Mental health and Parkinson's disease: from the cradle to the grave.

IntrOductIOn With advances seen in medical imaging (for example, functional magnetic resonance imaging), and development of new drugs and breakthroughs in molecular medicine (for example, neuroprotective agents for Parkinson’s disease [PD]), many clinicians may become caught up in the idea that PD is merely a movement disorder with motor symptoms only. However, research has shown that patients with PD suffer from non-motor symptoms (including mental comorbidities), just as they do from motor symptoms. This article sheds light on mental health and PD; it provides a concise background on issues related to mental welfare from pre-diagnosis to the end of life. PD is a neuropsychiatric disorder characterised by motor symptoms, postural instability as well as non-motor symptoms. Non-motor symptoms are usually categorised into sensory, autonomic, cognitive–behavioural, and sleep-related symptoms.1 Of these, cognitive–behavioural symptoms are of special importance, due to their insidious onset, relative difficulty in diagnosis and treatment, and significant impact on both patients with PD and their caregivers. Mental health care in patients with PD should be a continuum of care from prediagnosis through to the patient’s last days, and extending further to their caregivers. However, research into PD-related cognitive– behavioural comorbidities as well as appropriate evidence-based mental health care in patients with PD has been fairly limited to date; and new research has not yet been assembled for proper clinical use and discussion. This article explores recent published research in the field of mental health and PD in a chronological sequence; from pre-diagnosis through to death as well as the ongoing effects on caregivers.