|Titre :||Tackling psychosocial maladjustment in Parkinson's disease patients following subthalamic deep-brain stimulation: A randomised clinical trial|
|Revue :||PLoS ONE, 12, 4|
|Auteurs :||Flores Alves Dos Santos J ; Tezenas du Montcel S ; Gargiulo M ; Behar C ; Montel S ; Hergueta T ; Navarro S ; Belaid H ; Cloitre P ; Karachi C ; Mallet L ; Welter ML|
|Type de document :||Article|
|Année de publication :||2017|
BACKGROUND: Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for the motor and non-motor signs of Parkinson's disease (PD), however, psychological disorders and social maladjustment have been reported in about one third of patients after STN-DBS. We propose here a perioperative psychoeducation programme to limit such social and familial disruption.
METHODS: Nineteen PD patients and carers were included in a randomised single blind study. Social adjustment scale (SAS) scores from patients and carers that received the psychoeducation programme (n=9) were compared, both 1 and 2 years after surgery, with patients and carers with usual care (n=10). Depression, anxiety, cognitive status, apathy, coping, parkinsonian disability, quality-of-life, carers' anxiety and burden were also analysed.
RESULTS: Seventeen patients completed the study, 2 were excluded from the final analysis because of adverse events. At 1 year, 2/7 patients with psychoeducation and 8/10 with usual care had an aggravation in at least one domain of the SAS (p=.058). At 2 years, only 1 patient with psychoeducation suffered persistent aggravated social adjustment as compared to 8 patients with usual care (p=.015). At 1 year, anxiety, depression and instrumental coping ratings improved more in the psychoeducation than in the usual care group (p=.038, p=.050 and p=.050, respectively). No significant differences were found between groups for quality of life, cognitive status, apathy or motor disability.
CONCLUSIONS: Our results suggest that a perioperative psychoeducation programme prevents social maladjustment in PD patients following STN-DBS and improves anxiety and depression compared to usual care. These preliminary data need to be confirmed in larger studies.
|Lien associé :||Texte complet disponible sur le site PMC|
|Pubmed / DOI :||DOI : 10.1371/journal.pone.0174512 / Pubmed : 28399152|
|En ligne :||http://www.ncbi.nlm.nih.gov/pubmed/28399152|