Evidence map›Paper›PMID 23325911›Full record

Trial reportNeurology2013

Trial of CBT for impulse control behaviors affecting Parkinson patients and their caregivers.

David Okai, Sally Askey-Jones, Michael Samuel, Sean S O'Sullivan, K Ray Chaudhuri, Anne Martin, Joel Mack, Richard G Brown, Anthony S David

Open access · greenAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 9 pooled it
9.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 9 syntheses or guidelines pooled it, 193 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Guideline
  5. Efficacy of cognitive behavioral therapy for anxiety and depression in Parkinson's disease patients: an updated systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
    Pooled it
  6. Pooled it
  7. Risk factors and intervention of caregiver burden in Parkinson's disease: a systematic review and meta-analysis.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024
    Pooled it
  8. Pooled it
  9. Pooled it
  10. Cognitive Behavioral Therapy for Anxiety in Parkinson's Disease: A Randomized Controlled Trial.Movement disorders : official journal of the Movement Disorder Society · 2021
    Trial
  11. Trial
  12. Trial
  13. Review
  14. Article
  15. Clinical utility of digital technologies in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2026
    Review
  16. Article
  17. Impulse control and related behavioral disorders in Parkinson's disease. Risk factors, diagnosis, and management. Is there a possible role for non-invasive brain stimulation?Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Review
  18. Article
  19. Levodopa-synergistic CBT intervention improves Parkinson's disease with anxiety disorder by regulating the BDNF/PI3K/AKT pathway.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

David OkaiDepartments of Psychosis Studies, King's College Hospital, London.
Sally Askey-Jones
Michael Samuel
Sean S O'Sullivan
K Ray Chaudhuri
Anne Martin
Joel Mack
Richard G Brown
Anthony S David
University College London · GB

Funding

Parkinson's UK J-0705
6 · The paper itself

Abstract

objectiveTo test the effects of a novel cognitive-behavioral therapy (CBT)-based intervention delivered by a nurse therapist to patients with Parkinson disease (PD) with clinically significant impulse control behaviors (ICB).

methodsThis was a randomized controlled trial comparing up to 12 sessions of a CBT-based intervention compared to a waiting list control condition with standard medical care (SMC). A total of 27 patients were randomized to the intervention and 17 to the waiting list. Patients with a Mini-Mental State Examination score of <24 were excluded. The coprimary outcomes were overall symptom severity and neuropsychiatric disturbances in the patients and carer burden and distress after 6 months. Secondary outcome measures included depression and anxiety, marital satisfaction, and work and social adjustment in patients plus general psychiatric morbidity and marital satisfaction in carers.

resultsThere was a significant improvement in global symptom severity in the CBT intervention group vs controls, from a mean score consistent with moderate to one of mild illness-related symptoms (χ(2) = 16.46, p < 0.001). Neuropsychiatric disturbances also improved significantly (p = 0.03), as did levels of anxiety and depression and adjustment. Measures of carer burden and distress showed changes in the desired direction in the intervention group but did not change significantly. General psychiatric morbidity did improve significantly in the carers of patients given CBT.

conclusionsThis CBT-based intervention is the first to show efficacy in ICB related to PD in terms of patient outcomes. The hoped-for alleviation of carer burden was not observed. The study demonstrates the feasibility and potential benefit of a psychosocial treatment approach for these disturbances at least in the short term, and encourages further larger-scale clinical trials. CLASSIFICATION OF EVIDENCE: The study provides Class IV evidence that CBT plus SMC is more effective than SMC alone in reducing the severity of ICB in PD, based upon Clinical Global Impression assessment (χ(2) = 16.46, p < 0.001): baseline to 6-month follow-up, reduction in symptom severity CBT group, 4.0-2.5; SMC alone group, 3.7-3.5.

Indexed as

AgedCaregiversCognitive Behavioral TherapyFemaleHumansImpulsive BehaviorMaleMiddle AgedParkinson DiseaseTreatment Outcome

Identifiers

PMID23325911
PMCPMC3598451
OpenAlexW1992423290

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.