Dopaminergic medication administered to ameliorate motor symptoms of Parkinson's disease is associated with impulse control disorders, such as pathological gambling, hypersexuality, compulsive buying, and binge eating. Studies indicate a prevalence of impulse control disorders in Parkinson's disease of 6-16%.
To estimate the prevalence of impulsive and compulsive behaviors among Danish patients with Parkinson's disease and to explore the relation of such behavioral disorders to depression and personality.
490 patients with Parkinson's disease (303 males), identified through the National Danish Patient Registry, were evaluated with: 1) the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease; 2) the Geriatric Depression Scale; and 3) the NEO-Personality Inventory.
176 (35.9%) patients reported impulsive and compulsive behaviors sometime during Parkinson's disease (current symptoms in 73, 14.9%). Hereof, 114 (23.3%) reported multiple behavioral symptoms. Patients with behavioral symptoms were significantly younger, were younger at PD onset, had longer disease duration, displayed more motor symptoms, and received higher doses of dopaminergic medication than patients without behavioral symptoms. Furthermore, they reported significantly more depressive symptoms and scored significantly higher on neuroticism and lower on both agreeableness and conscientiousness than patients without behavioral symptoms.
A history of impulsive and compulsive behaviors are common in Danish patients with Parkinson's disease and have clinical correlates that may allow identification of patients at risk for developing these behaviors.
"Certain neurological disorders can cause an individual to act inappropriately and possibly cause hypersexuality as a result. Some of the most common examples are Alzheimer's Disease (sexual disinhibition due to the effects of the disease on the frontal and temporal lobes, with a prevalence of 4.3%–9.0% of patients ; Cooper et al., 2009; Callesen, Weintraub, Damholdt & Møller, 2014), Pick's Disease (impairs the regulation of socially acceptable behaviors) and Kleine-Levin Syndrome (causing hypersomnia, which can cause abnormal behavior such as hypersexuality) (Callesen et al., 2014; Cooper et al., 2009; Dhikav, Anand & Aggarwal, 2007; Gadoth, Kesler, Vainstein, Peled & Lavie, 2001; Mendez, Selwood, Mastri & Frey, 1993). In addition, certain types of medications or illicit drugs can also cause an increased sexual drive such as dopamine agonists used to treat Parkinson's disease or cocaine, GHB, and methamphetamine (Smith, 2007). "
[Show abstract][Hide abstract] ABSTRACT: Background and aims:
Compulsive sexual behavior (CSB) is a common disorder featuring repetitive, intrusive and distressing sexual thoughts, urges and behaviors that negatively affect many aspects of an individual's life. This article reviews the clinical characteristics of CSB, cognitive aspects of the behaviors, and treatment options.
We reviewed the literature regarding the clinical aspects of CSB and treatment approaches.
The literature review of the clinical aspects of CSB demonstrates that there is likely a substantial heterogeneity within the disorder. In addition, the treatment literature lacks sufficient evidence-based approaches to develop a clear treatment algorithm.
Although discussed in the psychological literature for years, CSB continues to defy easy categorization within mental health. Further research needs to be completed to understand where CSB falls within the psychiatric nosology.
"Behaviourally the young onset patients are quite different (Schrag et al., 2003). These different behavioural profiles inevitably call for different pharmacological management and it requires careful judgement on behalf of the neurologist to match treatment to persona (Callesen et al., 2014). "
"For example, research has shown that depression in PD can result from reduction of dopamine levels in the brain (Thobois et al., 2010). This is contrasted from ICDs, which is often associated with increased dopamine levels, due mostly to the administration of dopamine agonist therapy (Voon et al., 2007), but also see Callesen et al. (2013b) for evidence of association of impulsivity and depression in PD. It is debated whether depression is caused by motor abnormalities or other neuropathology in PD. "
[Show abstract][Hide abstract] ABSTRACT: Parkinson's disease (PD) is a neurological disorder, associated with rigidity, bradykinesia, and resting tremor, among other motor symptoms. In addition, patients with PD also show cognitive and psychiatric dysfunction, including dementia, mild cognitive impairment (MCI), depression, hallucinations, among others. Interestingly, the occurrence of these symptoms-motor, cognitive, and psychiatric-vary among individuals, such that a subgroup of PD patients might show some of the symptoms, but another subgroup does not. This has prompted neurologists and scientists to subtype PD patients depending on the severity of symptoms they show. Neural studies have also mapped different motor, cognitive, and psychiatric symptoms in PD to different brain networks. In this review, we discuss the neural and behavioral substrates of most common subtypes of PD patients, that are related to the occurrence of: (a) resting tremor (vs. nontremor-dominant); (b) MCI; (c) dementia; (d) impulse control disorders (ICD); (e) depression; and/or (f) hallucinations. We end by discussing the relationship among subtypes of PD subgroups, and the relationship among motor, cognitive, psychiatric factors in PD.
Frontiers in Systems Neuroscience 12/2013; 7:117. DOI:10.3389/fnsys.2013.00117
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