ABSTRACT
The COVID-19 pandemic, with the consequent lockdown of about 3 months, can be viewed as an experimental model to observe the impact of the depletion of environmental factors that stimulate gambling, particularly electronic gambling machines (EGMs) that were set to zero. The effects of some structural characteristics of gambling activities that increase gambling behavior were studied among disordered gamblers in treatment in this unique scenario. In fact, studies investigating the effects of the lockdown on problem gamblers (PGs) under treatment are missing. The aims of this study were to analyze patients' gambling behavior and craving during the lockdown and to conduct a comparison between gambling disorder (GD) symptoms at the beginning of the treatment and during lockdown. The study was conducted in Italy, the European country with the largest gambling market and the first to be affected by the virus. Data were collected through a semi-structured telephone interview conducted by healthcare professionals. Participants were 135 PGs under treatment (109 males, mean age = 50.07). Results showed that most PGs achieved a significant improvement in their quality of life, with less gambling behavior, GD symptoms, and lower craving. No shift toward online gambling and very limited shift towards other potential addictive and excessive behaviors occurred. The longer the treatment, the more monitoring is present and the better the results in terms of symptoms reduction. Individual and environmental characteristics during the lockdown favored the reduction in symptoms. Consideration for prevention and treatment are discussed.
Subject(s)
Behavior, Addictive/epidemiology , COVID-19/epidemiology , Gambling/epidemiology , Communicable Disease Control , Female , Humans , Italy/epidemiology , Male , Middle Aged , Pandemics , Quality of Life , Surveys and QuestionnairesABSTRACT
Dopaminergic medications could increase the occurrence of a set of dysregulated behaviours in Parkinson's disease (PD), including reward-seeking behaviours (pathological gambling, hypersexuality, compulsive shopping, binge eating, reckless driving), punding and compulsive medication use. We report a preliminary evaluation of a questionnaire to assess the presence of these impulsive-compulsive behaviours associated to dopamine replacement therapy in PD. We screened 38 patients and their caregivers, comparing dopamine dysregulation syndrome (DDS) patients and non-DDS patients. The questionnaire was well accepted and demonstrated a preliminary good discriminant validity (p = 0.000). In addition, clinically relevant dysregulated condition is associated with a younger age (p = 0.006), younger age at disease onset (p = 0.001), levodopa-equivalent daily dose (p = 0.029), UPDRS III (p = 0.021), increased global psychopathology (interpersonal sensitivity and psychoticism), and differences in our inventory (p = 0.000). These preliminary results suggest that the DDS-PC inventory could help to identify patients experiencing impulsive-compulsive behaviours associated to DDS.
Subject(s)
Antiparkinson Agents/adverse effects , Disruptive, Impulse Control, and Conduct Disorders/chemically induced , Disruptive, Impulse Control, and Conduct Disorders/psychology , Dopamine Agents/adverse effects , Dopamine/physiology , Neuropsychological Tests , Parkinson Disease/complications , Aged , Antiparkinson Agents/therapeutic use , Caregivers , Compulsive Personality Disorder/chemically induced , Compulsive Personality Disorder/psychology , Disruptive, Impulse Control, and Conduct Disorders/diagnosis , Dopamine Agents/therapeutic use , Female , Gambling/etiology , Gambling/psychology , Humans , Levodopa/adverse effects , Levodopa/therapeutic use , Longitudinal Studies , Male , Middle Aged , Parkinson Disease/drug therapy , Personality Tests , Psychometrics , ROC Curve , Reward , Surveys and QuestionnairesABSTRACT
We report two male patients with Parkinson's disease who developed compulsive risk-seeking driving behaviour as a result of self-administering high doses of L-dopa despite an adequate therapeutic response at lower doses. When L-dopa reduction was feasible, it resulted in cessation of unsafe driving. We believe that this impairment in driving performance, due to deliberate overuse of dopaminergic medication, should be included as a new behavioural phenomenon in dopamine dysregulation syndrome.
Subject(s)
Automobile Driving , Parkinson Disease/physiopathology , Parkinson Disease/psychology , Psychomotor Performance/physiology , Aged , Dopamine Agents/administration & dosage , Dopamine Agents/adverse effects , Humans , Levodopa/administration & dosage , Levodopa/adverse effects , Male , Parkinson Disease/drug therapy , Psychomotor Performance/drug effectsABSTRACT
Pathological gambling (PG) is a psychiatric disorder characterized by loss of control of gambling, which has repercussions on family, personal, and professional life. Several recent studies have reported the relationship between PG and the treatment of Parkinson's disease (PD), but no prevalence study has yet been conducted to investigate this correlation. The purpose of this study was to evaluate the prevalence of PG in Italian patients with PD on dopamine replacement therapy. The prevalence of PG in a PD sample (n = 98) and in an age- and sex-matched control group (n = 392) was obtained. The prevalence of PG results significantly higher (P = 0.00001) in PD patients than in control subjects (6.1% vs. 0.25%). Our results emphasize that PG in patients with idiopathic PD on dopamine replacement therapy is an emergent comorbidity, but probably at present the condition is not properly diagnosed because it is mostly unknown.
