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A Single-Center, Cross-Sectional Prevalence Study of Impulse Control Disorders in Parkinson Disease: Association With Dopaminergic Drugs

Poletti, Michele PsyD*; Logi, Chiara MD; Lucetti, Claudio MD; Del Dotto, Paolo MD; Baldacci, Filippo MD*; Vergallo, Andrea MD; Ulivi, Martina MD; Del Sarto, Simone PhD; Rossi, Giuseppe PhD; Ceravolo, Roberto MD*; Bonuccelli, Ubaldo MD*

Journal of Clinical Psychopharmacology: October 2013 - Volume 33 - Issue 5 - p 691–694
doi: 10.1097/JCP.0b013e3182979830
Brief Reports

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 disease-related 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], 2.60–12.46; P < 0.0001) and levodopa (OR, 2.43; 95% CI, 1.06–6.35; P = 0.034). Impulse control disorders frequency was similar for pramipexole and ropinirole (16.6% vs 12.5%; OR, 1.45; 95% CI, 0.79–2.74; 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.

From the *Department of Neuroscience, University of Pisa, Pisa; †Neurology Unit, Hospital of Viareggio, USL 12 Toscana; and ‡Unit of Epidemiology and Biostatistics, Institute of Clinical Physiology, National Research Council, Pisa, Italy.

Received May 27, 2012; accepted after revision October 26, 2012.

Reprints: Ubaldo Bonuccelli, MD, Department of Neuroscience, University of Pisa, Italy (e-mail: u.bonuccelli@med.unipi.it).

© 2013 by Lippincott Williams & Wilkins.