Abstract
Background: Impulse control and related disorders (ICRDs) have gained recognition as a severe complication of Parkinson's disease (PD) and are connected to poor quality of life and devastating financial and social problems. This study aimed to evaluate the usefulness of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP) and estimate the risk factors for ICRDs in Chinese patients with PD.Methods: 207 PD patients were assessed using the QUIP and evaluated for PD motor and nonmotor symptoms. ICRDs were diagnosed via interviews of patients or their caregivers, and the clinical characteristics of patients with and without ICRDs were compared.Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the C-QUIP were 95.0, 83.4, 38.0, 99.4, and 84.5%. The prevalence of each disorder among participants diagnosed via interview was pathological gambling (0.5%), hypersexuality (1.9%), compulsive shopping (1.0%), binge eating (3.9%), hobbyism (1.9%), punding (0.5%), walkabout (0.5%), and dopamine dysregulation syndrome (2.9%). PD patients with ICRDs had longer PD duration, higher Hoehn and Yahr stage, Non-Motor Symptoms Scale (NMSS), and Hamilton-Depression Rating Scale (HAMD). Also, they received a larger total daily levodopa equivalent dose (LED), levodopa dosage, and dopamine agonist only LED (DA-LED) than did PD patients without ICRDs.Conclusions: Given its psychometric properties, the C-QUIP is a valid and rapid screening instrument for assessing of ICRDs in PD patients. Higher Hoehn and Yahr staging, NMSS and HAMD scores, a larger mean LED and levodopa dosage are risk factors for ICRDs.
Highlights
In addition to its characteristic motor signs and symptoms, Parkinson’s disease (PD), a common degenerative neurological disorder, has many non-motor signs and symptoms, olfactory dysfunction, constipation, depression, apathy, rapid-eyemovement sleep behavior disorder, and sleep disturbances
Among the 207 patients, 24.2% screened positive on the C-Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP), but only 9.7% were diagnosed eventually with impulse control and related disorders (ICRDs)
5.3% of the patients screened positive for compulsive gambling, but only one person met the diagnostic criteria, and 2.9% had more than one type of ICRDs (Table 1)
Summary
In addition to its characteristic motor signs and symptoms, Parkinson’s disease (PD), a common degenerative neurological disorder, has many non-motor signs and symptoms, olfactory dysfunction, constipation, depression, apathy, rapid-eyemovement sleep behavior disorder, and sleep disturbances. Impulse control disorders (ICDs) involve repetitive, excessive, and compulsive behaviors driven by intense desire [1]. As the presence of ICDs in PD has received increasing attention, its clinical symptom spectrum has expanded to include impulse control and related disorders (ICRDs), dopamine dysregulation syndrome (DDS), hobbyism, and punding. These behaviors are linked by their repetitive nature based on incentives or rewards [2]. Impulse control and related disorders (ICRDs) have gained recognition as a severe complication of Parkinson’s disease (PD) and are connected to poor quality of life and devastating financial and social problems. This study aimed to evaluate the usefulness of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP) and estimate the risk factors for ICRDs in Chinese patients with PD
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