A Novel Approach for Investigating Parkinson's Disease Personality and Its Association With Clinical and Psychological Aspects.

Laura Carelli,Claudia Morelli,Francesca Mancini,Andrea Ciammola,Barbara Poletti,Federica Solca,Jacopo Pasquini,Silvia Torre,Vincenzo Silani,Rita Pezzati

doi:10.3389/fpsyg.2019.02265

Abstract

ObjectiveA complex relationship between neuropsychiatric symptoms, personality traits and neurochemical changes in patients with Parkinson’s disease (PD) has been highlighted in the past several decades. In particular, a specific Parkinson personality with obsessive traits has been described. However, despite the great amount of anecdotal evidence, this aspect, together with its neurobiological, psychological and clinical correlates, are still not clearly defined. Therefore, we performed a case-control study in order to investigate the presence and rate of obsessive personality traits in PD patients within the theoretical framework of cognitive-constructivist model. Moreover, the relationship between PD personality and clinical, psychological and quality of life (QoL) aspects in PD were investigated.MethodsFifty-one non-demented patients with probable or possible PD (not demented) were recruited at the inpatient-outpatient San Luca Hospital, IRCCS Istituto Auxologico Italiano. Control group was composed by forty-eight age- and education-matched healthy volunteers. Patients underwent a neurological investigation including Unified PD Rating Scale (UPDRS), Modified Hoehn and Yahr and Schwab and England staging scales. The following psychological questionnaires were administered to the overall sample: Personal Meaning Questionnaire (PMQ), State-Trait Anxiety Inventory-Form Y (STAI-Y), Beck Depression Inventory (BDI), Symptom Check List-90 (SCL-90), Short-Form Health Survey-36 (SF-36).ResultsNo significant differences in personality styles were observed in PD patients and controls, with a prevalence of phobic personal meaning organization (PMO) in both groups. However, PD patients showed more anxiety, depression and obsessive-compulsive (OC) symptoms than controls at the psychological questionnaires, as well as poorer QoL levels. The intensity of personality traits, and in particular for the obsessive personality style, were negatively associated with QoL and positively with disease severity. No significant relationships were observed between personality and other clinical aspects, such as side of onset and disease duration.ConclusionParkinson’s disease patients did not show a different personality profile according to the cognitive-constructivist model with respect to controls. However, in this population, a general enhancement in the tendency to codify experience by means of specific cognitive and emotional patterns was associated to disease progression and to a poorer QoL.

Highlights

Parkinson’s disease (PD) is a chronic neurodegenerative disorder involving both motor and non-motor manifestations
In addition to cognitive impairment and sleep disorders, patients with PD often present with neuropsychiatric symptoms such as depression, anxiety, apathy and impulse control disorders (ICDs) as common non-motor symptoms
In the present case-control study, we aim to investigate the following aspects: the presence of higher rates, and higher prevalence, of obsessive personality traits in a sample of PD patients compared to age- and education-matched healthy controls; the possible association of obsessive personality traits with PD clinical factors; the relationship between personality traits and psychological symptoms commonly observed in PD such as depression, anxiety and OC symptoms; the impact of personality traits on patients’ quality of life (QoL)

Summary

Introduction

Parkinson’s disease (PD) is a chronic neurodegenerative disorder involving both motor and non-motor manifestations. In addition to cognitive impairment and sleep disorders, patients with PD often present with neuropsychiatric symptoms such as depression, anxiety, apathy and impulse control disorders (ICDs) as common non-motor symptoms. ICD and apathy respectively represent hyperand hypo-dopaminergic symptoms and they are both influenced by the introduction of dopaminergic drugs (Sierra et al, 2015). Together with such aspects, a higher incidence of obsessivecompulsive (OC) symptoms has been recorded in PD, with heterogeneous results (Maia et al, 2003; Harbishettar et al, 2005; Kummer et al, 2009; Sharp et al, 2015). A relationship between OC symptoms and lateralization of motor symptoms in PD patients has been detected (Kummer and Teixeira, 2009b)

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