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Published Online: 1 April 2013

The Role of Self-Awareness and Cognitive Dysfunction in Parkinson’s Disease With and Without Impulse-Control Disorder

Publication: The Journal of Neuropsychiatry and Clinical Neurosciences

Abstract

The aim of this study was to investigate the clinical, neuropsychological, and self-awareness correlates of impulse-control disorder (ICD) in a group of 17 Parkinson’s disease (PD) subjects with an active ICD and a comparison group of 17 PD subjects without ICD. Self-awareness was assessed with the Beck Cognitive Insight Scale and patient–caregiver discrepancy scores from ratings on the Dysexecutive Questionnaire and the Everyday Memory Questionnaire–Revised. Self-awareness was comparable or increased in those with ICD, versus those without, and measures of neuropsychological functioning did not differ between the two groups. Those with ICD had more motor complications of PD therapy and were more likely to be on an antidepressant than those without ICD, whereas dopaminergic medication profiles were comparable between the two groups. In this group, PD patients with current ICDs were aware of their impulsivity. Although executive dysfunction may contribute to ICD behavior, it is not a necessary component. The awareness of the inability to resist these motivated behaviors may be a source of increased depression.

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Information

Published In

Go to The Journal of Neuropsychiatry and Clinical Neurosciences
Go to The Journal of Neuropsychiatry and Clinical Neurosciences
The Journal of Neuropsychiatry and Clinical Neurosciences
Pages: 141 - 149
PubMed: 23686032

History

Received: 30 March 2012
Revision received: 17 July 2012
Accepted: 11 August 2012
Published online: 1 April 2013
Published in print: Spring 2013

Authors

Details

Joel Mack, M.D.
From the Dept. of Psychiatry, Oregon Health and Science University, Portland, OR; Dept. of Psychiatry and Northwest Parkinson's Disease Research, Education and Clinical Center, Portland Veterans Administration Medical Center, Portland, OR; Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King’s College London, London, UK; Imperial Healthcare NHS Trust and West London Mental Health Trust; Dept. of Psychology, Institute of Psychiatry, King’s College London, London, UK; Dept. of Mental Health & Specialist Care, Florence Nightingale School of Nursing & Midwifery, King's College London, London, UK; National Parkinson Foundation Centre of Excellence, Dept. of Neurology, King’s College Hospital, King’s Health Partners, London, UK; East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, UK.
David Okai, B.Med.Sci., M.B.B.S.
From the Dept. of Psychiatry, Oregon Health and Science University, Portland, OR; Dept. of Psychiatry and Northwest Parkinson's Disease Research, Education and Clinical Center, Portland Veterans Administration Medical Center, Portland, OR; Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King’s College London, London, UK; Imperial Healthcare NHS Trust and West London Mental Health Trust; Dept. of Psychology, Institute of Psychiatry, King’s College London, London, UK; Dept. of Mental Health & Specialist Care, Florence Nightingale School of Nursing & Midwifery, King's College London, London, UK; National Parkinson Foundation Centre of Excellence, Dept. of Neurology, King’s College Hospital, King’s Health Partners, London, UK; East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, UK.
Richard G. Brown, Ph.D.
From the Dept. of Psychiatry, Oregon Health and Science University, Portland, OR; Dept. of Psychiatry and Northwest Parkinson's Disease Research, Education and Clinical Center, Portland Veterans Administration Medical Center, Portland, OR; Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King’s College London, London, UK; Imperial Healthcare NHS Trust and West London Mental Health Trust; Dept. of Psychology, Institute of Psychiatry, King’s College London, London, UK; Dept. of Mental Health & Specialist Care, Florence Nightingale School of Nursing & Midwifery, King's College London, London, UK; National Parkinson Foundation Centre of Excellence, Dept. of Neurology, King’s College Hospital, King’s Health Partners, London, UK; East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, UK.
Sally Askey-Jones, M.Sc. B.Nurs (Hons)
From the Dept. of Psychiatry, Oregon Health and Science University, Portland, OR; Dept. of Psychiatry and Northwest Parkinson's Disease Research, Education and Clinical Center, Portland Veterans Administration Medical Center, Portland, OR; Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King’s College London, London, UK; Imperial Healthcare NHS Trust and West London Mental Health Trust; Dept. of Psychology, Institute of Psychiatry, King’s College London, London, UK; Dept. of Mental Health & Specialist Care, Florence Nightingale School of Nursing & Midwifery, King's College London, London, UK; National Parkinson Foundation Centre of Excellence, Dept. of Neurology, King’s College Hospital, King’s Health Partners, London, UK; East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, UK.
K. Ray Chaudhuri, D.Sc., F.R.C.P., M.D.
From the Dept. of Psychiatry, Oregon Health and Science University, Portland, OR; Dept. of Psychiatry and Northwest Parkinson's Disease Research, Education and Clinical Center, Portland Veterans Administration Medical Center, Portland, OR; Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King’s College London, London, UK; Imperial Healthcare NHS Trust and West London Mental Health Trust; Dept. of Psychology, Institute of Psychiatry, King’s College London, London, UK; Dept. of Mental Health & Specialist Care, Florence Nightingale School of Nursing & Midwifery, King's College London, London, UK; National Parkinson Foundation Centre of Excellence, Dept. of Neurology, King’s College Hospital, King’s Health Partners, London, UK; East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, UK.
Anne Martin, RGN Dipl
From the Dept. of Psychiatry, Oregon Health and Science University, Portland, OR; Dept. of Psychiatry and Northwest Parkinson's Disease Research, Education and Clinical Center, Portland Veterans Administration Medical Center, Portland, OR; Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King’s College London, London, UK; Imperial Healthcare NHS Trust and West London Mental Health Trust; Dept. of Psychology, Institute of Psychiatry, King’s College London, London, UK; Dept. of Mental Health & Specialist Care, Florence Nightingale School of Nursing & Midwifery, King's College London, London, UK; National Parkinson Foundation Centre of Excellence, Dept. of Neurology, King’s College Hospital, King’s Health Partners, London, UK; East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, UK.
Michael Samuel, F.R.C.P.
From the Dept. of Psychiatry, Oregon Health and Science University, Portland, OR; Dept. of Psychiatry and Northwest Parkinson's Disease Research, Education and Clinical Center, Portland Veterans Administration Medical Center, Portland, OR; Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King’s College London, London, UK; Imperial Healthcare NHS Trust and West London Mental Health Trust; Dept. of Psychology, Institute of Psychiatry, King’s College London, London, UK; Dept. of Mental Health & Specialist Care, Florence Nightingale School of Nursing & Midwifery, King's College London, London, UK; National Parkinson Foundation Centre of Excellence, Dept. of Neurology, King’s College Hospital, King’s Health Partners, London, UK; East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, UK.
Anthony S. David, M.D.
From the Dept. of Psychiatry, Oregon Health and Science University, Portland, OR; Dept. of Psychiatry and Northwest Parkinson's Disease Research, Education and Clinical Center, Portland Veterans Administration Medical Center, Portland, OR; Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King’s College London, London, UK; Imperial Healthcare NHS Trust and West London Mental Health Trust; Dept. of Psychology, Institute of Psychiatry, King’s College London, London, UK; Dept. of Mental Health & Specialist Care, Florence Nightingale School of Nursing & Midwifery, King's College London, London, UK; National Parkinson Foundation Centre of Excellence, Dept. of Neurology, King’s College Hospital, King’s Health Partners, London, UK; East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, UK.

Notes

Correspondence: Joel Mack, M.D., Portland VA Medical Center, Portland, OR; e-mail: [email protected]

Funding Information

Relevant conflicts of interest/financial disclosures: RGB has received honoraria for speaking at conferences and educational events from UCB Pharma, GSK, Lundbeck, and is an Advisory Board member for UCB Pharma. MS has received lecture fees from Medtronic, Inc., St. Judes, Inc., unrestricted educational grants from Ipsen and Solvay Pharmaceuticals, and sponsorship for educational meetings from Boehringer Ingelheim. KRC serves as the European Editor of Basal Ganglia, as an editorial board member of Parkinsonism and Related Disorders, and The Journal of Parkinson’s Disease, and, as the Liaison and PR Committee Chairman of the Movement Disorders Society, has received honoraria for academic lectures at sponsored symposiums from UCB Pharma, Britannia, GSK, Abbott, Teva, Medtronic, and Boehringer Ingelheim, and has received educational grants for research from UCB Pharma, Abbott, Boehringer Ingelheim, and Britannia.Funding: The authors acknowledge support from: Parkinson’s UK; Authors RGB and ASD acknowledge support from the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College, London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.

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