Within the UK, the variety of individuals affected by Parkinson’s Illness is predicted to rise to 172,000 by 2030 (Parkinson’s UK, 2023). Parkinson’s entails a lack of neurons and dopamine, leading to over 40 signs that may be motor (e.g., tremors) and non-motor (e.g., despair; Bloem et al., 2021). Psychological signs are alarmingly frequent: despair and anxiousness are reported in as much as 40% of individuals with Parkinson’s, and poor psychological wellbeing interferes with medicine adherence and high quality of life (Malek & Grosset, 2014; Al-Khammash et al., 2023).
Present help programmes hardly ever deal with psychological wellbeing, however as an alternative on decision-making and symptom administration (Pigott et al., 2022). Unsurprisingly, little is thought concerning the effectiveness and acceptability of psychological interventions, significantly third-wave therapies. In contrast to second-wave therapies (e.g., CBT), which goal maladaptive pondering patterns, third-wave approaches emphasise mindfulness, acceptance, and psychological flexibility. Theoretically, this strategy could also be particularly related for dwelling with a persistent, progressive situation.
Christodoulou and colleagues (2025) at College Faculty London reviewed proof on the results of third-wave therapies on misery, wellbeing, and high quality of life in individuals with Parkinson’s, whereas additionally figuring out variations particular to this inhabitants.
Psychological wellbeing is commonly missed in Parkinson’s regardless of excessive prevalence of psychological morbidities, highlighting the necessity for tailor-made therapies.
Strategies
The systematic evaluate was pre-registered on Prospero and adopted PRISMA pointers and the PICOs framework.
Eligible research concerned adults over 18 with a proper Parkinson’s Illness analysis. RCTs, pilot RCTs, or non-randomised managed trials have been included within the evaluate. The interventions concerned third-wave psychotherapies (acceptance and dedication remedy, compassion-focused remedy, and so forth.), and have been in comparison with both therapy as regular/ready listing, or different interventions (e.g., help teams, pharmacological therapy, and so forth.). The research additionally needed to embody not less than one of many following outcomes: psychological misery, psychological wellbeing, high quality of life in Parkinson’s, and attrition charges.
Three impartial reviewers screened research, resolving discrepancies with a fourth reviewer. Knowledge have been extracted on demographics, design, intervention particulars, comparators, outcomes, and findings.
High quality was assessed utilizing Efficient Public Well being Observe Venture instrument, taking a look at six domains, together with choice bias and confounders.
Outcomes
Ten RCTs have been included. 9 took mindfulness-based approaches, and one examined acceptance and dedication remedy (ACT). Pattern sizes have been small (30 to 138 members), and just one examine was giant sufficient to be thought-about effectively powered. Throughout the research, a spread of validated measures included Hospital Nervousness and Despair Scale (HADS), Despair Nervousness Stress Scale (DASS-21), and Parkinson’s Illness Questionnaire (PDQ-39). Whereas this helped anchor findings in established scientific measures, variability within the measures launched inconsistency throughout research.
Psychological misery
There was substantial variation within the reported outcomes for psychological misery. One trial of mindfulness yoga (Kwok et al., 2019) discovered vital reductions in despair and anxiousness in comparison with stretching and resistance coaching. A smaller examine of a mindfulness meditation-based train programme (Son & Choi, 2018) additionally confirmed decreased despair. Nevertheless, most interventions produced combined or non-significant outcomes. As an example, one examine reported a discount in trait anxiousness however not despair (Buchwitz et al., 2021), and on-line MBCT led to solely small, non-significant modifications (Bogosian et al., 2021).
Wellbeing and high quality of life
Equally, the research various tremendously within the reported results on wellbeing and high quality of life. Mindfulness yoga once more appeared to indicate advantages in some points. Nevertheless, different research reported extra combined findings. For instance, MBSR improved social help however not total high quality of life (Ayromlou et al., 2020), whereas on-line MBCT improved high quality of life however not misery (Bogosian et al., 2021). Furthermore, a number of research discovered no significant variations on high quality of life measures.
Variations for individuals with Parkinson’s
About half of the research integrated Parkinson’s-specific variations, reminiscent of:
- shorter classes;
- seated yoga/meditation choices;
- simplified language;
- flexibility for motor signs;
- distant supply.
These changes appeared to make interventions extra acceptable and possible, however reporting was patchy and inconsistent throughout research, making generalisation unsure.
Mindfulness yoga stands out as essentially the most promising strategy for psychological help in Parkinson’s, with some reported enhancements in misery, wellbeing, and high quality of life.
Conclusions
The proof base for third-wave therapies in Parkinson’s care stays restricted and exploratory. Most research have been small, underpowered, with brief follow-up intervals, thus stopping agency conclusions concerning the intervention efficacy. The shortage of meta-analytic synthesis additional constrain interpretation.
Whereas Mindfulness Yoga seems to be promising, there’s a want for bigger and extra rigorous RCTs, particularly for ACT, DBT, and CFT. The evaluate additionally reiterates the necessity to discover how the interventions needs to be tailor-made to the wants and experiences of individuals with Parkinson’s.
Mindfulness interventions might assist individuals with Parkinson’s, however bigger and extra rigorous trials are wanted on this subject of third wave interventions.
Strengths and limitations
As Parkinson’s is projected to be one of many main neurological circumstances by 2050 (Su et al., 2025), there’s growing want for holistic care. This evaluate highlights gaps in psychological interventions and provides a robust rationale for investigating third-wave therapies particularly.
The proof base, as reported on this evaluate, stays preliminary. Most research have been small and exploratory, with just one being adequately powered. The heterogeneity of the findings undermines any skill to attract any conclusions concerning the efficacy of third-wave therapies for Parkinson’s. Furthermore, members typically self-selected, and the outcomes relied on self-report, introducing potential bias into the outcomes.
The research got here from the UK, Germany, Australia, Iran, and South Korea, providing some worldwide breadth. The evaluate additionally acknowledged potential sources of bias, such because the reliance on self-report measures, excessive drop-out charges, and variable management circumstances.
Consideration of Parkinson’s-specific variations was additionally important, because the intervention’s success might rely on the results of fatigue, cognitive slowing, and fluctuating medicine results in Parkinson’s.
Lastly, most members have been white and well-educated, limiting generalisability. Importantly, racial, ethnical, and different social disparities are linked to genetic predisposition to Parkinson’s, healthcare-seeking behaviours and healthcare inequalities, and different social deprivation components (Aamodt et al., 2023; Heimrich et al., 2023), making it essential to extend pattern variety in future analysis.
This well timed systematic evaluate attracts consideration to the gaps in psychologically centered analysis into Parkinson’s help.
Implications for observe
A 2019 Neurological Alliance survey discovered that 30% of people with circumstances together with Parkinson’s, who sought psychological help, weren’t referred for psychological well being companies, and 40% reported unmet psychological well being wants. The demand for psychological help is obvious, however it’s not ample to default to the normal CBT strategy. The findings by Christodoulou et al. (2025) have implications for scientific observe by asking what help works and find out how to adapt it. Nevertheless, I might additionally have an interest within the format of this help (e.g., on-line, with spouses, and so forth.), its minimal period, any advantages for medicine adherence, and the follow-up results.
From my very own analysis and volunteering, I’ve been lucky to listen to immediately from individuals with Parkinson’s and their households on the Parkinson’s Centre for Built-in Remedy. Many described how present companies deal with symptom management however hardly ever on the emotional or existential challenges of analysis. This resonates with the evaluate’s discovering that psychological wellbeing stays peripheral in Parkinson’s care. Equally, my grasp’s dissertation, which explored the experiences of spouses and members of the family, echoed the findings as carers repeatedly spoke about lack of accessible wellbeing sources and psychological help.
As Sheryl Jedlinsky put in her memoir, Parkinson’s is the New Regular – a brand new expertise that wants psychological help simply as a lot as medical therapy. The evaluate by Christodoulou and colleagues contributes to the continued dialogue on the supply of psychological take care of individuals with Parkinson’s. The evaluate additionally enhances the not too long ago printed BPS steering on a matched-care framework for Parkinson’s (Foley & Mobley, 2025 – see p. 7). Third-wave therapies might turn into a precious part of Parkinson’s care, however bigger, better-powered RCTs are wanted, particularly for therapies reminiscent of ACT, DBT and CFT.
Moreover, future research must doc the event of latest psychological interventions. This implies constructing the intervention program with a strong theoretical rationale by drawing on present analysis on persistent sickness, qualitative research of lived expertise, and different conceptually related fields. Equally, it’s important to co-produce the interventions with individuals with Parkinson’s to replicate the wants and improve acceptability.
Lastly, reflecting on this as a scientific psychology pupil, I’m eager to see a vital interrogation of which therapeutic strategies are deemed generalisable and therefore included within the toolkit for nationwide psychological help. With Parkinson’s being such a various situation physiologically and psychologically, it provides a layer of complexity alongside the normal intersectional lens to therapeutic care.
Psychological care shouldn’t be optionally available in Parkinson’s, and third-wave approaches deserve severe consideration alongside medical care.
Assertion of pursuits
Sofiia not too long ago accomplished an MSc in Scientific Psychology on the College of Kent, the place her dissertation centered on the experiences of carers of individuals with Parkinson’s. She has additionally volunteered on the Parkinson’s Centre for Built-in Remedy. She has no different conflicts of curiosity.
Edited by
Dafni Katsampa.
Hyperlinks
Major paper
Christodoulou, D., Reeves, S., Carvalho, N. M. V. d., Stellman, J., & Gould, R. L. (2025). A scientific evaluate of third-wave therapies to scale back misery and enhance wellbeing and high quality of life in individuals with Parkinson’s illness. Scientific Gerontologist, 1-24. https://doi.org/10.1080/07317115.2025.2511957
Different references
Su, D., Cui, Y., He, C., Yin, P., Bai, R., Zhu, J., … & Feng, T. (2025). Projections for prevalence of parkinson’s illness and its driving components in 195 nations and territories to 2050: modelling examine of worldwide burden of illness examine 2021. BMJ, e080952. https://doi.org/10.1136/bmj-2024-080952
Aamodt, W. W., Willis, A. W., & Dahodwala, N. (2023). Racial and ethnic disparities in parkinson illness. Neurology Scientific Observe, 13(2). https://doi.org/10.1212/cpj.0000000000200138
Heimrich, Ok. G., Schönenberg, A., & Prell, T. (2023). Social deprivation and exclusion in parkinson’s illness: a cross-sectional and longitudinal examine. BMJ Open, 13(12), e074618. https://doi.org/10.1136/bmjopen-2023-074618
Aarsland, D., Påhlhagen, S., Ballard, C. G., Ehrt, U., & Svenningsson, P. (2012). Despair in Parkinson illness—epidemiology, mechanisms and administration. Nature Critiques Neurology, 8(1), 35-47. https://doi.org/10.1038/nrneurol.2011.189
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Foley, J. A., & Mobley, A. (2025). Psychological and neuropsychological companies for individuals with Parkinson’s illness. The British Psychological Society. https://doi.org/10.53841/bpsrep.2025.rep189
Parkinson’s UK. Reporting on Parkinson’s: data for journalists [Internet]. Parkinson’s UK. 2023. Obtainable from: https://www.parkinsons.org.uk/about-us/reporting-parkinsons-information-journalists
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Pigott, J., Kane, E., Ambler, G., Walters, Ok., & Schrag, A. (2022). Systematic evaluate and meta-analysis of scientific effectiveness of self-management interventions in Parkinson’s illness. BMC Geriatrics, 22(1), 1–15. https://doi.org/10.1186/s12877-021-02656-2
Ayromlou, H., Fattahzadeh-Ardalani, G., & Seyedmirzaei, S. M. (2020). The impact of mindfulness-based stress discount on high quality of life in sufferers with Parkinson’s illness. Worldwide Scientific Neuroscience Journal, 7(3), 118–123. https://doi.org/10.34172/icnj.2020.21
Bogosian, A., Chadwick, P., Windgassen, S., Norton, S., McCrone, P., Mosweu, I., … Mckenna, S. (2021). Misery improves after mindfulness coaching for individuals with Parkinson’s illness: A pilot randomised managed trial. Journal of Psychosomatic Analysis, 145, 110485. https://doi.org/10.1016/j.jpsychores.2021.110485
Buchwitz, M., Helbig-Lang, S., Kriston, L., Konnopka, A., Balzer-Geldsetzer, M., Hermann, W., … Kessler, J. (2021). Web-based, mindfulness-integrated stress discount for individuals with Parkinson’s illness (IPSUM): A randomised managed pilot examine. Journal of Neural Transmission, 128(7), 1005–1015. https://doi.org/10.1007/s00702-021-02363-9
Kwok, J. Y. Y., Kwan, J. C. Y., Auyeung, M., Mok, V. C. T., Lau, C. Ok. Y., Choi, Ok. C., … Chan, H. Y. L. (2019). Results of mindfulness yoga vs stretching and resistance coaching workout routines on anxiousness and despair for individuals with Parkinson’s illness: A randomized scientific trial. JAMA Neurology, 76(7), 755–763. https://doi.org/10.1001/jamaneurol.2019.0534
Son, H., & Choi, E. O. (2018). The consequences of mindfulness meditation-based advanced train program on motor and nonmotor signs and high quality of life in sufferers with Parkinson’s illness. Asian Nursing Analysis, 12(2), 145–153. https://doi.org/10.1016/j.anr.2018.04.003
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