Objective: For the nearly 100,000 veterans with Parkinson’s disease (PD) receiving Veterans Affairs (VA) health care, depression is prevalent, yet often undiagnosed or undertreated. This treatment gap undermines PD management and accelerates functional decline. Effective depression treatment can be restorative, yet there is currently no evidence-based standard of care in the VA for veterans with depression and PD (dPD). This study compared the effectiveness of video-to-home cognitive-behavioral therapy (CBT) to VA depression treatment as usual (TAU) for veterans with dPD.
Background: In two prior RCTs, brief, PD-informed CBT for dPD significantly outperformed usual care, whether CBT was provided in person or remotely. Veterans with Parkinson’s (VWP) represent a high-need (medically/psychiatrically complex) cohort facing geographic and disability-related obstacles to specialized, evidence-based care. VA’s telemedicine capabilities can bypass these barriers and extend PD-informed mental health treatment to these underserved veterans.
Method: Ninety VWP were randomized to video-to-home CBT+TAU or TAU only. CBT was individualized to veterans’ unique needs and provided weekly for 3 months, then monthly through 6-month follow-up. Care-partners received ancillary coaching to support VWPs’ CBT coping skills.
Results: Treatment feasibility, satisfaction, and adherence rates were high. Over the course of the trial, veterans receiving CBT achieved significant, durable reductions in depression, compared to TAU, on clinician-administered (Hamilton Rating Scale for Depression) and self-report (Beck Depression Inventory) measures (p<.001). Significantly more veterans in CBT qualified as “treatment responders” with depression “very much improved ” or “much improved” from baseline; Clinical Global Impression Improvement Scale; p<.001). Gains in anxiety, physical functioning, and quality of life also favored CBT (p<.05).
Conclusion: Brief, PD-informed CBT for depression, delivered via video-to-home, could significantly enhance VA’s standard PD care, improving global PD treatment outcomes. It is notable that this telemedicine intervention was both feasible and effective for veterans with PD with significant medical and psychiatric burden.
To cite this abstract in AMA style:
R. Dobkin, S. Mann, K. Rodriguez, L. St. Hill, R. Miller, A. King, M. Gara, A. Interian. Video-to-Home Cognitive-Behavioral Therapy for Veterans with Depression and Parkinson’s Disease: A Randomized Controlled Trial [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/video-to-home-cognitive-behavioral-therapy-for-veterans-with-depression-and-parkinsons-disease-a-randomized-controlled-trial/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/video-to-home-cognitive-behavioral-therapy-for-veterans-with-depression-and-parkinsons-disease-a-randomized-controlled-trial/