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.