BACKGROUND Individuals with Parkinson's disease (PD) and their caregivers are at risk for emotional distress and hypercortisolism. Expressive writing is an effective complementary intervention to ameliorate the psychological and physiological effects of chronic illness. This pilot study aimed to evaluate feasibility and preliminary effectiveness of an expressive writing intervention for individuals with PD and their caregivers. METHODS Individuals with PD (N = 27) and their caregivers (N = 14) were randomly assigned to expressive (N = 15 patients, eight caregivers) or neutral (N = 12 patients, six caregivers) writing conditions. Cortisol awakening response (CAR), non-motor functioning, quality of life, and performance on tests of cognitive functioning were assessed at baseline, immediate post, 4-month, and 10-month post intervention. RESULTS Attrition was a challenge as eight patients (29.62 %) and four caregivers (28.57 %) chose to discontinue before beginning the intervention or were lost to follow up prior to completing the intervention or the first follow up visit. Significant reduction in anxiety, marginally significant improvement in depression and caregiver burden, and significant improvements in performance on tests of learning and memory were observed, but these changes did not differ by writing condition. CAR significantly differed over time between patients and caregivers and writing conditions. CONCLUSIONS Some evidence for the feasibility and effectiveness of writing to alleviate hypercortisolism was demonstrated in a small sample of PD patients; however, relatively high attrition rates and the lack of difference between expressive and neutral writing conditions on emotional and neurocognitive outcomes suggests expressive writing procedure modifications may be needed to obtain optimal results for this population. TRIAL REGISTRATION ClinicalTrials.gov, NCT02217735 , Study Start Date: August 30, 2011.

中文翻译：

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帕金森氏病患者及其看护者的随机对照表达性写作试点。

背景技术患有帕金森氏病（PD）的人及其照料者处于情绪困扰和皮质醇过多症的风险中。富有表现力的写作是改善慢性疾病的心理和生理影响的有效补充干预。这项初步研究旨在评估针对PD患者及其照顾者的表达性写作干预措施的可行性和初步有效性。方法将PD（N = 27）及其护理者（N = 14）的患者随机分配为表现性（N = 15例患者，八名护理者）或中性（N = 12例患者，六名护理者）书写条件。在基线，干预后即刻，4个月和10个月后评估皮质醇苏醒反应（CAR），非运动功能，生活质量以及认知功能测试的表现。结果减员是一项挑战，因为八名患者（29.62％）和四名护理人员（28.57％）选择在开始干预之前停药，或者在完成干预或第一次随访后失去随访。观察到焦虑显着降低，抑郁和照顾者负担显着改善，学习和记忆测试的性能显着改善，但是这些变化在写作条件上没有差异。在患者，护理人员和写作条件之间，CAR随时间变化显着。结论在一小部分PD患者中证明了一些书面文字减轻皮质醇过多症的可行性和有效性的证据。然而，相对较高的流失率以及情感和神经认知结果的表达和中性写作条件之间没有差异，这表明可能需要对表达写作程序进行修改才能获得该人群的最佳结果。试验注册ClinicalTrials.gov，NCT02217735，研究开始日期：2011年8月30日。