Objective: To quantify how impulse control disorders (ICDs) alter day-to-day functionality and overall quality of life (QoL) among individuals living with Young-Onset Parkinson’s Disease (YOPD), alongside the resulting burden placed on their primary caregivers.

Background: While dopamine replacement therapy (DRT) remains the cornerstone for alleviating YOPD motor deficits, sustained administration—especially at elevated doses—frequently triggers severe behavioral side effects. These ICDs encompass pathological gambling, hypersexuality, compulsive buying, binge eating, and dopamine dysregulation syndrome. Such iatrogenic psychiatric manifestations can devastate the emotional stability of patients and fracture family dynamics.

Method: We initially screened 550 individuals with YOPD (300 males, 250 females) using the short-form Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP-Short). Within this group, 155 subjects confirmed to have active ICDs (average disease progression: 6.2 ± 0.56 years; daily L-dopa equivalent: 900–2000 mg) underwent comprehensive secondary assessments. To measure functional and psychological outcomes, we applied the Parkinson’s Disease Questionnaire (PDQ-39) for QoL, the Schwab & England scale for activities of daily living (ADL), and the Zarit Burden Interview to gauge caregiver strain.

Results: Active ICDs profoundly hindered routine independence, evidenced by a 67% ± 19.67% average reduction in functional capacity according to the Schwab & England index. Furthermore, overall QoL was substantially diminished in the affected cohort, demonstrating PDQ-39 scores between 25% and 89% (average: 52.4% ± 19.97). These behavioral anomalies concurrently generated significant caregiver distress, with 61.5% reporting a moderate burden and 7.7% experiencing a high burden as a direct consequence of managing the patient’s impulsivity.

Conclusion: High-dose DRT-associated ICDs inflict a severe toll on the functional independence and QoL of the YOPD population. The substantial secondary trauma experienced by caregivers highlights the urgent necessity for continuous behavioral monitoring and personalized titration of dopaminergic medications in younger patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-impact-of-dopamine-induced-impulse-control-disorders-on-quality-of-life-in-young-onset-parkinsons-disease/