Abstract
Cognitive behavioral therapy (CBT) for depression and anxiety, established since the 1960s in the USA, and now in Europe, and all over the world has been found to be effective for treating depression in Parkinson’s disease (PD). CBT is further developed to acceptance and commitment therapy (ACT) in Europe and the USA. The neural mechanism of CBT or ACT is still under investigation. In Japan, Morita therapy, a psychotherapy founded in 1919 by Masatake (Shoma) Morita, has been used for common mental problems such as anxiety and depression, but rarely for the psychological symptoms in PD. Morita Therapy is in sharp contrast to western CBT in teaching that undesired mental symptoms such as anxiety and depression are natural features of human emotion in health and disease rather than something to control or eliminate, but it is speculated to be similar to ACT in the approach to acceptance but not elimination of mental symptoms. I speculate that the neural basis might be similar in CBT, ACT, and Morita Therapy. In this commentary, a hypothesis is proposed that CBT, ACT, as well as Morita Therapy might be effective for the treatment of the psychological symptoms such as anxiety and depression in PD and in other mental and physical diseases, probably by similar neural mechanisms in the brain.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Change history
28 January 2020
The original version of this article unfortunately contained a mistake. The year in the Acknowledgements section should be “1963” not “1993”.
References
Atkins PWB, Ciarrochi J, Guadiano BA, Bricker JB, Donald J, Rovner G, Smout M, Livheim F, Lundgren T, Hayes S (2017) Departing from essential features of a high quality systematic review of psychotherapy: a response to Öst (2014) and recommendations for improvement. Behav Res Ther 97:259–272
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiat 4:561–571
Beck AT, Rush AJ, Shaw BF, Emery G (1979) Cognitive therapy of depression. Guilford Press, New York
Bluett EJ, Homan KJ, Morrison KL, Levin ME, Twohig MP (2014) Acceptance and commitment therapy for anxiety and OCD spectrum disorders: an empirical review. J Anxiety Disord 28:612–624
Dissanayaka NNW, Pye D, Mitchell LK, Byrne GJ, O’Sullivan JD, Marsh R, Pachana NA (2017) Cognitive behavior therapy for anxiety in Parkinson’s disease: outcomes for patients and caregivers. Clin Geront 40:159–171
Egan SJ, Laidlaw K, Starkstein S (2015) Cognitive behaviour therapy for depression and anxiety in Parkinson’s disease. J Parkinson Dis 5:443–451
Graham CD, Gouick J, Kathé C, Gillanders D (2016) A systematic review of the use of acceptance and commitment therapy (ACT) in chronic disease and long-term conditions. Clin Psychol Rev 46:46–58
Hadina A, Meyer A, Bruegger V, Hatz F, Nowak K, Taub E, Nyberg E, Stieglitz RD, Fuhr P, Gschwandtner U (2017) Cognitive group therapy reduces and improves the quality of life in patients with Parkinson’s disease. Front Psychol 7:1975
Hofmann SG (2012) An introduction to modern CBT: psychological solutions to mental health problems. Wiley, Chichester (Japanese translation by Ito M and Horikosi M (2012) Shinndan To Chiryou Sha, Tokyo, Japan)
Hökfelt T, Martensson O, Björlund A, Kleinau S, Goldstein M (1984) Distribution of maps of tyrosine-hydroxylase-immunoreactive neurons in the rat brain. In: Björklund A, Hökfelt T (eds) Handbook of chemical neuroanatomy. Classical transmitters in the CNS, part 1, vol 2. Elsevier, Amsterdam, pp 277–379
Kaczkurkin AN, Foa EB (2015) Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues Clin Neurosci 17:337–346
Kawanishi H, Sekiguchi A, Funaba M, Fujii Y, Yoshiuchi K, Kikuchi H, Kawai K, Maruo K, Sugawara N, Hatano K, Shoji T, Tamazaki T, Toda K, Murakami M, Shoji M, Ohara C, Tomita Y, Fukudo S, Ando T (2019) Cognitive behavioral therapy with interoceptive exposure and complementary video materials for irritable bowel syndrome (IBS): protocol for a multicenter randomized controlled trial in Japan. Biopsychosoc Med. 13:14
Kitanishi K (2005) The philosophical background of Morita therapy: its application to therapy. In: Tseng WS, Chang SC, Nishizono M (eds) Asia culture and psychotherapy. University of Hawaii Press, Honolulu, pp 169–185
Kitanishi K, Mori A (1995) Morita therapy: 1919 to 1995. Psychiatry Clin Neurosci 49:245–254
Kwok JYY, Kwan JCY, Auyeung M, Mok VCT, Lau CYK, Choi KC, Chan HL (2019) Effects of mindfulness Yoga vs stretching and resistance training exercise on anxiety and depression for people with Parkinson disease; a randomized clinical trial trial. JAMA Neurol 76:755–763
Lackner JM, Jaccard J, Keefer L, Brenner DM, Firth RS, Gudleski GD (2018) Improvement after cognitive behavioral therapy for irritable bowel syndome. Gasteroenterology 155:47–57
McLean G, Lawrence M, Simpson R, Mercer SW (2017) Mindfulness-based reduction in Parkinson’s disease: a systematic review. BMJ Neurol 17:92
Morita M, Kondo A, LeVine P (1998) Morita therapy and the true nature of anxiety-based disorders (Shinkeishitsu). State University of New York Press, New York, Albany
Nagatsu T, Nagatsu I (2016) Tyrosine hydroxylase (TH), its cofactor tetrahydrobiopterin (BH4), other catecholamine-related enzymes, and their human genes in relation to the drug and gene therapies of Parkinson’s disease (PD): historical overview and future prospects. J Neural Transm 123:1255–1278
Nagatsu T, Levitt M, Udenfriend S (1964) Tyrosine hydroxylase: the initial step in norepinephrine biosynthesis. J Biol Chem 239:2910–2917
Nagatsu T, Nakashima A, Ichinose H, Kobayashi K (2019) Human tyrosine hydroxylase in Parkinson’s disease and related disorders. J Neural Transm 126:397–409
Nagy A, Schrag A (2019) Neuropsychiatric aspects of Parkinson’s disease. J Neural Transm 126:889–896
Nakamura K, Kitanishi K, Maruyama S, Ishiyama FI, Ito K, Tatematsu K (2010) Guidelines for practicing outpatient Morita therapy. Japanese Society for Morita Therapy, Tokyo
Ogawa B (2013) Desire for life: the practinoner’s introduction to Morita therapy for treatment of anxiety disorders. Xlibris Corporation, Indiana
Öst L-G (2014) The efficacy of acceptance and commitment therapy: an updated systematic review and meta-analysis. Behav Res Ther 61:105–121
Santangelo G, Piscopo F, Barone P, Vitale C (2017) Personality in Parkinson’s disease: clinical, behavioural and cognitive correlates. J Neurol Sci 374:17–25
Santangelo G, Garramone F, Baiano C, D’lorio A, Piscopo F, Raimo S, Vitale C (2018) Personality and Parkinson’s disease: a meta-analysis. Parkinsonism Relat Disord 49:67–74
Schrag A, Taddei RN (2017) Depression and anxiety in Parkinson’s disease. Int Rev Neurobiol 133:623–655
Serfaty M, King M, Nazareth I, Tookman A, Wood J, Gola A, Aspden T, Mannix K, Davis S, Moorey S, Jones L (2016) The clinical and cost effectiveness of cognitive behavioural therapy plus treatment as usual for the treatment of depression in advanced cancer (CanTalk): study protocol for a randomised controlled trial. Trials 17:113
Shinmei I, Kobayashi K, Oe Y, Takagishi Y, Kanie A, Ito M, Takebayashi Y, Murata M, Horikoshi M, Dobkin RD (2016) Cognitive behavioral therapy for depression in Japanese Parkinson’s disease patients: a pilot study. Neuropsychiatr Dis Treat 12:1319–1331
Sugg HV, Richards DA, Frost J (2016) Morita therapy for depression and anxiety (Morita Trial): study protocol for a pilot randomised controlled trial. Trials 24:161
Sugg HVR, Richards DA, Forst J (2018) Morita therapy for depression (Morita Trial): a pilot randomised control trial. BMJ Open 8(8):e021605
Swalwell C, Pachana NA, Dissanayaka NN (2018) Remote delivery of psychological interventions for Parkinson’s disease. Int Psychogeriatr 30:1783–1795
Taylor D, Meader N, Bird V, Pilling S, Creed F, Goldberg D, Pharmacology subgroup of the National Instutute for Health and Clinical Excellence Guideline Development Group for Depression in Chronic Physical Health Problems (2011) Pharmacological interventions for people with depression and chronic physical health problems: systematic review and meta-analyses of safety and efficacy. Brit J Psychiatry 198:179–188
Twohig MP, Levin ME (2017) Acceptance and Commitment Therapy as a treatment for anxiety and depression: a review. Psychiatr Clin North Am 40:751–770
Acknowledgements
This commentary is submitted for publication in the Special Issue of Journal of Neural Transmission to celebrate the 80th birthday of Prof. Dr. Moussa Youdim (Israel Institute of Technology) and his 50 years of excellent achievements on monoamine oxidase and on drug development based on his basic research. I first met with Dr. Moussa Youdim at Federation Meeting in Atlantic City in the USA in 1993, when we presented our discovery of TH. Since then, we kept our honorable friendship for over 50 years. Since my speciality is neurochemistry, I am not familiar with the progress being made in psychotherapy: CBT, AMT, and Morita Therapy. I have found many references on CBT and AMT and some references in international journals on Motrita Therapy, mainly in PubMed. I apologize many authors on CBT, AMT, and Morita Therapy research for not having been able to cite their manuscripts in this short commentary.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The author declares no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Nagatsu, T. Hypothesis: neural mechanism of psychotherapy for the treatment of Parkinson’s disease: cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and Morita therapy?. J Neural Transm 127, 273–276 (2020). https://doi.org/10.1007/s00702-019-02111-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00702-019-02111-y