Alexithymia—an independent risk factor for impulsive‐compulsive disorders in Parkinson's disease

Abstract

Impulsive-compulsive disorders (ICDs) are frequent side effects of dopaminergic medication in Parkinson's disease (PD). Alexithymia, a personality trait characterized by difficulties identifying and describing feelings and an externally oriented thinking style, has been linked to various impulse-control problems in the general population. In PD, the prevalence of alexithymia is approximately twice as high as in the general population. However, whether alexithymia is associated with ICDs in PD is currently unknown. We examined the relationship between self-reported ICDs and alexithymia in a sample of 91 PD patients (89 on dopaminergic medication). Additional self-report measures assessed impulsivity, depression, anxiety, behavioral inhibition/approach, and emotion-regulation strategies. We observed that alexithymia, and particularly difficulty identifying feelings and difficulty describing feelings, was significantly correlated with ICDs, even when controlling for impulsivity, anxiety, and depression. In addition, a group analysis revealed that PD patients with clinical and moderate levels of alexithymia had significantly more ICDs than non-alexithymic patients, suggesting that even moderately high alexithymia levels increase the risk for ICDs in PD. Our results identify alexithymia as an independent risk factor for ICDs in PD. Thus, the inclusion of alexithymia in the neuropsychiatric assessment of patients with PD may help identify patients at risk for ICDs.

Impulse control disorders in Parkinson’s disease: Predominant role of psychological determinants

“…Similarly high (>30%) prevalence rates have been reported in other studies using the QUIP-RS (Papay et al, 2011;Lim et al, 2011;Goerlich-Dobre et al, 2014). Given that the diagnosed prevalence of ICDs in the current study was close to that reported elsewhere (11.1%), the greater level of selfreported ICDs supports the theory that ICDs are under reported and often may not always be recognised by clinicians (Vilas et al, 2011;Voon & Fox, 2007).…”

Impulse control disorders in Parkinson's disease: don't set your mind at rest by self‐assessments

“…12 Another cause of underreporting might be deliberate withholding of relevant information due to the often humiliating nature of these symptoms. In this line, Farnikova and colleagues examined personality characteristics in PD patients with and without ICD.…”

Neural and behavioral substrates of subtypes of Parkinson’s disease

“…Further, few studies have investigated the prevalence and predictors of ICDs. For example, it was reported that alexithymia is a predictor of ICDs in PD patients (Goerlich-Dobre et al, 2013). It was also found that frontal executive function is a predictor of the occurrence of pathological gambling (Santangelo et al, 2009b).…”