In addition to body tremors and hand tremors, Parkinson's can make people become "shopaholics"
This year's Double Eleven shopping season, do you regret after the "shopping" is over?
"Hand chopping party" refers to those people who are addicted to shopping, and most of them are girls.
If this behavior is difficult to control, or even adversely affects others and oneself, it is called "compulsive shopping".
There is such a common disease of the elderly-Parkinson's disease, which can not only cause hand tremors, but also make people become "shopaholics".
what 's wrong?
Today, the doctor will talk to you about the compulsive shopping behavior caused by Parkinson's disease.
Do not ignore non-motor symptoms other than tremor
Everyone should be familiar with Parkinson's disease. The clinical symptoms are mainly divided into motor symptoms and non-motor symptoms.
Motor symptoms include resting tremor, muscle rigidity, bradykinesia, and postural disturbance; non-motor symptoms include sensory disturbance, cognitive impairment, affective disturbance (such as anxiety, depression, etc.), and autonomic dysfunction (such as constipation, hyperhidrosis), etc. .
Among them, non-motor symptoms are often ignored by patients and their families.
What we call compulsive shopping is one of the manifestations of impulse control disorders in Parkinson's disease neuropsychiatric disorders.
Impulse control disorder refers to taking certain inappropriate behaviors to obtain a certain pleasure under the drive of excessive desire.
Patients often have difficulty controlling themselves, and even cause harm to others and themselves.
Taking this drug doubles the risk of impulsiveness
In recent years, the incidence of impulse control disorders in patients with Parkinson's disease has been increasing year by year, which has attracted more and more public attention.
The incidence of impulse control disorder caused by Parkinson's disease in China ranges from 3% to 20.42%.
Among them, the incidence of pathological gambling was 0.43% to 7%, the incidence of impulsive shopping was 0.87% to 4.9%, the incidence of compulsive eating was 2.68% to 5.6%, and the incidence of compulsive sexual behavior was 1.73% to 2.8%.
Impulse control disorders in Parkinson's disease can occur at any stage of the Parkinson's disease course.
The incidence of single impulse control disorders is much higher than the incidence of compound impulse control disorders.
Risk factors for impulsive control disorder in Parkinson's disease are unknown.
The patient reported that this behavior was impulsive and uncontrollable.
Studies have shown that patients who take dopamine receptor agonists are about three times more likely to suffer from impulse control disorders than those who do not.
Other risk factors include early onset, long course of disease, male sex, history of drug abuse, previous history of impulse control disorder, alcoholism, smoking, and impulsive novelty-seeking personality.
It's not just shopaholics, these are impulse control disorders.
Pathological gambling is an irresistible urge to gamble.
Patients often complain that they have uncontrollable gambling desires, accompanied by a sense of tension and relaxation before and after gambling.
It often occurs in the "on" period of Parkinson's disease, and it is an earlier and more impulsive control disorder.
Compulsive shopping is mainly manifested as frequent purchases of items that cannot be afforded or are not needed, or items that will be needed for a long time in the future.
The impulse to buy is irresistible and uncontrollable. Regardless of whether it will generate huge debts or not, it will buy repeatedly. Before and after shopping, it will also produce a sense of tension or relaxation similar to pathological gambling.
It is more common in female patients.
The main clinical feature of compulsive eating is a sudden and significant increase in food intake, which mainly refers to a sharp increase in appetite and intake of carbohydrates or high-salt foods, which obviously exceed their own physiological needs.
Manifested by compulsive eating or more frequent snacking, and compulsive eating at night, resulting in significant weight gain.
It is more common in female patients.
Compulsive sexual behaviors have a strong sexual desire and a significant increase in sexual needs, which are seriously inconsistent with age.
It occurs mainly in males and in younger patients with Parkinson's disease, and may be related to smoking, alcohol abuse, or mental illness.
Other manifestations include drug addiction, hoarding behavior, pathological theft, pathological arson, impulsive smoking, etc.
Prevention + intervention patients should do risk assessment
In view of the potential harm of impulse control disorder in Parkinson's disease, active clinical patient education should be carried out, and prevention should be given priority.
Hierarchical management and individualized intervention should be carried out according to the individual situation of patients with Parkinson's disease.
The risk of impulsive control disorders in Parkinson's disease should be assessed first when choosing initial treatment options for Parkinson's disease patients.
Patients with high-risk Parkinson's disease should carefully choose dopamine receptor agonist therapy. If it must be used, the dose of dopamine receptor agonist should be monitored and regular evaluation of Parkinson's disease impulse control disorder should be performed; low-risk patients can be treated on the premise of effective monitoring According to the condition, dopamine receptor agonists and/or other drugs should be used in sufficient doses to improve the quality of life.
While following the overall treatment principles of Parkinson's disease, individualized treatment is also taken into consideration.
At present, there is no specific drug for the treatment of impulse control disorder in Parkinson's disease. For patients with impulse control disorder in Parkinson's disease, graded evaluation of the symptoms of impulse control disorder in Parkinson's disease should be carried out.
In addition, it is also important to strengthen psychological intervention for patients.
For patients with mild Parkinson's disease and impulse control disorder, under the premise of close monitoring, cognitive-behavioral intervention is mainly used; for patients with moderate-to-severe Parkinson's disease, cognitive-behavioral intervention should be given gradually under the guidance of specialists. Reduce the dose of dopamine agonist drugs.
Text/Jiang Wenjing (Beijing Geriatric Hospital)