Impact of Mood and Behavioral Disorders on Quality of Life in Parkinson’s disease

Article type: Research Article

Authors: Rieu, Isabelle^{a; b} | Houeto, Jean Luc^c | Pereira, Bruno^d | De Chazeron, Ingrid^{b; e} | Bichon, Amélie^f | Chéreau, Isabelle^e | Ulla, Miguel^{a; b} | Brefel-Courbon, Christine^g | Ory-Magne, Fabienne^g | Dujardin, Kathy^h | Tison, Françoisⁱ | Krack, Paul^f | Durif, Franck^{a; b; *}

Affiliations: [a] CHU Clermont-Ferrand, Department of Neurology, CHU Gabriel Montpied, Clermont-Ferrand, France | [b] Université Clermont 1, UFR Medecine, EA7280, Clermont-Ferrand, France | [c] Department Neurology, CIC INSERM-0802, CHU de Poitiers 86021 Poitiers cedex; INSERM U 1084, Laboratoire de Neurosciences Expérimentales et Cliniques, Université de Poitiers, France | [d] CHU Clermont-Ferrand, DRCI, Biostatistics Unit, Clermont-Ferrand, France | [e] CHU Clermont-Ferrand, Department of Psychiatry B, CHU Gabriel Montpied, Clermont-Ferrand, France | [f] Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University and INSERM, Unité 836, Grenoble Institut des Neurosciences, 38043 Grenoble, France | [g] University, Hospital Toulouse, Neurology department, CHU Purpan, Toulouse, France | [h] Neurology and Movement Disorders Department, Lille University Medical Center, Lille, France | [i] University of Bordeaux, Institut des Maladies Neurodégénératives, CNRS UMR 5293 et CHU de Bordeaux, France

Correspondence: [*] Correspondence to: Franck Durif, Service de Neurologie, Centre Hospitalier Universitaire Gabriel Montpied, 58 rue Montalembert, 63003 Clermont-Ferrand cedex 1, France. Tel.: +33 4 73 75 22 00; Fax: +33 4 73 75 22 06; E-mail: fdurif@chu-clermontferrand.fr.

Abstract: Background: Mood symptoms negatively affect quality of life of Parkinson’s disease (PD); however little is known about the impact of behavioral disorders such as impulse control disorders, and non-motor fluctuations on quality of life. Objective: To assess the impact of mood and behavioral disorders on quality of life in PD. Methods: 136 (84% male) PD were included (mean age: 61±8y; mean duration of disease: 8.8±5.4y). Mood symptoms, behavioral disorders and non-motor fluctuations were detected and quantified using the recently validated “Ardouin Scale of Behavior in Parkinson’s Disease”. Motor symptoms were assessed using UPDRS and quality of life with the “39-item Parkinson’s Disease Questionnaire”. Results: Both motor and non-motor factors significantly affected the quality of life of PD patients. Multivariate regression of the relationship between items of the quality of life questionnaire and the Ardouin Scale showed that alteration of patients’ quality of life was strongly correlated with the presence of mood symptoms (such as depression, anxiety ...) and with non-motor fluctuations (especially in the OFF period). A significant correlation was also found between the number of symptoms and their severity, and the quality of life deterioration. Some behavioral disorders (compulsive buying / eating behavior) also negatively affected patient’s quality of life to a lesser extent. Alternatively, excess in motivation and hobbyism behaviors had a positive impact on mobility and emotional well-being dimensions respectively of quality of life. Conclusions: This study shows the main impact of mood symptoms and non-motor fluctuations on worsening quality of life in PD.

Keywords: Parkinson’s disease, quality of life, impulse control disorders, mood disorders

DOI: 10.3233/JPD-150747

Journal: Journal of Parkinson's Disease, vol. 6, no. 1, pp. 267-277, 2016