Parkinson's disease: a journey
BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7466.0-h (Published 09 September 2004) Cite this as: BMJ 2004;329:0-h
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The front cover of the current BMJ features a headline
thus:"Treatment of early Parkinson's disease" and above it is a photograph
of that towering and very tragic hero Muhammad Ali. There are two more
pictures of him inside, each one also associating him with the idiopathic
degenerative condition known as Parkinson's disease.
Muhammad Ali has certainly suffered from the parkinsonian syndrome
since his early thirties when he was the most famous heavy weight boxer in
the world. His affliction however is not Parkinson's disease but
Parkinson's syndrome, one of the commoner features of post-boxing
traumatic encephalopathy (or the punch-drunk syndrome), caused by
destruction of nuclei in the upper brain stem by repeated heavy blows to
the head. The pro-boxing lobby, always anxious to assure the world that
Muhammad Ali's condition is nothing to do with boxing, seems to have
convinced the BMJ too....
Competing interests:
None declared
Competing interests: No competing interests
Parkinson's disease: the role of psychiatrists is ignored.
Sir:
The chronic diseases such as diabetes mellitus, cardiovascular
disorders, cancers, and HIV/AIDS are well defined medical illustrations of
body and mind connection. Parkinson's disease is another example of this
sort. Surprisingly, the theme of this years World Mental Health Day to be
celebrated worldwide on October 10, 2004 is "the relationship between
physical and mental health: co-occurring disorders".
In the context of this neurodegenerative disease, a variety of
psychiatric disorders and non-motor symptoms are reported to comorbid with
Parkinson's disease (PD), which are depression, anxiety, fatigue,
nocturnal insomnia, diurnal excessive sleep, psychosis, visual
hallucinations, paranoid ideations, schizophrenia and dementia and these
disorders and behavioral symptoms have devastating impact on the quality
of life of patients with PD. Besides psychologists, psychiatrists have a
definite and very important role in the management of patients with PD
and, unfortunately none of the contributors (1-5) to this beautifully
written journey of PD patients has realized the potential therapeutic role
of mental health professionals in particular psychiatrists.
Finally, health consists of physical, psychological, social,
spiritual and economic well being and it is not merely an absence of
disease. It is advisable that the future reviews to be published in BMJ on
chronic diseases and their journeys should embrace all these concepts in
their descriptions.
References:
1. Kamran Abbasi . Parkinson's disease: a journey. BMJ 2004; 329: 0-h
2. Yoav Ben-Shlomo and Kailash Bhatia. Using monoamine oxidase type B
inhibitors in Parkinson's disease.
BMJ 2004 329: 581-582.
3. Peter Lapsley and Trish Groves. The patient's journey: travelling
through life with a chronic illness. BMJ 2004 329: 582-583.
4. Natalie J Ives, Rebecca L Stowe, Joanna Marro, Carl Counsell,
Angus Macleod, Carl E Clarke, Richard Gray, and Keith Wheatley. Monoamine
oxidase type B inhibitors in early Parkinson's disease: meta-analysis of
17 randomised trials involving 3525 patients. BMJ 2004 329: 593-0.
5. Mary G Baker and Lizzie Graham. The journey: Parkinson's disease.
BMJ 2004 329: 611-614.
Competing interests:
None declared
Competing interests: No competing interests