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Sociopsychological Obstacles to L‐Dopa Therapy That May Limit Effectiveness in Parkinsonism
Author(s) -
HYMAN MARTIN D.
Publication year - 1972
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1972.tb00799.x
Subject(s) - medicine , pessimism , social isolation , disease , parkinsonism , isolation (microbiology) , social functioning , psychiatry , chronic disease , intensive care medicine , bioinformatics , philosophy , epistemology , biology
Chronic illness produces changes in patients' self‐conceptions and social relationships which may impair their level of functioning. L‐dopa therapy is particularly relevant to patients ill for some time with a disease believed by themselves and their associates to be chronic. In parkinsonian patients, therefore, the effect of L‐dopa on their level of functioning, as distinct from their symptoms, is likely to be inhibited by some of the social and psychological concomitants of chronic illness. The literature on these concomitants and on recovery from chronic illness indicates that functional recovery will be impeded if: 1) the patient considers himself to be impaired, devalued and stigmatized, and 2) his social environment is characterized by extreme social isolation or cohesion, a pessimistic prognosis on the part of others, or an illness‐induced family restructuring which the relatives are loath to reverse.