BACKGROUND Othello syndrome(OS)is characterized by delusional beliefs concerning the infidelity of a spouse or sexual partner,which may lead to extreme behaviors.Impulse control disorders refer to behaviors involving ...BACKGROUND Othello syndrome(OS)is characterized by delusional beliefs concerning the infidelity of a spouse or sexual partner,which may lead to extreme behaviors.Impulse control disorders refer to behaviors involving repetitive,excessive,and compulsive activities driven by an intense desire.Both OS and impulse control disorders in Parkinson’s disease(PD)may be side effects of dopamine agonists.At present,there are only a few case reports and studies related to PD with concomitant OS and impulse control disorders.CASE SUMMARY We describe a 70-year-old male patient with PD,OS,and impulse control disorders,who presented with a six-month history of the delusional belief that his wife was having an affair with someone.He began to show an obvious increase in libido presenting as frequent masturbation.He had been diagnosed with PD ten years earlier and had no past psychiatric history.In his fourth year of PD,he engaged in binge eating,which lasted approximately one year.Both OS and hypersexuality were alleviated substantially after a reduction of his pramipexole dosage and a prescription of quetiapine.CONCLUSION Given its potential for severe consequences,OS should be identified early,especially in patients undergoing treatment with dopamine agonists.展开更多
Purpose: Rapid eye movement sleep behavior disorder (RBD) and impulse control disorders (ICDs) are common in subjects with Parkinson’s disease. The association between these two conditions has been contradictory. The...Purpose: Rapid eye movement sleep behavior disorder (RBD) and impulse control disorders (ICDs) are common in subjects with Parkinson’s disease. The association between these two conditions has been contradictory. The aim of this study is to analyze the association between these two non-motor symptoms. Methods: Consecutive subjects with Parkinson’s disease attending the Movement Disorders Outpatient Clinic were included. The presence of ICDs was assessed using the Questionnaire for Impulse Control Disorders Rating Scale. RBD was diagnosed by an overnight, single night polysomnography. Results: Fifty-five consecutive subjects with Parkinson’s disease were included. The prevalence of ICDs and related behaviors was 23.6% (ICD in 14.5% and related behaviors in 9.1%). RBD was diagnosed in 47.2% of the patients. No differences were found in the frequency of ICDs and related behaviors when comparing subjects with and without RBD (23% versus 24.1%, p = 0.926, respectively). Conclusion: No association between the presence of RBD and the frequency of ICDs in subjects with Parkinson’s disease was found.展开更多
泌乳素瘤是最常见的功能性垂体腺瘤,首选多巴胺受体激动剂作为一线治疗方案。在接受多巴胺受体激动剂治疗的泌乳素瘤患者中可能出现各种类型的冲动控制障碍(impulse control disorders,ICDs),如病理性赌博、强迫性购物、性欲亢进、强迫...泌乳素瘤是最常见的功能性垂体腺瘤,首选多巴胺受体激动剂作为一线治疗方案。在接受多巴胺受体激动剂治疗的泌乳素瘤患者中可能出现各种类型的冲动控制障碍(impulse control disorders,ICDs),如病理性赌博、强迫性购物、性欲亢进、强迫性进食等。这些不良反应会对患者的工作和生活造成严重的影响。然而目前国内缺少相关研究报道,内分泌学界对冲动控制障碍的临床表现、诊断及治疗缺乏全面的认识。本文就泌乳素瘤中ICDs的发生比例、发生机制、危险因素、诊断及治疗等方面展开综述,以深入了解泌乳素瘤多巴胺受体激动剂治疗相关ICDs,为今后在临床诊治中筛查识别及诊治提供帮助。展开更多
基金Supported by Zhejiang Province Medical Science and Technology Project,No.2018KY872Yiwu Science and Technology Bureau Project,No.20-3-074.
文摘BACKGROUND Othello syndrome(OS)is characterized by delusional beliefs concerning the infidelity of a spouse or sexual partner,which may lead to extreme behaviors.Impulse control disorders refer to behaviors involving repetitive,excessive,and compulsive activities driven by an intense desire.Both OS and impulse control disorders in Parkinson’s disease(PD)may be side effects of dopamine agonists.At present,there are only a few case reports and studies related to PD with concomitant OS and impulse control disorders.CASE SUMMARY We describe a 70-year-old male patient with PD,OS,and impulse control disorders,who presented with a six-month history of the delusional belief that his wife was having an affair with someone.He began to show an obvious increase in libido presenting as frequent masturbation.He had been diagnosed with PD ten years earlier and had no past psychiatric history.In his fourth year of PD,he engaged in binge eating,which lasted approximately one year.Both OS and hypersexuality were alleviated substantially after a reduction of his pramipexole dosage and a prescription of quetiapine.CONCLUSION Given its potential for severe consequences,OS should be identified early,especially in patients undergoing treatment with dopamine agonists.
文摘Purpose: Rapid eye movement sleep behavior disorder (RBD) and impulse control disorders (ICDs) are common in subjects with Parkinson’s disease. The association between these two conditions has been contradictory. The aim of this study is to analyze the association between these two non-motor symptoms. Methods: Consecutive subjects with Parkinson’s disease attending the Movement Disorders Outpatient Clinic were included. The presence of ICDs was assessed using the Questionnaire for Impulse Control Disorders Rating Scale. RBD was diagnosed by an overnight, single night polysomnography. Results: Fifty-five consecutive subjects with Parkinson’s disease were included. The prevalence of ICDs and related behaviors was 23.6% (ICD in 14.5% and related behaviors in 9.1%). RBD was diagnosed in 47.2% of the patients. No differences were found in the frequency of ICDs and related behaviors when comparing subjects with and without RBD (23% versus 24.1%, p = 0.926, respectively). Conclusion: No association between the presence of RBD and the frequency of ICDs in subjects with Parkinson’s disease was found.
文摘目的探讨帕金森病(PD)冲动控制障碍(ICDs)发生的相关影响因素。方法检索Pub Med、MEDLINE、EMbase、Cochrane图书馆、中国期刊全文数据库、维普中文科技期刊全文数据库和万方数据库中2008年1月~2016年12月公开发表的关于PD ICDs相关因素研究的病例对照研究,采用纽卡斯尔-渥太华量表对入选文献进行质量评价,使用Rev Man 5.3软件进行Meta分析。结果纳入文献8篇。PD伴ICDs(PDICDs)组和PD不伴ICDs(PD-NICDs)组起病年龄、多巴胺受体激动剂每日等效剂量、左旋多巴每日等效剂量及男性、吸烟、使用多巴胺受体激动剂比率差异有统计学意义(均P<0.0),PD病程、Hoehn-Yahr分级、统一PD评价量表评分、MMSE评分及使用左旋多巴、使用金刚烷胺比率差异无统计学意义(均P>0.05)。PDICDs组及PD-NICDs组白色人种亚组起病年龄、男性比率、MMSE评分、使用金刚烷胺的比率、使用多巴胺受体激动剂的比率、多巴胺受体激动剂每日等效剂量、左旋多巴每日等效剂量差异有统计学意义(均P<0.05),黄色人种亚组PD病程、使用金刚烷胺的比率、多巴胺受体激动剂每日等效剂量、左旋多巴每日等效剂量差异有统计学意义(均P<0.05)。结论起病年龄早、男性、既往有吸烟史、使用多巴胺受体激动剂、多巴胺受体激动剂每日等效剂量较高和左旋多巴每日等效剂量较高是PD伴ICDs的影响因素。
文摘泌乳素瘤是最常见的功能性垂体腺瘤,首选多巴胺受体激动剂作为一线治疗方案。在接受多巴胺受体激动剂治疗的泌乳素瘤患者中可能出现各种类型的冲动控制障碍(impulse control disorders,ICDs),如病理性赌博、强迫性购物、性欲亢进、强迫性进食等。这些不良反应会对患者的工作和生活造成严重的影响。然而目前国内缺少相关研究报道,内分泌学界对冲动控制障碍的临床表现、诊断及治疗缺乏全面的认识。本文就泌乳素瘤中ICDs的发生比例、发生机制、危险因素、诊断及治疗等方面展开综述,以深入了解泌乳素瘤多巴胺受体激动剂治疗相关ICDs,为今后在临床诊治中筛查识别及诊治提供帮助。