Impulse control disorders and depression in Finnish patients with Parkinson's disease

Joutsa, Juho; Martikainen, Kirsti; Vahlberg, Tero; Voon, Valerie; Kaasinen, Valtteri

doi:10.1016/j.parkreldis.2011.09.007

« Previous Next »Parkinsonism & Related Disorders
Volume 18, Issue 2 , Pages 155-160, February 2012

Impulse control disorders and depression in Finnish patients with Parkinson's disease

Juho Joutsa
- Department of Neurology, University of Turku and Turku University Hospital, Finland
- Turku PET Centre, University of Turku and Turku University Hospital, Finland
- Turku Graduate School of Biomedical Sciences, University of Turku, Finland
- Corresponding author. Turku PET Centre c/o Turku University Hospital, P.O. Box 52, Kiinamyllynkatu 4-8, FIN-20521 Turku, Finland. Tel.: +358 2 3131879; fax: +358 2 2318191.
Kirsti Martikainen
- The Finnish Parkinson Association and the Finnish Parkinson Foundation, Turku, Finland
Tero Vahlberg
- Department of Biostatistics, University of Turku, Finland
Valerie Voon
- Behavioural and Clinical Neurosciences Institute, Cambridge University, Cambridge, UK
Valtteri Kaasinen
- Department of Neurology, University of Turku and Turku University Hospital, Finland
- Turku PET Centre, University of Turku and Turku University Hospital, Finland

Received 31 May 2011; received in revised form 16 July 2011; accepted 6 September 2011. published online 10 October 2011.

Abstract

Introduction

Impulse control disorders occur frequently in patients with Parkinson's disease. However, the frequencies have been investigated mainly in patients from secondary or tertiary care centers, and thus, the prevalence rates in general community are not known.

Objective

Our objective was to study the prevalence rates of impulse control disorders and related factors in a large, non-selected sample of Parkinson's disease patients.

Methods

We conducted a cross-sectional survey among Parkinson's disease patients from Finnish Parkinson Association [n = 575; 365 men, 240 women, median age 64 (range 43–90) years]. Problem and pathological gambling were estimated with the South Oaks Gambling Screen, risk for impulse control disorders with the validated Questionnaire for Impulsive–Compulsive Disorders in Parkinson's Disease, and depression with the Beck Depression Inventory.

Results

The frequency of pathological gambling was 7.0%. The overall frequency of a positive screen for an impulse control disorder was 34.8%, and 12.5% of the patients screened positive for multiple disorders. Depressive symptoms were statistically the most important factor in explaining variance in impulse control disorder risk, even more than sex, age, age of disease onset, alcohol use, or medication.

Conclusions

The high proportion of patients screened positive for impulse control disorders in a non-selected sample emphasize the importance of routine screening of these disorders in Parkinson's disease. Pathological gambling prevalence in Parkinson's disease is seven times higher than in the general population in Finland. The results underline the importance of depression in impulse control disorders associated with Parkinson's disease.

Keywords: Parkinson's disease, QUIP, SOGS, BDI, Depression