MENTAL HEALTH STANDARDS FOR PARKINSON'S DISEASE
:VIEWING THE box DIFFERENTLY
Physical wellness and mental wellness go hand in hand. If a person is physically strong, but mentally weak, then the body will soon follow and break down. If the body is weak and the mind is strong, then there is hope the body can be willed back to a healthier physical well-being. It is important to realize that the physical symptoms and disabilities caused by Parkinson’s disease can have a major impact on a patient's health and mental outlook.
Since Parkinson’s disease (PD) is a progressive disorder, the truth is, over time, virtually all patients will experience substantial cognitive decline. As the years progress, the signs and symptoms become more pronounced. According to Schrag (2004), patients with PD disturbances of mental state constitute some of the most difficult treatment challenges of advanced disease, often limiting effective treatment of motor symptoms and leading to increased disability and poor quality of life. As health professionals, we have a responsibility to provide the best health care possible. A holistic and interdisciplinary approach will give patients some tools to live a functioning life as long as the disease allows. Inter-collaborative health care is a positive path to utilize in providing positive results as it pertains to quality of life for PD patients. |
IMPORTANCE OF MENTAL HEALTH ASSESSMENT IN PARKINSON'S DISEASE
Parkinson's disease is not an easy illness to live with, and for that reason, emotions can become out of control — some patients might have a difficult time dealing with those feelings. That is why counseling should be an integral part of a treatment program for PD. A therapist or counselor will be able to guide people with Parkinson's through their wide range of emotions before they become impediments in treating PD or even start contributing to the symptoms. An evidence-based guideline from the American Academy of Neurology (AAN) reports that physician recognition of depression is low in Parkinson's disease, at less than 30% of clinically proven cases (Miyasaki, Shannon, Voon, Ravina, & Kleiner-Fisman, 2006). Screening Parkinson's disease patients for depression and treating it when present is paramount in providing an opportunity for a healthy and hopeful outlook. Screening tools such as the Beck Depression Inventory should given to PD patients at the onset of their diagnosis for Parkinson's disease. There are many factors that confound its diagnosis in these patients, and depression has the single largest effect on the quality of life of patients with Parkinson disease. As cited by Feeney, Egan, & Gasson (2005), most research on PD focuses on physical symptoms and pharmacological treatments. However, psychological effects that may include dementia, psychosis, depression, and anxiety, can be the most distressing and disabling. Feeney et. al also stated psychotherapy was effective in producing significant positive change in anxiety, depression, and hopelessness levels (2005).
INTERDISCIPLINARY CONSIDERATIONS
Medications are used to quell physical symptoms of PD and have been known to produce positive results. Mixing anti-depressants such as selective serotonin reuptake inhibitors (SSRIs) could make the PD medication less effective at best. Psychological and emotional issues stemming from PD are secondary, but in no way should be treated as such. However, positive results in a PD patient's physical health could translate into better self-efficacy. With that in mind, Feeney et. al (2005) suggests that due to the intense daily regimen of medications PD sufferers take, non-pharmacological treatment options such as psychotherapy should be considered to reduce the risk of negative interactions between various medications.
A study conducted by Ellis et al. (2011) shows self-efficacy, rather than disability, appears to be strongly associated with whether ambulatory people with PD exercise regularly. The results of the study suggest that physical therapists should include strategies to increase exercise self-efficacy when designing patient intervention programs for patients with PD. The results of the study showed that the PD participants with high self-efficacy were more than twice as likely to engage in regular exercise than those with low self-efficacy.
Treatment of psychological disorders should be carefully monitored and treated. Schreiber & Thompson suggest that collaborative models of depression care may be a promising approach to support the identification and effective treatment of those with PD also suffering from depressive disorders (2013). It is well established that depressive symptoms are very common in PD. it is important for all health professionals involved to be aware of the complexity of identifying depression and other psychological issues in Parkinson's Disease and the uncertainties surrounding its treatment.
A study conducted by Ellis et al. (2011) shows self-efficacy, rather than disability, appears to be strongly associated with whether ambulatory people with PD exercise regularly. The results of the study suggest that physical therapists should include strategies to increase exercise self-efficacy when designing patient intervention programs for patients with PD. The results of the study showed that the PD participants with high self-efficacy were more than twice as likely to engage in regular exercise than those with low self-efficacy.
Treatment of psychological disorders should be carefully monitored and treated. Schreiber & Thompson suggest that collaborative models of depression care may be a promising approach to support the identification and effective treatment of those with PD also suffering from depressive disorders (2013). It is well established that depressive symptoms are very common in PD. it is important for all health professionals involved to be aware of the complexity of identifying depression and other psychological issues in Parkinson's Disease and the uncertainties surrounding its treatment.