Objective: To investigate whether anxiety, depression, and sleep impairment relate to development of impulse control disorders (ICD) in patients with early-stage Parkinson’s disease (PD).

Background: A sub-group of PD patients experience ICDs. ICDs are characterized by a failure to resist a temptation to perform repetitive actions that can be harmful and/or substantially affect quality of life. Cross-sectional studies have demonstrated that patients with PD and ICD have significantly higher self-reported anxiety, depression, and sleep impairment compared to patients with PD without ICD. A few recent studies have investigated a prospective link between anxiety and/or depression, and development of ICD in PD, with conflicting results. No previous studies have investigated sleep problems as predictors of ICD in early PD.

Method: We investigated 188 early-stage PD patients (disease duration < 24 months) from the Parkinson’s Progressive Marker Initiative (PPMI). In patients without ICDs at baseline, defined by the Questionnaire for Impulsive-Compulsive Behaviours-Current-Short, we  contrasted measures of anxiety, depression, and sleep problems at baseline in patients who later developed ICDs within ten years (n=53) or did not (n=135), using the State-Trait-Anxiety Inventory, Geriatric Depression Scale, and part 1.7 of the Movement Disorder Society- Unified Parkinson’s Disease Rating Scale, respectively.

Results: Patients with ICDs revealed significantly higher anxiety (M = 72.34 vs. 59.80; p < .001), depression (M = 2.76 vs. 1.84; p = .017), and sleep problems (M = 0.98 vs. 0.64; p = .026) at baseline compared to patients without ICD. Logistic regression analysis revealed that only anxiety significantly predicted ICD after controlling for age and sex, OR = 1.04, p = .001.

Conclusion: PD patients with ICD demonstrate significantly higher anxiety, depression, and sleep problems at baseline, though only anxiety scores predicted ICD development. Anxiety screening could alert clinicians to patients at greater risk of developing ICDs, which could inform type and dose of dopaminergic therapy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-predictors-of-impulse-control-disorders-in-parkinsons-disease/