A Single-Center, Cross-Sectional Prevalence Study of Impulse Control Disorders in Parkinson Disease

Abstract

The current study aimed at establishing the prevalence of impulse control disorders (ICDs) in patients with Parkinson disease (PD) and their association with demographic, drug-related, and diseaserelated characteristics. We performed a single-center cross-sectional study of 805 PD patients. Impulse control disorders were investigated with the Questionnaire for Impulsive Compulsive Disorders in Parkinson's Disease; also comorbid neuropsychiatric complications (dementia, delusions, visual hallucinations) were investigated with clinical interviews and ad hoc instruments (Parkinson Psychosis Questionnaire and Neuropsychiatry Inventory). Impulse control disorders were identified in 65 patients (prevalence, 8.1%), with pathological gambling and hypersexuality the most frequent. Impulse control disorders were present in 57 of 593 cognitively preserved patients (prevalence, 9.6%) and in 8 of 212 demented patients (prevalence, 3.8%). Impulse control disorders were significantly associated with dopamine agonists (odds ratio [OR], 5.50; 95% confidence interval [CI], 2.60Y12.46; P G 0.0001) and levodopa (OR, 2.43; 95% CI, 1.06Y6.35; P = 0.034). Impulse control disorders frequency was similar for pramipexole and ropinirole (16.6% vs 12.5%; OR, 1.45; 95% CI, 0.79Y2.74; P = 0.227). Additional variables associated with ICDs were male sex and younger age. These findings suggested that dopaminergic treatments in PD are associated with increased odds of having an ICD, but also other demographic and clinical variables are associated with ICDs, suggesting the multifactorial nature of the ICD phenomenon in PD.

Treatment of Cognitive, Psychiatric, and Affective Disorders Associated with Parkinson's Disease

“…Worsening of PD motor symptoms may develop while tapering the dopamine agonist, and simultaneous titration of levodopa may help to alleviate this, although levodopa use has also been associated with ICDs [139]. Involvement of caregivers, family, and friends to limit the patients' access to money, internet websites, food, casinos, etc., may be necessary.…”

The prevalence and clinical characteristics of hypersexuality in patients with Parkinson's disease following dopaminergic therapy: A systematic literature review

“…In the Scandinavian surveys [26,27] and the large single-centre study conducted in Italy [31] and Mexico [32], the frequency of ICDs was assessed using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP), a self-administered screening questionnaire for ICDs and other compulsive behaviours in PD [33]. In the two single-centre studies, the QUIP was complemented by diagnostic interviews [31,32].…”

Impulse control disorders in Parkinson’s disease: Predominant role of psychological determinants

“…This added stressor multiplies the complexity of living with PD and has been found to have a significant detrimental effect on people's quality of life (Phu et al, 2014). Although ICDs are commonly under reported (Vilas, Pont-Sunyer, & Tolosa, 2011), it is estimated that between 10 and 14% of people with PD have ICDs (Giladi et al, 2007;Poletti et al, 2013;Weintraub, Potenza, Siderowf, & Voon, 2010), compared to between 1 and 8% within the general population (Dell'Osso, Altamura, Allen, Marazziti, & Hollander, 2006). Where explicit comparisons have been made between people with PD and matched controls, ICDs are around twice as common in Parkinson's patients than in controls (Rodriguez-Violante, Gonzalez-Latapi, Cervantes-Arriaga, Camacho-Ordonez, & Weintraub, 2015), although the difference can be even greater (Perez-Lloret, Rey, Fabre, Ory, Spampinato, Brefel-Courbon, Montastruc, & Rascol, 2012).…”