Background 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.
Objectives To assess the presence of ICD behaviours over a 2-year period, and evaluate patients’ clinical characteristics.
Methods 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).
Results 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.
Conclusions 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.
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Contributors AA: research project conception, organisation, and execution; review and critique of statistical analysis; review and critique of manuscript. PB: research project conception, review and critique of statistical analysis, review and critique of manuscript. UB: research project conception and execution; review and critique of statistical analysis, review and critique of manuscript. KA: research project conception, organisation, and execution; review and critique of statistical analysis; review and critique of manuscript. MA: research project conception, organisation, and execution; review and critique of statistical analysis, review and critique of manuscript. PS: research project conception and execution, review and critique of statistical analysis, review and critique of manuscript.
Funding This study was supported by UCB Pharma, Monheim am Rhein, Germany.
Competing interests AA, PB, UB and PS were study investigators on this UCB Pharma sponsored study. AA has received consultancy fees/honoraria from AbbVie, UCB Pharma, Zambon, Angelini, Lundbeck, Mundipharma and Medtronic; has served on advisory boards for AbbVie and Acadia, provided expert testimony for Boehringer Ingelheim (pathological gambling cases); and received grants from Neureca Foundation, Gossweiler Foundation, Mundipharma, Italian National Research (project no RF-2009-1530177, RF- 2010-2319551) and Horizon2020 (project no 643706). PB has received personal fees from Acorda, Union Chimique Belge and Zambon, and grants from AbbVie, Biotie and Zambon. UB has received personal compensation for serving on scientific advisory boards from UCB Pharma and Zambon. PS has received consultancy fees/honoraria from UCB Pharma, Zambon and Chiesi; has served on advisory boards for UCB Pharma and Italian National Health Minister Research (project no RF-2013-2719661). KA is a salaried employee of UCB Pharma. MA is a former employee of UCB Pharma and received stock options from her employment.
Provenance and peer review Not commissioned; externally peer reviewed.
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