Effect Of Positive Intervention On Depression And Cognitive Impairment In Patients With Parkinson’s Disease

Parkinson’s disease (PD) is a chronic degeneration of the nervous system which isvery common in the middle aged and elderly people. With the increasing of agingpopulation, the prevalence rate of Parkinson’s disease keeps going up, which bring thenegative effect on the patients‘life quality and huge burden on family and society. Besidesdyskinesia, PD patients suffer from non-motor symptoms such as anxiety, depression,insomnia, cognitive impairment, autonomic nerve disorder and so on. Depression andCognitive impairment are the most common symptoms. In the research of psychologicalintervention more attention was paid to the elimination of the negative emotion, less to theexcavation of the positive quality and energy. Therefore, based on the positive psychology,it is meaningful of the positive psychological intervention in the PD patients withdepression and cognitive impairment by the standardized psychological test and positivepsychological intervention.Objective1. To investigate the development and the related influential factors of depression andcognitive impairment in PD patients.2. To investigate the effect of psychological intervention based on the positive psychology on depression and/or cognitive impairment in PD patients, to provide a newstrategy in the mental nursing and a practical guide in the improvement of psychologicalstatus and cognitive level in PD patients.Methods1. The level of depression and cognitive impairment were evaluated by HAMD andMoCA in PD patients and healthy control.2. The positive psychological intervention wasused in PD patients based on the experts‘discussion. The statistical analysis was carriedout by SPSS17.0, including Chi-square test, Independent-t test, stepwise multipleregression analysis and ANOVA of repeated measurement.Results1. The depression and cognitive level in PD patients and the healthy control.There were98patients with depression in216PD patients (45.4%), among whichthere were86patients with mild-to-moderate depression (39.8%),12patients with seriousdepression (5.6%). There were statistical correlation between gender, educational level,family income per capita, duration, cognitive function score and depression score, p<0.05.There were90patients with cognitive impairment in216PD patients (41.7%). Therewere statistical correlation between marital status, medical expense payment, depressionscore and cognitive function score, p<0.05.There was obvious statistical difference in the depression score between the PDpatients and the healthy control,(18.13±9.99Vs3.67±1.92), p <0.01. Compared to thehealthy control, the cognitive function score (19.500±3.967Vs26.000±2.449),Visual-space and executing ability (2.200±1.361Vs4.250±0.851), Attention (3.500±0.827Vs to5.450±0.686), Language competence (2.150±0.617Vs2.550±0.510) andOrientation ability (5.500±0.889Vs5.95±0.224) in PD patients was lower, with thestatistical difference, p<0.05. There was no statistical difference between the two groupsin the Naming ability, Abstract ability and Delayed memory, p>0.05.Compared to the non-depression group, the total MoCA score (20.40±3.85Vs22.87±3.76), Visual space and executing ability (2.83±1.49Vs3.17±1.44), Naming ability(2.50±0.68Vs3.03±0.72), Language competence (2.13±0.73Vs2.77±0.82), Delayedmemory (2.60±1.40Vs3.17±1.56), Orientation ability (5.27±0.98Vs5.47±0.78) in thedepression group were lower, with the statistical difference p<0.05. There was nostatistical difference between the groups of attention and abstract ability.2. The effect of positive psychological intervention on depression and cognitive impairment in the patients with PD.Compared to the healthy control, the HAMD scores in the experimental group wasobviously decreased, with the statistical difference, p<0.01.However, the Cognitivefunction score, Visual-space and executing ability, Naming ability, Language competence,Delayed memory and Orientation ability in the experimental group were higher, with thestatistical difference, p<0.05. There was no statistical difference in the Attention andAbstract ability, p>0.05.Conclusion1. The PD patients were easy to suffer from depression, which was mainly mild tomoderate, with the following influential factors: gender, cultural level, family income,duration and cognitive level.2. There was obviously cognitive impairment in PD patients, such as the visual-spaceand executing ability, attention, language competence and orientation ability, with thefollowing influential factors: marital status, medical expense payment and degree ofdepression.3. Compare to the PD patients without depression; the PD patients with depressionwere easier to suffer from the cognitive impairment.4. Psychological intervention based on positive psychology can improve thedepression and cognitive impairment in the PD patients.