceived stigma in particular.

A significant proportion of participants expressed their desire to continue practising CMT after the six-week intervention, which adds to the feasibility of an online CMT programme to support people with PD.

Dr Ricciardi explains how HRV could be used as a guide for therapists to offer tailored psychotherapy to patients. "Individuals with reduced HRV might need an additional number of sessions or an integrated approach where psychotherapy is combined with interventions aimed at increasing HRV, such as slow breathing techniques," she said.

'Compassionate mind training for people with Parkinson's disease: A pilot study and predictors of response', By Silvia Della Morte, Elena Berti, Carolina Lalli, Nicola Modugno1, Francesca Morgante, Anette Schrag, Elena Makovac and Lucia Ricciardi, is published in the European Journal of Neurology.

Nadine Palmer, Media Relations +44 (0)1895 267090
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