Parkinson and Movement Disorders Unit, IRCCS Hospital San Camillo, Venice, and Department of Neurosciences (DNS), Padova University, Padova, Italy
University of Salerno, Fisciano, Italy.
J Neurol Neurosurg Psychiatry. 2017 Apr;88(4):317-324. doi: 10.1136/jnnp-2016-315277.
Impulse control disorders/other compulsive behaviours ('ICD behaviours') occur in Parkinson's disease (PD), but prospective studies are scarce, and prevalence and clinical characteristics of patients are insufficiently defined.
To assess the presence of ICD behaviours over a 2-year period, and evaluate patients' clinical characteristics.
A prospective, non-interventional, multicentre study (ICARUS (Impulse Control disorders And the association of neuRopsychiatric symptoms, cognition and qUality of life in ParkinSon disease); SP0990) in treated Italian PD outpatients. Study visits: baseline, year 1, year 2. Surrogate primary variable: presence of ICD behaviours and five ICD subtypes assessed by modified Minnesota Impulsive Disorder Interview (mMIDI).
1069/1095 (97.6%) patients comprised the Full Analysis Set. Point prevalence of ICD behaviours (mMIDI; primary analysis) was stable across visits: 28.6% (306/1069) at baseline, 29.3% (292/995) at year 1, 26.5% (245/925) at year 2. The most prevalent subtype was compulsive eating, followed by punding, compulsive sexual behaviour, gambling and buying disorder. Patients who were ICD positive at baseline were more likely to be male, younger, younger at PD onset, have longer disease duration, more severe non-motor symptoms (including mood and sexual function), depressive symptoms, sleep impairment and poorer PD-related quality of life. However, they did not differ from the ICD-negative patients in their severity of PD functional disability, motor performance and cognitive function.
Prevalence of ICD behaviours was relatively stable across the 2-year observational period. ICD-positive patients had more severe depression, poorer sleep quality and reduced quality of life.
冲动控制障碍/其他强迫行为（“ICD 行为”）在帕金森病（PD）中较为常见，但前瞻性研究较为匮乏，患者的患病率及临床特征尚不清楚。
评估 PD 患者在 2 年内 ICD 行为的发生情况，并评估患者的临床特征。
这是一项前瞻性、非干预性、多中心研究（ICARUS（冲动控制障碍及神经精神症状、认知与帕金森病患者生活质量的相关性研究）；SP0990），纳入意大利 PD 门诊患者。研究访视时间点：基线、第 1 年、第 2 年。替代主要变量：使用改良明尼苏达冲动障碍访谈表（mMIDI）评估的 ICD 行为及 5 种 ICD 亚型的存在。
共 1069/1095 例（97.6%）患者纳入全分析集。通过 mMIDI（主要分析）评估，ICD 行为的时点患病率在各访视点保持稳定：基线时为 28.6%（306/1069），第 1 年时为 29.3%（292/995），第 2 年时为 26.5%（245/925）。最常见的亚型为强迫性进食，其次为冲动性掷币行为、强迫性性行为、赌博障碍和购物障碍。基线时 ICD 阳性的患者更可能为男性、更年轻、PD 发病年龄更小、病程更长、更严重的非运动症状（包括情绪和性功能障碍）、抑郁症状、睡眠障碍和较差的 PD 相关生活质量。然而，与 ICD 阴性患者相比，他们的 PD 功能残疾、运动表现和认知功能并无差异。
在 2 年的观察期内，ICD 行为的患病率相对稳定。ICD 阳性患者的抑郁程度更严重，睡眠质量更差，生活质量更低。
