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帕金森病中与多巴胺能药物相关的病理性赌博的相关因素。

Factors associated with dopaminergic drug-related pathological gambling in Parkinson disease.

作者信息

Voon Valerie, Thomsen Teri, Miyasaki Janis M, de Souza Minella, Shafro Ariel, Fox Susan H, Duff-Canning Sarah, Lang Anthony E, Zurowski Mateusz

机构信息

National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA.

出版信息

Arch Neurol. 2007 Feb;64(2):212-6. doi: 10.1001/archneur.64.2.212.

Abstract

OBJECTIVE

To evaluate factors associated with pathological gambling (PG) in Parkinson disease (PD).

DESIGN

Case-control study.

SETTING

Outpatient tertiary clinic. Patients Twenty-one patients with idiopathic PD with PG after the patients began receiving medications compared with a consecutive sample of 42 patients with idiopathic PD without compulsive behaviors.

MAIN OUTCOME MEASURES

Clinical features, comorbid psychiatric and substance use disorders, personality traits, and impulsivity scores.

RESULTS

Patients with PG had a younger age at PD onset (P = .006), higher novelty seeking (P<.001), medication-induced hypomania or mania (P = .001), impaired planning (P = .002), or a personal or immediate family history of alcohol use disorders (P = .002). Novelty seeking, a personal or immediate family history of alcohol use disorders, and younger age at PD onset accurately predicted PG at 83.7% in a logistic regression model, with the model accounting for 62% of the variance.

CONCLUSIONS

Patients with PD having a younger age at PD onset, higher novelty seeking traits, and a personal or family history of alcohol use disorders may have a greater risk for PG with dopamine agonists.

摘要

目的

评估帕金森病(PD)中与病理性赌博(PG)相关的因素。

设计

病例对照研究。

设置

门诊三级诊所。患者21例特发性PD患者在开始接受药物治疗后出现PG,与42例无强迫行为的特发性PD患者的连续样本进行比较。

主要观察指标

临床特征、共病精神和物质使用障碍、人格特质及冲动性评分。

结果

PG患者PD发病年龄较轻(P = 0.006),寻求新奇性较高(P<0.001),药物诱发的轻躁狂或躁狂(P = 0.001),计划能力受损(P = 0.002),或有个人或直系家族酒精使用障碍史(P = 0.002)。在逻辑回归模型中,寻求新奇性、个人或直系家族酒精使用障碍史以及PD发病年龄较轻可准确预测PG,准确率为83.7%,该模型解释了62%的方差。

结论

PD发病年龄较轻、寻求新奇性特质较高且有个人或家族酒精使用障碍史的患者使用多巴胺激动剂时发生PG的风险可能更高。

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