(Neuro)Psychological Interventions for Non-Motor Symptoms in the Treatment of Patients with Parkinson's Disease: a Systematic Umbrella Review

Conducted in a multidisciplinary and multimodal setting, the main objectives of neuropsychological treatment are to improve cognition, alleviate affective disorders, and to promote activities and participation. This article reviews the evidence on therapeutic or educative interventions based on psychological principles for patients with Parkinson's disease. The electronic bibliographic databases MEDLINE, PsycINFO, PSYNDEX, and CINAHL were systematically searched for meta-analyses on psychological interventions for patients with Parkinson's disease, published from January 2000 to June 2018. We extracted psychological interventions, non-motor outcomes, effect sizes, confidence intervals, and I-2 heterogeneity statistics. In addition, we rated the level of evidence on an intervention's effectiveness regarding a specific outcome. We identified 15 meta-analyses out of 1084 search results and identified a broad variety of psychological interventions for non-motor symptoms in patients with Parkinson's disease. In total, 48 outcome-intervention-pairs were extracted. Psychotherapy, mind and body interventions, and cognitive training are promising treatment approaches when addressing cognition, depression, and QoL in patients with Parkinson's disease. The available evidence on the effectiveness of psychological interventions in the treatment of symptoms in patients with Parkinson's disease is very heterogeneous. Still, our review reveals that some interventions are appropriate and effective for a variety of symptoms. Primary studies are not considered in this review, resulting in the omission of potentially relevant findings. Further high-quality research is needed to confirm the existing evidence and to explore the potential of psychological interventions for patients with Parkinson's disease.