I enjoyed reading the special communication article in the June issue titled “Soul Sickness: A Frequently Missed Diagnosis,” by Charles R. Perakis, DO.
1 Dr Perakis
1 emphasizes the importance of an attentive caring physician. “Doctor” in Latin means
teacher, derived from
docere, meaning
to teach.
2 Webster's New Twentieth Century Dictionary3 defines physician as “any person or thing that heals, relieves, or comforts.” Hope is vital for life, and the following statements expressed by Dr Perakis
1 are appropriate:
However, the type of patient discussed by Dr Perakis
1 has signs and symptoms of serious mood disorder, and I believe that the following description by Dr Perakis
1 is misleading:
Unipolar depression is one of the two most disabling medical conditions in the world, and it is associated with serious medical comorbidities and potential suicide.
4–6 In addition, organic brain changes associated with mood disorder compromise many bodily functions, such as sleep, appetite, and cognition (eg, concentration, learning, memory).
7,8
Although Dr Perakis
1 is well-meaning, he seems to downplay the need for a comprehensive diagnosis in such conditions:
There is a need to perform a comprehensive differential diagnosis in order to maintain objectivity regarding the patient's disease process. The physician should not take the risk that the patient has an undiagnosed destructive disease.
While a student at Kirksville College of Osteopathic Medicine-A.T. Still University in Missouri, I admired the clinical skill of the chairman of the osteopathic manipulative medicine department, Ira C. Rumney, DO, who humorously but wisely said, “DO means dig on.”