成人原发性PD患者发生强迫性精神障碍的影响因素

Influencing factors of obsessive-compulsive disorder in adult patients with primary PD

目的 探讨成人原发性帕金森氏病患者发生强迫性精神障碍的影响因素。方法 将462例成人原发性帕金森氏病患者采用冲动控制障碍问卷筛查强迫性精神障碍发生状况,对入组患者发生强迫性精神障碍的影响因素进行单因素分析及多元Logistic回归分析。结果 462例患者中确诊强迫性精神障碍26例,其中存在刻板行为16例,占比61.54%。成人原发性帕金森氏病患者发生强迫性精神障碍情况在多巴胺受体激动剂左旋多巴等效剂量及其使用情况、喝茶方面存在显著差异(P<0.05),在性别、年龄等方面差异无统计学意义(P>0.05)。Logistic回归显示,帕金森氏病发病年龄<65岁是入组患者发生强迫性精神障碍的独立保护因素(OR=0.27,P<0.05),多巴胺受体激动剂左旋多巴等效剂量≥100 mg·d是其独立危险因素(OR=4.26,P<0.05)。结论 成人原发性帕金森氏病患者强迫性精神障碍主要临床表现为刻板行为,多巴胺受体激动剂左旋多巴等效剂量超过≥100 mg·d者更易发生强迫性精神障碍,帕金森氏病发病年龄<65岁的患者发生强迫性精神障碍的风险降低。

Objective To explore the influencing factors of obsessive-compulsive disorder in adults patients with primary Parkinson’s disease(PD). Methods A total of 462 adult patients with primary PD were screened for obsessive-compulsive disorder by questionnaire for impulsive-compulsive disorders in Parkinson’s disease(QUIP). Univariate and multiple logistic regression analysis were conducted to analyze the influencing factors of obsessive-compulsive disorder in the enrolled patients. Results Among the 462 patients, 26 cases were diagnosed with obsessive-compulsive disorder, of which 16 cases had stereotypical behavior, accounting for 61.54%. There were significant differences in dopamine receptor agonist levodopa equivalent dose(LEDD) and drinking tea in adult primary PD patients with obsessive-compulsive disorder. There was no significant difference in gender and age(P>0.05). Logistic regression showed that the onset age of PD less than 65 years old was an independent protective factor for patients with obsessive-compulsive disorder(OR=0.27, P<0.05), and dopamine receptor agonist LEDD greater than or equal to 100 mg·dwas an independent risk factor(OR=4.26, P<0.05). Conclusions The obsessive-compulsive disorder in adult patients with primary PD is mostly stereotypical behavior, and those with dopamine receptor agonist LEDD greater than or equal to 100 mg·dare more likely to develop obsessive-compulsive disorder, while those with PD onset age less than 65 years old have a lower risk of developing obsessive-compulsive disorder.