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Predictors of Burden in Carers of Patients with Impulse Control Behaviors in Parkinson's Disease

Johnson, Daniel; Townsend, Leigh; David, Anthony S; Askey-Jones, Sally; Brown, Richard; Samuel, Mike; Okai, David; (2023) Predictors of Burden in Carers of Patients with Impulse Control Behaviors in Parkinson's Disease. Movement Disorders Clinical Practice 10.1002/mdc3.13824. Green open access

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Abstract

Background: Impulse control behaviors (ICBs) are problematic, reward-based behaviors, affecting 15% to 35% of patients with Parkinson's disease. Evidence exists of increased carer burden as a result of these behaviors; however, little is known about the variables mediating this effect and their management. Objective: To identify factors predictive of carer burden in a cohort of patients with Parkinson's disease with ICBs to enable the development of targeted therapeutic interventions for carers. Methods: Data were collected from 45 patients with clinically significant ICBs and their carers, including levodopa equivalent daily dosage, motor and neuropsychiatric symptoms, cognitive function, and ICB severity. Carer burden was quantified by Zarit Burden Interview (ZBI). Univariate analyses were performed using the Spearman rank correlation. Linear regression was used to create a multivariate model for predicting ZBI. Results: Univariate analysis identified significant correlations between ZBI and patient total Neuropsychiatric Inventory (NPI) (rs = 0.50), 4 NPI subscores (agitation/aggression, rs = 0.41; depression/dysphoria, rs = 0.47; apathy/indifference, rs = 0.49; and irritability/lability, rs = 0.38; all P < 0.02), and the carer 28-item General Health Questionnaire (GHQ-28) (rs = 0.52, P < 0.0005). Multivariate linear regression retained total NPI and GHQ-28 scores and were collectively predictive of 36.6% of the variance in the ZBI. Conclusions: Our study suggests that depressive symptoms and aspects of executive dysfunction (apathy and disinhibition) in the patient are potential drivers of carer burden in patients with ICBs. Such findings suggest the presence of executive difficulties and/or mood disturbance should point the clinician to inquire about burden in the caring role and encourage the carer to seek help for any of their own general health problems, which may compound carer burden.

Type: Article
Title: Predictors of Burden in Carers of Patients with Impulse Control Behaviors in Parkinson's Disease
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/mdc3.13824
Publisher version: https://doi.org/10.1002/mdc3.13824
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: Science & Technology, Life Sciences & Biomedicine, Clinical Neurology, Neurosciences & Neurology, Parkinson's disease, impulse control disorders, carer burden, QUALITY-OF-LIFE, CONTROL DISORDERS, CAREGIVER-BURDEN, DOPAMINE, DYSREGULATION, SYMPTOMS, DEMENTIA, VERSION, IMPACT
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Institute of Mental Health
URI: https://discovery.ucl.ac.uk/id/eprint/10174953
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