Factors associated with dopaminergic drug-related pathological gambling in Parkinson disease

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.