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Valerie Voon, MD; Teri Thomsen, MD; Janis M. Miyasaki, MD; Minella de Souza, MD; Ariel Shafro, MD; Susan H. Fox, MD, PhD; Sarah Duff-Canning, PhD; Anthony E. Lang, MD; Mateusz Zurowski, MD

Arch Neurol. 2007;64(2):212-216.

Objective  To evaluate factors associated with pathological gambling (PG) in Parkinson disease (PD).

Design  Case-control study.

Setting  Outpatient tertiary clinic.

Patients  Twenty-one patients with idiopathic PD with PG after the patients began receiving medications compared with a consecutive sample of 42 patients with idiopathic PD without compulsive behaviors.

Main Outcome Measures  Clinical features, comorbid psychiatric and substance use disorders, personality traits, and impulsivity scores.

Results  Patients with PG had a younger age at PD onset (P = .006), higher novelty seeking (P<.001), medication-induced hypomania or mania (P = .001), impaired planning (P = .002), or a personal or immediate family history of alcohol use disorders (P = .002). Novelty seeking, a personal or immediate family history of alcohol use disorders, and younger age at PD onset accurately predicted PG at 83.7% in a logistic regression model, with the model accounting for 62% of the variance.

Conclusions  Patients with PD having a younger age at PD onset, higher novelty seeking traits, and a personal or family history of alcohol use disorders may have a greater risk for PG with dopamine agonists.

Author Affiliations: National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md (Dr Voon); and Department of Psychiatry (Drs Voon, de Souza, Shafro, and Zurowski) and Division of Neurology (Drs Thomsen, Miyasaki, Fox, Duff-Canning, and Lang), Toronto Western Hospital, Toronto, Ontario.

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