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帕金森病患者赌博、购物、饮食或性行为方面新出现的兴趣增加或冲动行为:多巴胺激动剂治疗及运动症状起病年龄的作用

New onset heightened interest or drive for gambling, shopping, eating or sexual activity in patients with Parkinson's disease: the role of dopamine agonist treatment and age at motor symptoms onset.

作者信息

Giladi Nir, Weitzman Nina, Schreiber Shaul, Shabtai Herzel, Peretz Chava

机构信息

Movement Disorders Unit and Parkinson Centre, Department of Neurology, Tel-Aviv Sourasky Medical Centre, Tel-Aviv, Israel.

出版信息

J Psychopharmacol. 2007 Jul;21(5):501-6. doi: 10.1177/0269881106073109. Epub 2007 Apr 19.

Abstract

Alterations of impulse control that have recently been associated with Parkinson's disease (PD) are serious behavioural disturbances with significant impact on PD patients and their families.A total of 193 consecutive PD patients with no history of psychiatric illness and 190 age/gender-matched healthy controls were queried on the presence of new onset heightened interest or drive for gambling, shopping, eating or sexual activity (GSES). Clinical data were retrieved from medical charts and interviews. logistic regressions models assessed risk factors for these specific troublesome behaviours. New or heightened interests or drives for GSES behaviours were reported by 27 patients (14% vs 0% for controls). Younger age at PD motor symptoms onset (OR = 0.99, p = 0.0172), male gender (OR = 1.10, p = 0.0576) and longer duration of treatment with dopamine agonists (DAs)(OR = 1.18, >/=6 years versus never treated, p = 0.0459) contributed additively to the risk of developing one or more of these behavioural features. New onset heightened interests or drives for GSES are not rare behavioural disturbances among patients with PD. Age, gender and duration of treatment with DAs have an independent and additive effect on the risk to develop such behavioural changes. Patients should be informed about potential treatment-associated behavioural changes.

摘要

最近与帕金森病(PD)相关的冲动控制改变是严重的行为障碍,对PD患者及其家庭有重大影响。对193例无精神疾病史的连续PD患者和190例年龄/性别匹配的健康对照者询问是否存在新出现的对赌博、购物、饮食或性活动的兴趣增加或冲动(GSES)。从病历和访谈中检索临床数据。逻辑回归模型评估这些特定麻烦行为的危险因素。27例患者报告有新的或增强的对GSES行为的兴趣或冲动(对照组为14%对0%)。PD运动症状发病时年龄较小(OR = 0.99,p = 0.0172)、男性(OR = 1.10,p = 0.0576)和多巴胺激动剂(DAs)治疗时间较长(OR = 1.18,≥6年与未治疗相比,p = 0.0459)对出现一种或多种这些行为特征的风险有累加作用。新出现的对GSES的兴趣增加或冲动在PD患者中并非罕见的行为障碍。年龄、性别和DAs治疗时间对出现此类行为改变的风险有独立的累加作用。应告知患者潜在的与治疗相关的行为改变。

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