title: Problematic Internet use in Parkinson's disease.
abstract: BACKGROUND
  Problematic Internet use (PIU) has been associated with impulse control disorders (ICDs), and postulated to share characteristics of a behavioral addiction with both impulsive and compulsive features. However, Internet use has not been previously systematically studied in Parkinson's disease.
  
  
  OBJECTIVE
  We explore Internet use in PD patients with and without ICDs and matched healthy controls. We hypothesize that the PD-ICD patients will spend more time on the Internet, accessing websites related to their ICDs, compared with PD patients without ICDs and healthy volunteers.
  
  
  METHODS
  Our study is the first to systematically explore problematic Internet use in patients with PD, with and without ICDs. Twenty-nine PD patients with ICDs, twenty PD patients without ICDs and nineteen healthy controls were recruited. All participants endorsed using the Internet for non-essential purposes. They underwent a semi-structured interview and completed questionnaires including the Yale-Brown Obsessive Compulsive Scale adapted for Internet use (Y-BOCS-Internet).
  
  
  RESULTS
  PD-ICD patients scored significantly higher on the Y-BOCS-Internet than the PD-control and HV groups (PD-ICD: 13.69; PD-control: 5.42; HV: 4.70; p < 0.0001). Compared to PD controls and HV groups, the PD-ICD group spent more time on the Internet (p = 0.0001), described significantly more effort to resist Internet use (p = 0.0002), thoughts about Internet use (p < 0.0001) and its interference with their life functioning (p = 0.0025).
  
  
  CONCLUSIONS
  Our results suggest that PD patients with ICDs have a relative increased tendency towards excessive Internet use compared to those without ICDs and healthy controls. Clinicians should actively screen for excessive Internet use in patients with ICDs.
authors.affiliation: Division of Brain Sciences, Department of Medicine, Hammersmith Hospital, Imperial College London, London W12 0NN, UK. Electronic address: Kit.wu@imperial.ac.uk.
authors.forename: Kit
authors.initials: K
authors.lastname: Wu
authors.affiliation: Division of Brain Sciences, Department of Medicine, Hammersmith Hospital, Imperial College London, London W12 0NN, UK; Neurodegeneration Imaging Group, Department of Clinical Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK.
authors.forename: Marios
authors.initials: M
authors.lastname: Politis
authors.affiliation: Division of Brain Sciences, Department of Medicine, Hammersmith Hospital, Imperial College London, London W12 0NN, UK; Reta Lila Weston Institute of Neurological Studies, University College London, WC1N 1PJ, UK.
authors.forename: Sean S
authors.initials: SS
authors.lastname: O'Sullivan
authors.affiliation: School of Psychology, Cardiff University, CF10 3AT, UK.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Lawrence
authors.affiliation: Division of Brain Sciences, Department of Medicine, Hammersmith Hospital, Imperial College London, London W12 0NN, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Warsi
authors.affiliation: Reta Lila Weston Institute of Neurological Studies, University College London, WC1N 1PJ, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lees
authors.affiliation: Division of Brain Sciences, Department of Medicine, Hammersmith Hospital, Imperial College London, London W12 0NN, UK.
authors.forename: Paola
authors.initials: P
authors.lastname: Piccini
mesh_terms: D000368:Aged; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013223:Statistics as Topic; D011795:Surveys and Questionnaires
keywords: Computer use; Impulse control disorder; Internet addiction; Parkinson's disease; Problematic Internet use; Yale-Brown Obsessive Compulsive Scale