Obsessive Compulsive Personality Disorder and Parkinson’s Disease

Abstract

ObjectivesTo evaluate the frequency of personality disorders in Parkinson’s disease (PD) patients and in a group of healthy controls.MethodsPatients affected by PD diagnosed according to the United Kingdom Parkinson’s disease Society Brain Bank diagnostic criteria and a group of healthy controls were enrolled in the study. PD patients with cognitive impairment were excluded from the study. Structured Clinical Interview for Personality Disorders-II (SCID-II) has been performed to evaluate the presence of personality disorders. Presence of personality disorders, diagnosed according to the DSM-IV, was confirmed by a psychiatric interview. Clinical and pharmacological data were also recorded using a standardized questionnaire.Results100 PD patients (57 men; mean age 59.0±10.2 years) and 100 healthy subjects (52 men; mean age 58.1±11.4 years) were enrolled in the study. The most common personality disorder was the obsessive-compulsive personality disorder diagnosed in 40 PD patients and in 10 controls subjects (p-value<0.0001) followed by the depressive personality disorder recorded in 14 PD patients and 4 control subjects (p-value 0.02). Obsessive-compulsive personality disorder was also found in 8 out of 16 de novo PD patients with a short disease duration.ConclusionPD patients presented a high frequency of obsessive-compulsive personality disorder that does not seem to be related with both disease duration and dopaminergic therapy.

Clinical spectrum of impulse control disorders in Parkinson's disease

“…For instance, obsessive‐compulsive disorder (OCD), an anxiety disorder characterized by the repetition of nonpleasurable, nonharmful behaviors (e.g., checking or counting) to reduce anxiety, may occur at an increased frequency in PD, although it has not been reported in association with PD medications . It is important to note that the types of impulsive and compulsive behaviors previously described also do not occur in the context of obsessive‐compulsive personality disorder, a lifelong personality‐style characterized by preoccupation with orderliness, perfectionism, and control that may be linked to PD independently of disease duration and medications …”

“…54 It is important to note that the types of impulsive and compulsive behaviors previously described also do not occur in the context of obsessive-compulsive personality disorder, a lifelong personality-style characterized by preoccupation with orderliness, perfectionism, and control that may be linked to PD independently of disease duration and medications. 55 For PD patients with an ICD, a large case-control study found that ICD patients drawn from the DOMINION study reported significantly more depression, state and trait anxiety, OCD, novelty seeking, and impulsivity symptoms. 7 Other studies have also reported an association between ICD and depression symptoms 8,28,39,40 and anxiety.…”

Obsessive–Compulsive Personality Disorder: a Current Review

“…Moreover, there is growing evidence for a considerable co-occurrence of OCPD with Cluster A personality disorders, in particular with paranoid and schizotypal personality disorders [16,24,42], which have led to the question whether OCPD should continue to be classified as a Cluster C personality disorder. Finally, it has recently been found that OCPD is very common amongst individuals suffering from medical conditions such as joint hypermobility syndrome/ Ehlers-Danlos syndrome hypermobility type [43] and Parkinson's disease [44]. High rates in joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type were explained with an elevated need of a "hyper-control" in congenitally hypermobile subjects due to musculoskeletal consequences or associated features, such as joint instability and lack of proprioception, which occur early in their life [43].…”

“…High rates in joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type were explained with an elevated need of a "hyper-control" in congenitally hypermobile subjects due to musculoskeletal consequences or associated features, such as joint instability and lack of proprioception, which occur early in their life [43]. The association of OCPD with Parkinson's disease was explained by similar dysfunctions in the fronto-basal ganglia circuitry [44].…”

Affective and personality disorders in Parkinson's disease premotor phase. Pilot study.

“…According to A. Nicoletti (2013), it was fond precedence of impulsive-compulsive traits in PD patients compared with the age-adjusted control group and its prevalence increased with increasing age and length of illness, which may indicate dysfunction of the fronto-striatal pathways before the onset of the disease [36,37].…”