title: [Hypersexuality in Parkinson's disease. Advantage of the presence of the entourage for medical assessment].
abstract: OBJECTIVE
  To improve the management of hypersexuality caused by antiparkinsonian treatment and its psychopathological implications in patients with Parkinson's disease (PD). If hypersexuality is a classic form of impulse control disorder (ICD) observed in PD, its rate is certainly underestimated.
  
  
  METHODS
  We have proposed to meet patients with Parkinson's disease, referred by the neurology department of Lille University Hospital, for detection or suspicion of hypersexuality, in the presence of their spouse. The session consisted of an interview conducted by our psychiatry team. This evaluation was conducted between January 1 and August 31, 2011. Nine patients were referred to our service, 7 agreed to meet us, 6 of them with their spouse.
  
  
  RESULTS
  An interview in the presence of the spouse has improved hypersexuality screening and information given to the patient and his close contacts regarding the side effects of treatment, and particularly the occurrence of hypersexuality. It also highlighted the various expressions of these behavioral changes, often minimized by patients, as spouses had great difficulty dealing with this. It helped them to improve verbal communication and, therefore, to be more informative concerning sexual behavior changes in connection with the treatment and its management. Finally, it has enabled improved support for secondary consequences of this impulse control disorder, such as guilt, jealousy or shame. Our interest has also focused on the impact of this hypersexuality on patients' families. Among the six sets partners, four had symptoms requiring specific psychiatric care: depression, suicidal intention or post-traumatic stress disorder.
  
  
  CONCLUSIONS
  Hypersexuality seems underestimated in patients receiving antiparkinsonian treatment. This underestimation is probably linked to some defense mechanisms such as denial or minimization, but also to the feelings generated by these behavioral problems, such as shame or guilt. On the other hand, some patients do not experience stress related behavioral changes (even though the family may complain). Systematic partner interview could be a solution to improving this screening.
authors.affiliation: CHRU de Lille, hôpital Fontan, service de psychiatrie adulte, 59037 Lille cedex, France; Université du Droit et de la Santé de Lille, EA 4559, 59000 Lille, France. Electronic address: Pierre.Grandgenevre@CHRU-LILLE.FR.
authors.forename: Pierre
authors.initials: P
authors.lastname: Grandgenevre
authors.affiliation: CHRU de Lille, service des urgences, 59037 Lille cedex, France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Warembourg
authors.affiliation: Université du Droit et de la Santé de Lille, EA 4559, 59000 Lille, France; CHRU de Lille, service de neurologie et pathologie du mouvement, 59037 Lille cedex, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Carrière
authors.affiliation: CHRU de Lille, hôpital Fontan, service de psychiatrie adulte, 59037 Lille cedex, France.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Vaillant
authors.affiliation: Université du Droit et de la Santé de Lille, EA 4559, 59000 Lille, France; CHRU de Lille, service de neurologie et pathologie du mouvement, 59037 Lille cedex, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Defebvre
authors.affiliation: CHRU de Lille, hôpital Fontan, service de psychiatrie adulte, 59037 Lille cedex, France; Université du Droit et de la Santé de Lille, EA 4559, 59000 Lille, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Vaiva
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects*; D017028:Caregivers / Q000523:psychology; D003657:Decision Making; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000628:therapy*; D012725:Sexual Behavior / Q000187:drug effects; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy*; D018454:Spouses / Q000523:psychology
chemical_list: D000978:Antiparkinson Agents