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Wawrziczny E, Flinois B, Constant E, Brugallé E, Sokolowski C, Manceau C, Baille G, Defebvre L, Dujardin K, Antoine P. Dealing with the diagnosis of Parkinson's disease and its implications for couple functioning in the early stage: An interpretative phenomenological analysis. PLoS One 2024; 19:e0294240. [PMID: 38381728 PMCID: PMC10880977 DOI: 10.1371/journal.pone.0294240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/27/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND For couples facing Parkinson's disease, marital relationships are significantly impacted, even at the early stages of the disease. However, very few studies have explicitly explored the functioning of the couple and how both partners deal with Parkinson's disease. The aim of this study was to explore the experiences and strategies of couples facing Parkinson's disease in the early stage using dyadic interpretative phenomenological analysis. METHODS Fifteen couples agreed to participate in the study. Semistructured interviews were conducted with each partner separately regarding his or her individual experience with Parkinson's disease, the couple's history, the impact of the diagnosis on the functioning of the couple, and his or her projections for the future. RESULTS Three higher-order themes emerged from the analyses. The first theme, "Being tested by the diagnosis", highlights 4 dyadic configurations according to the individual's and the couple's capacity for adjustment following the diagnosis: "noncongruent", "collapsed", "relieved" and "avoidant". The second theme, "Talking about everything except the disease", underlines that communication about the disease is often avoided both within the couple and with relatives to protect the persons with Parkinson's disease or respect their wishes. The third theme, "Supporting each other", describes the different levels of harmony between the two partners in the management of daily life and symptoms and their relational impacts. CONCLUSION These results allow us to better understand the experiences of both partners and to highlight the importance of promoting better acceptance of the diagnosis by persons with Parkinson's disease to allow better communication between partners and with relatives. Such support prevents disease-specific distress and facilitates better adjustment in the later stages of the disease.
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Affiliation(s)
- Emilie Wawrziczny
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | | | - Emilie Constant
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Elodie Brugallé
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Céline Sokolowski
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Charlotte Manceau
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | | | - Luc Defebvre
- Regional and University Hospital Centre of Lille, Lille, France
| | - Kathy Dujardin
- Regional and University Hospital Centre of Lille, Lille, France
| | - Pascal Antoine
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
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Manceau C, Constant E, Brugallé E, Wawrziczny E, Sokolowski C, Flinois B, Baille G, Defebvre L, Dujardin K, Antoine P. Couples facing the “honeymoon period” of Parkinson's disease: A qualitative study of dyadic functioning. Br J Health Psychol 2022; 28:366-382. [PMID: 36301684 DOI: 10.1111/bjhp.12629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The public health issue of the Parkinson's disease (PD) has led to a great deal of research that has highlighted the individual challenges faced by the person with the Parkinson's disease (PwPD) and the caregiving spouse. Few studies, however, have sought to understand the functioning of couples facing PD, by differentiating each stage, each of which has its own issues. In particular, the "honeymoon period", characterized by a symptomatic respite allowed by the effectiveness of treatments for motor symptoms, has been poorly documented, especially at the dyadic level. DESIGN AND METHOD This qualitative study, based on Interpretative Phenomenological Analysis, aimed to understand the experience of couples and their functioning at this stage. Fifteen couples participated in separate semi-structured interviews for each partner. The analyses highlighted four dyadic dynamics, which call into question the relevance of the term "honeymoon" to describe the experience of couples. RESULTS While some couples appear to adjust by means of flexible functioning and a positive reinterpretation of this experience, other dyads oscillate between rigid hyperprotection in the face of perceived distress or a vicious circle of control/avoidance and, in some cases, gradually slipping towards the erosion of the relationship. DISCUSSION These results show that the relational difficulties suffered by partners at this stage should be taken into account as soon as possible after the diagnosis. Strengthening the communication and the togetherness between partners, as well as working on dyadic emotional regulation, are particularly relevant options for these couples.
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Affiliation(s)
- Charlotte Manceau
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
| | - Emilie Constant
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
| | - Elodie Brugallé
- Neurology and Movement Disorders Department CHU‐Lille Lille France
| | - Emilie Wawrziczny
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
| | - Céline Sokolowski
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
| | | | - Guillaume Baille
- Neurology and Movement Disorders Department Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU‐Lille Lille France
| | - Luc Defebvre
- Neurology and Movement Disorders Department Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU‐Lille Lille France
| | - Kathy Dujardin
- Neurology and Movement Disorders Department Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU‐Lille Lille France
| | - Pascal Antoine
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
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Constant E, Brugallé E, Wawrziczny E, Sokolowski C, Manceau C, Flinois B, Baille G, Luc D, Dujardin K, Antoine P. Relationship Dynamics of Couples Facing Advanced-Stage Parkinson’s Disease: A Dyadic Interpretative Phenomenological Analysis. Front Psychol 2022; 12:770334. [PMID: 35140654 PMCID: PMC8818672 DOI: 10.3389/fpsyg.2021.770334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background/ObjectiveSeveral studies have examined the impact of Parkinson’s disease (PD) on the quality of couples’ relationships. To date, few studies have explored how couples experience their relationship dynamic by taking into account the disease stage. The objectives of this study were to understand the experience of each partner and to study the mechanisms that underlie their couple organization in the advanced stage of PD.MethodsSemistructured individual interviews conducted with fifteen patients and their partners were the subject of a dyadic interpretative phenomenological analysis.ResultsThree themes were identified from the analysis: the first, “A Closeness That Separates,” allows the identification of different patterns of interactions that lead to emotional distancing between the partners; the second, “The Adversity Is Not Unbearable, But Going It Alone Would Be,” emphasizes the importance of how the assisting partner provides support; and the third, “Be Prepared for Anything and Facing an Uncertain Future,” reveals the extent and modes of the dyadic regulation of the emotions linked to what the future may hold.ConclusionPsychological support is important to help couples express both their feelings and their respective needs in the evolving context of PD.
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Affiliation(s)
- Emilie Constant
- Université de Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
- *Correspondence: Emilie Constant,
| | - Elodie Brugallé
- Université de Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Emilie Wawrziczny
- Université de Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Céline Sokolowski
- Université de Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Charlotte Manceau
- Université de Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Bérengère Flinois
- Centre Hospitalier Regional et Universitaire de Lille, Lille, France
| | - Guillaume Baille
- Centre Hospitalier Regional et Universitaire de Lille, Lille, France
| | - Defebvre Luc
- Centre Hospitalier Regional et Universitaire de Lille, Lille, France
| | - Kathy Dujardin
- Centre Hospitalier Regional et Universitaire de Lille, Lille, France
| | - Pascal Antoine
- Université de Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
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Moonen AJH, Mulders AEP, Defebvre L, Duits A, Flinois B, Köhler S, Kuijf ML, Leterme AC, Servant D, de Vugt M, Dujardin K, Leentjens AFG. Cognitive Behavioral Therapy for Anxiety in Parkinson's Disease: A Randomized Controlled Trial. Mov Disord 2021; 36:2539-2548. [PMID: 33617699 PMCID: PMC9290129 DOI: 10.1002/mds.28533] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/13/2021] [Accepted: 01/22/2021] [Indexed: 12/14/2022] Open
Abstract
Background Anxiety disorders are among the most prevalent and disabling neuropsychiatric syndromes in patients with Parkinsonʼs disease (PD), but no randomized controlled treatment trials of anxiety have been published to date. Objective The aim of this study was to assess the effectiveness of cognitive behavioral therapy (CBT) in the treatment of anxiety in patients with PD. Methods Forty‐eight patients with PD with anxiety were randomized 1:1 between CBT and clinical monitoring only (CMO). The CBT program was developed to specifically address anxiety symptoms in PD and consisted of 10 weekly sessions. Assessments were conducted by blinded assessors at baseline, at the end of the intervention, after 3 months, and after 6 months (CBT group only). Main outcome measures were the Hamilton Anxiety Rating Scale (HARS) and the Parkinson Anxiety Scale (PAS). Results Both the CBT and CMO groups showed clinically relevant improvement. Although there was no between‐group difference in outcome on the Hamilton Anxiety Rating Scale (6.7‐point reduction in the CBT group versus 3.9‐point reduction in the CMO group; P = 0.15), there was both a statistically significant and a clinically relevant between‐group difference on the total PAS in favor of CBT (9.9‐point reduction in the CBT group versus 5.2‐point reduction in the CMO group; P = 0.012), which was due to improvement on the PAS subscales for episodic (situational) anxiety and avoidance behavior. This greater improvement was maintained at 3‐ and 6‐month follow‐ups. Conclusion CBT is an effective treatment for anxiety in patients with PD and reduces situational and social anxiety, as well as avoidance behavior. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Anja J H Moonen
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Anne E P Mulders
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Luc Defebvre
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France
| | - Annelien Duits
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Bérengère Flinois
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France
| | - Sebastian Köhler
- Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Mark L Kuijf
- Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands.,Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Anne-Claire Leterme
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France
| | - Dominique Servant
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Kathy Dujardin
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France.,Degenerative & Vascular Cognitive Disorders, University of Lille, Lille, France
| | - Albert F G Leentjens
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
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Mulders AEP, Moonen AJH, Dujardin K, Kuijf ML, Duits A, Flinois B, Handels RLH, Lopes R, Leentjens AFG. Cognitive behavioural therapy for anxiety disorders in Parkinson's disease: Design of a randomised controlled trial to assess clinical effectiveness and changes in cerebral connectivity. J Psychosom Res 2018; 112:32-39. [PMID: 30097133 DOI: 10.1016/j.jpsychores.2018.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/03/2018] [Accepted: 04/05/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Anxiety disorders occur in up to 35% of patients with Parkinson's disease (PD) and have a negative effect on motor symptoms and quality of life. To date, no clinical trials specifically targeting anxiety in PD patients have been published. OBJECTIVE To describe the rationale and methodology of a randomised controlled trial (RCT) that aims to study the clinical effectiveness, alterations in brain circuitry, and cost-effectiveness of cognitive behavioural therapy (CBT) for anxiety in PD. METHODS This study is a prospective, two-centre RCT in which sixty PD patients with anxiety will be randomised to CBT treatment and clinical monitoring (intervention group) or to clinical monitoring only (control group). The CBT module used in this study was specifically developed to address symptoms of anxiety in PD patients. Participants will undergo standardised clinical, cognitive and behavioural assessment at baseline and at 2 follow-up measurements, as well as resting-state fMRI and DTI scanning before and after the intervention. The primary outcome measure is changes in severity of anxiety symptoms. Secondary outcome measures involve long-term changes in anxiety symptoms, changes in functional and structural connectivity between limbic and frontal cortices, and cost-effectiveness of the treatment. The study is registered at the ClinicalTrials.gov database under registration number NCT02648737. CONCLUSION This study is the first that evaluates both the clinical effectiveness, cost-effectiveness, as well as the biological impact of CBT for anxiety in PD patients that, if proven effective, will hopefully contribute to a better and evidence-based approach for these non-motor symptoms.
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Affiliation(s)
- A E P Mulders
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - A J H Moonen
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - K Dujardin
- Degenerative & Vascular Cognitive Disorders, University of Lille, Lille, France; Neurology and Movement Disorders Department, CHU, Lille, France
| | - M L Kuijf
- Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - A Duits
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - B Flinois
- Neurology and Movement Disorders Department, CHU, Lille, France
| | - R L H Handels
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - R Lopes
- Degenerative & Vascular Cognitive Disorders, University of Lille, Lille, France; Neuroimaging Department, CHU Lille, Lille, France
| | - A F G Leentjens
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands.
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Antoine P, Flinois B, Doba K, Nandrino JL, Dodin V, Hendrickx M. Living as a couple with anorexia nervosa: A dyadic interpretative phenomenological analysis. J Health Psychol 2016; 23:1842-1852. [DOI: 10.1177/1359105316672095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined the difficulties couples face in relation to anorexia nervosa. Using interpretative phenomenological analysis, five couples in which one of the partners lives with anorexia nervosa were interviewed separately. The findings are conceptualized into three areas: first, the encounter ‘at the crossroads between remission and relapse’; second, the way that ‘anorexia reveals itself’; and finally, the way the ‘ménage à trois’ works, including the illness fully as part of the couple. Psychotherapists should take into account the context of the couple and the complex interaction between the couple and the illness to support both partners’ development of appropriate responses.
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Affiliation(s)
- Pascal Antoine
- Lille University, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives,Lille, France
| | - Bérengère Flinois
- Lille University, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives,Lille, France
| | - Karyn Doba
- Lille University, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives,Lille, France
| | - Jean-Louis Nandrino
- Lille University, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives,Lille, France
| | - Vincent Dodin
- Department of Psychiatry, Hôpital Saint Vincent de Paul, GHICL, F-59000 Lille, France
| | - Marion Hendrickx
- Department of Psychiatry, Hôpital Saint Vincent de Paul, GHICL, F-59000 Lille, France
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