Factors associated with dopaminergic drug-related pathological gambling in Parkinson disease

Abstract

Objective: To evaluate factors associated with pathological gambling (PG) in Parkinson disease (PD).

Design: Case-control study.

Setting: Outpatient tertiary clinic. Patients Twenty-one patients with idiopathic PD with PG after the patients began receiving medications compared with a consecutive sample of 42 patients with idiopathic PD without compulsive behaviors.

Main outcome measures: Clinical features, comorbid psychiatric and substance use disorders, personality traits, and impulsivity scores.

Results: Patients with PG had a younger age at PD onset (P = .006), higher novelty seeking (P<.001), medication-induced hypomania or mania (P = .001), impaired planning (P = .002), or a personal or immediate family history of alcohol use disorders (P = .002). Novelty seeking, a personal or immediate family history of alcohol use disorders, and younger age at PD onset accurately predicted PG at 83.7% in a logistic regression model, with the model accounting for 62% of the variance.

Conclusions: Patients with PD having a younger age at PD onset, higher novelty seeking traits, and a personal or family history of alcohol use disorders may have a greater risk for PG with dopamine agonists.