Objective: In Parkinson’s Disease (PD), neuropsychiatric symptoms start in the prodromal stage. Increased rates of depression and anxiety in PD have been associated with living in rural areas, reduced access to healthcare, and decline in mobility. With integration of a Mental Health Collaborative Care Model (COCM) into a national teleneurology clinic, there would be increased psychiatric resources and reduced neuropsychiatric burden for those living with PD.
Background: In PD, affective disorders have a higher prevalence than the general population with rates of depression at 35% and anxiety at 30%. It is known that depression rate increases as PD severity increases. Depression is also associated with increased risk of cognitive impairment, disease progression, and disability in PD. Mental health care access is limited by geography and mobility. Experience with PD is limited in the mental health space.
The COCM which was pioneered at the University of Washington is a proven multidisciplinary approach that leverages behavioral health care managers and a remote Psychiatrist to expand psychiatric resources. While this model has been extensively proven in primary care and through telemedicine, no prior publication has reported the integration of this model into PD care.
Method: COCM was integrated into our teleneurology clinic by incorporating behavioral health care managers, psychologists, psychiatrists, and new workflows to encourage collaboration. Standardized measurements of depression (PHQ-9) and anxiety (GAD-7) were tracked within a registry that helped to evaluate each individual as well as the population as a whole. 62 PD patients were enrolled in this program and these measures of symptom burden were analyzed over time.
Results: There was significant reduction in both the PHQ-9 (10.64 to 6.46) and GAD-7 (8.94 to 5.67) within the first 6 months of treatment. The majority (74%) were managed on psychotropic medications with 45% of patients having psychotropics adjusted based on psychiatric recommendations. Therapies provided in different contexts including individual (61% attended), family (14% attended), and group (39% attended) therapies.
Conclusion: The use of COMC in a virtual neurology clinic facilitated access to mental health resources for PD patients. Within 6 months, there was a demonstrable reduction in symptom burden through the use of therapy and medications.
Average PHQ-9 Score
Average GAD-7 Score
References: 1. Postuma RB, Berg D. Prodromal Parkinson’s Disease: The Decade Past, the Decade to Come. Mov Disord. 2019 May;34(5):665-675. doi: 10.1002/mds.27670. Epub 2019 Mar 28. PMID: 30919499.
2. Burchill E, Watson CJ, Fanshawe JB, Badenoch JB, Rengasamy E, Ghanem DA, Holle C, Conti I, Sadeq MA, Saini A, Lahmar A, Cross B, McGuigan G, Nandrha A, Kane EJ, Wozniak J, Farouk Ghorab RM, Song J, Sommerlad A, Lees A, Zandi MS, David AS, Lewis G, Carter B, Rogers JP. The impact of psychiatric comorbidity on Parkinson’s disease outcomes: a systematic review and meta-analysis. Lancet Reg Health Eur. 2024 Feb 9;39:100870. doi: 10.1016/j.lanepe.2024.100870. PMID: 38361749; PMCID: PMC10867667.
3. Aminian KS, Strafella AP. Affective disorders in Parkinson’s disease. Curr Opin Neurol. 2013 Aug;26(4):339-44. doi: 10.1097/WCO.0b013e328363304c. PMID: 23757262; PMCID: PMC4452223.
4. Micalos PS, Logan PA, Bramble M, Wong A. Prevalence and factors associated with mental health status in Parkinson’s disease: Data from the 45 and Up Study. Aust J Rural Health. 2024 Aug;32(4):693-702. doi: 10.1111/ajr.13125. Epub 2024 Apr 29. PMID: 38680061.
5. Archer J, Bower P, Gilbody S, et al. Collaborative care for depression and anxiety problems. Cochrane Common Mental Disorders Group, ed. Cochrane Database Syst Rev. Published online October 17, 2012. doi:10.1002/14651858.CD006525.pub2
6. Gilbody S. Collaborative Care for Depression: A Cumulative Meta-analysis and Review of Longer-term Outcomes. Arch Intern Med. 2006;166(21):2314. doi:10.1001/archinte.166.21.2314
7. Fortney JC, Pyne JM, Edlund MJ, et al. A Randomized Trial of Telemedicine-based Collaborative Care for Depression. J Gen Intern Med. 2007;22(8):1086-1093. doi:10.1007/s11606-007-0201-9
To cite this abstract in AMA style:
E. Ferluga, E. Anderson, N. Flanagan, D. Geraldi-Samara, J. Riser, K. Brendle. Integrating the Collaborative Care Mental Health Model into Virtual Parkinson’s Disease Care [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/integrating-the-collaborative-care-mental-health-model-into-virtual-parkinsons-disease-care/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/integrating-the-collaborative-care-mental-health-model-into-virtual-parkinsons-disease-care/