Objective: (1) To determine the prevalence and severity of Impulse Control Disorders (ICDs) in adult Filipino patients with idiopathic Parkinson’s disease seen at a tertiary center in Manila, and (2) to identify risk factors and clinical correlates of subjects with ICDs.

Background: Impulse control disorders are pathological impulsive, excessive and/or repetitive behaviors such as pathological gambling, hypersexuality, compulsive eating or shopping, hobbyism, punding or dopamine dysregulation syndrome (DDS) which occur in 15-20% of PD patients. This is due to the effect of the damaged dopaminergic transmission in the brain brought about by the pathogenesis of the disease itself or the dopaminergic therapy used. ICDs have significant impact on their psychological, socioeconomic aspect and overall quality of life. The prevalence of ICDs among Filipino PD patients may be underreported.

Methods: This is a prospective study looking into all consecutive adult Filipino PD patients seen from March 2015 to September 2015. Staging of PD was done using the Modified Hoehn and Yahr (H&Y) staging.Upon obtaining approval from the author, the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s disease-Rating Scale (QUIP-RS) was utilized to screen the subjects. It is a validated questionnaire designed to detect clinically significant ICDs and its severity.

Results: A total of 66 adult patients (31 males and 35 females) with idiopathic PD were examined. Majority of subjects have Tremor Dominant (50%) subtype of PD, followed by Early Disease Onset (34.8%), and Non-Tremor Dominant (15.2%). Using QUIP-RS, 16 out of 66 patients (24.2%) demonstrated ICDs with the following frequency rates: pathological gambling 12.5%, hypersexuality 18.75%, compulsive eating 50%, compulsive shopping 18.75, hobbyism/ punding 56.25%, and DDS 18.75%. The mean QUIP-RS score is 5.42. Longer PD duration is associated with higher risk of developing ICDs (x2 20.41; p = 0.026). Independent sample T test showed that higher mean modified Hoehn and Yahr stage (2.66 +/- 0.94), t 2.735, df 64, p 0.008, have more incidence of ICDs.

Conclusions: Impulse control disorders have high prevalence among Filipino PD patients who are mostly on levodopa + carbidopa therapy. Longer duration of Parkinson’s disease and a higher mean Modified Hoehn and Yahr stage are also contributory factors for having ICDs.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/prevalence-of-impulse-control-disorders-among-adult-filipino-patients-with-idiopathic-parkinsons-disease-seen-at-a-tertiary-center-in-manila/