Background Parkinson's disease (PD) is often associated with depression and anxiety. The availability of evidence-based psychological interventions is low. Objective This pilot study investigates the feasibility and preliminary effect of internet-based cognitive behavioral therapy (ICBT) for depression and anxiety in PD. Methods 9 patients with PD with comorbid symptoms on the relevant subscale of Hospital Anxiety and Depression Scale (HADS), of either depression (HADS-D>7) or anxiety (HADS-A>7) received 12weeks of ICBT, specially adapted for depression and anxiety in PD. Primary outcome was change in depression and anxiety symptoms, measured with HADS total score. Effects on non-motor symptoms, PD specific health and quality of life and insomnia were explored, plus the participant's involvement, satisfaction, and subjective evaluation of the treatment. Results Participants reported lower symptoms on HADS after ICBT (Cohen's d =0.79, p<0.05). However, levels of inactivity were rather high and questionnaires and comments from participants suggested that the treatment can be improved, for example by adding more therapist support. Conclusions The results suggest that ICBT could be a feasible way to alleviate depression and anxiety in PD. However, a somewhat simplified treatment and different ways to provide support to enhance adherence and outcome are warranted. 
Internet-based cognitive behavioral therapy for depression and anxiety in Parkinson's disease — A pilot study