Obsessive Compulsive Symptoms, Obsessive Compulsive Disorder and Related Disorders in Idiopathic Parkinson’s Disease

Abstract

Introduction

Obsessive-compulsive symptoms and Obsessive-Compulsive Disorder (OCD) have been reported by clinicians in Parkinson’s disease (PD) due to the involvement of a shared circuitry. In DSM-5, OCD related disorders include Trichotillomania, Hoarding Disorder, Skin Picking Disorder, and Body Dysmorphic Disorder. However, there is no prevalence information about Obsessive Compulsive and Related Disorders in PD.

Objectives

The aim of this study is to evaluate patients with Idiopathic Parkinson’s Disease (IPD) in terms of obsessive-compulsive symptoms, OCD and Related Disorders, compare with a matched control group, and determine the relationship between the two phenomena.

Methods

80 patients between 52-82 years of age, diagnoised IPD and 80 healthy controls between 52-80 years of age were included in this study. Structured Clinical Interview for DSM-5 Disorders, a Structured sociodemographic and clinical form, The Unified Parkinson’s Disease Rating Scale, Frontal Assessment Battery (FAB), Parkinson’s Disease Questionnaire-39 (PDQ-39) and Yale-Brown Obsessive-Compulsive Scale were applied to the participants. The relationship between PD and OCD and related disorders and obsessive-compulsive symptoms was evaluated.

Results

Contamination obsession was found in 21.3% of patients and 16.3% of the control group; cleaning compulsion was found in 13.8% of patients and 8.8% of the control group. Two groups were compared in terms of obsessions (p=0.215) and compulsions (p=0.361); no statistically significant difference was found between the groups.The presence of obsessions (p=0.027) and compulsions (p=0.007) in patients with a family history of Parkinson’s disease was found to be significantly higher. A statistically significant correlation was found between FAB scores and PDQ-6 (cognition item) in the Parkinson’s group (r= -0.359, p=0.001). Compared to the control group (mean 15,08; SD: 1,84), FAB scores were found to be significantly lower in the Parkinson’s group (mean 13,95; SD: 2,23) .(p=0.001). The presence of any obsession (p=0.003) or any compulsion (p<0.001) was found to be significantly higher in patients with hoarding in the Parkinson’s group. The presence of any obsession (p<0.001) or any compulsion (p<0.001) was found to be significantly higher in patients with Skin Picking Disorder in the Parkinson group. The scores obtained from the PDQ emotional well-being (p=0.027) and bodily discomfort (p=0.001) items in the Parkinson group with Skin Picking Disorder were significantly higher than the Parkinson group without Skin Picking Disorder.

Conclusions

PD is characterized by dysfunction in frontobasal ganglia circuits. A similar circuit is also important in OCD. Obsessions and compulsions, Hoarding Disorder, Skin Picking and Trichotillomania may accompany PD. Family history increases any obsession and compulsion in PD.

Disclosure of Interest

None Declared