Parkinson's Disease: Coping Strategies, Cognitive Restructuring and Deep Brain Stimulation.

Abstract

Objective: Less is known concerning the evolution of coping strategies before and after deep brain stimulation (DBS) in Parkinson's disease (PD) patients.

Methods: In a randomized controlled trial, coping was measured with the neurological version of the CHIP (Coping with Health Injuries and Problem) and the BriefCOPE in PD patients before ( T1: DBS - 2 months) and after (T2: + 3 months, T3: + 6 months) DBS. Patients (N = 50, age 59 ± 5.7 years, disease duration 9.54 ± 3.7 years) were randomised in 3 groups: CRTG (preoperative psychological preparation with cognitive restructuring), PIG (preoperative non structured interviews), and CG (no psychological preparation).

Results: Coping strategies are modulated by the time of evaluation. Some strategies are significantly more used preoperatively than postoperatively, as strategies about the research for information (CHIP: F = 16.14; P = .000; η² = .095; BriefCOPE F = 5.71; P = .005; η² = .066), emotional regulation (F = 3.29; P = .042; η² = .029), and well-being searching (F = 4.59; P = .013; η² = .043). Some other strategies appear more used post than preoperatively, as palliative coping (F = 5.57; P = .005; η² = .064), humour (F = 3.35; P = .041; η² = .0.35), and use of substance (F = 4.43; P = .015; η² = .070). No other specific time, group or time per group interaction effect was found.

Conclusion: Coping strategies are crucial for PD patients to adapt to the evolution of their parkinsonian state. Their consideration should be more systematic in the neurosurgical process, particularly when neurological symptoms would remain after DBS. More insights are needed concerning the evolution of coping strategies through DBS and the impact of a preoperative psychotherapy over them in preoperative PD patients.