Impulse control disorders and other non-motor symptoms in Sri Lankan patients with Parkinson’s disease

by H. M. M. T. B. Herath, K. W. S. M. Wijayawardhana, U. I. Wickramarachchi, Sunethra Senanayake, Chaturaka Rodrigo, Bimsara Senanayake

The impact of non-motor symptoms is often overlooked in favour of the motor symptoms when managing Parkinson’s disease resulting in suboptimal patient outcomes. This study aimed to characterise the non-motor symptoms of Parkinson’s disease in a cohort of Sri Lankan patients with a special focus on the impulsive control disorders and other compulsive behaviours (ICDs-CB) that had not been previously studied in this population. All patients with idiopathic Parkinson’s disease followed up at the National Hospital of Colombo, Sri Lanka were included. The presence or absence of non-motor symptoms and their perceived impact was recorded with an interviewer administered questionnaire. Symptoms of anxiety and depression were assessed with Hamilton Anxiety and Depression scales. Presence of ICDs-CB was assessed with the questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease. Of 192 patients 97% (186) reported at least 2 non-motor symptoms. About 83% (160/192) screened positive for anxiety, 40% (76/192) for depression, and 17% (32/192) for an ICDs-CB. A lower Barthel index, history of past psychiatric disorders and family history of alcohol abuse were independent predictors of ICDs-DB. Managing both motor and non-motor symptoms are important to preserve the quality of life of patients with Parkinson’s disease. They should be screened for symptoms for anxiety and depression regularly during follow up and educated about the possibility of ICDs-CB soon after diagnosis.