title: Impulsive-compulsive behaviors are common in Asian Parkinson's disease patients: assessment using the QUIP.
abstract: BACKGROUND
  There are limited data on the prevalence of impulsive-compulsive behaviors and subsyndromal impulsive-compulsive behaviors in Asian patients with Parkinson's disease, who are treated with lower dosages of dopaminergic medications.
  
  
  METHODS
  The recently-validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease was administered to 200 consecutive patients attending a Malaysian university-based neurology clinic. Informant report was also systematically obtained.
  
  
  RESULTS
  A high rate of Questionnaire positivity was found (35.0% by combined patient and informant report; 24.6% by patient report alone; 27.4% by informant report alone), despite usage of relatively low dosages of dopaminergic medications (mean/median total l-dopa equivalent units of 528/450 mg/day; mean/median agonist-only l-dopa equivalent units of 74/37 mg/day). Eating, sexual and punding or hobbyism behaviors were relatively common, while gambling and compulsive medication use occurred less frequently. Agreement between patient- and informant-reporting of impulsive-compulsive behaviors was moderate-to-fair (Kappa values ranging from 0.203 to 0.494). Factors associated with Questionnaire positivity on univariate analysis were male gender, younger age at Parkinson's disease onset, longer disease duration, use of dopamine agonist or amantadine therapy, higher total l-dopa equivalent units and higher dopamine agonist-only l-dopa equivalent units. On multivariate analysis, male gender and longer disease duration independently predicted Questionnaire positivity. No association was found with cognitive or apathy scores.
  
  
  CONCLUSIONS
  Our findings suggest that Asian patients with Parkinson's disease may be susceptible to dopaminergic medication-related side effects. The data here also contribute to the understanding of the psychometric properties of the Questionnaire for Impulsive-Compulsive Disorders.
authors.affiliation: Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. limshenyang@ymail.com
authors.forename: Shen-Yang
authors.initials: SY
authors.lastname: Lim
authors.forename: Zi Kheng
authors.initials: ZK
authors.lastname: Tan
authors.forename: Pei Ing
authors.initials: PI
authors.lastname: Ngam
authors.forename: Tong Liang
authors.initials: TL
authors.lastname: Lor
authors.forename: Hafsa
authors.initials: H
authors.lastname: Mohamed
authors.forename: Jie Ping
authors.initials: JP
authors.lastname: Schee
authors.forename: Aik Keat
authors.initials: AK
authors.lastname: Tan
authors.forename: Jun Yan
authors.initials: JY
authors.lastname: Goh
authors.forename: Eugene
authors.initials: E
authors.lastname: Ooi
authors.forename: Patrick Chin-Hooi
authors.initials: PC
authors.lastname: Soh
mesh_terms: D017668:Age of Onset; D044466:Asian People; D003192:Compulsive Behavior / Q000453:epidemiology* / Q000209:etiology; D018491:Dopamine Agonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000453:epidemiology* / Q000209:etiology; D007980:Levodopa / Q000627:therapeutic use; D008296:Malaysia; D008297:Male; D010300:Parkinson Disease / Q000188:drug therapy / Q000523:psychology*; D015995:Prevalence; D011795:Surveys and Questionnaires
chemical_list: D018491:Dopamine Agonists; D007980:Levodopa