Mov Disord: Bipolar disorder makes Parkinson "worse worse"

Bipolar spectrum disorder (BSD), including bipolar type I disorder, bipolar type II disorder, and cyclic thyroid disorder, is rarely discussed in Parkinson's disease (PD), PD with dementia, and dementia with Lewy bodies
.

Early literature clearly listed mania or mania as one of the possible complications of PD and involved precautions
.

Mania/mania disappeared from the list of psychiatric complications of PD, which may be due to the conceptual reframing of the non-motor aspects of PD and the identification of ICD as a specific psychiatric aspect of PD.
In patients exposed to dopamine agonist (DA) therapy
.

ICDs include risky behaviors such as gambling, hypersexuality, shopping spree, bulimia, aggressive driving, or hoarding, and were identified for the first time by Andew Lees as a clinical entity related to dopaminergic treatment exposure.
He named this disease hedonistic homomorphism Behavior
.

Driven by individual and class actions related to DAs, PD's ICD has become a unique clinical entity and has gained a wide range of space on social media
.

However, the behavior listed in the ICD is quite similar to the unique aspects of BSD listed in DSM-534
.

These studies show that the prevalence of BSD in PD is higher than that in the control group
.

In this way, Marco Onofrj and others of the University of Chieti-Pescara, Italy, studied whether the previous diagnosis of BSD would affect the phenotype of PD
.

It is also assumed that:
(1) The previous diagnosis of BSDs (ie, BSDs assessed before the onset of PD motor symptoms) affects the development of motor symptoms; (2) BSDs affects the non-motor and psychiatric symptoms of PD;
(3) BSDs and identifiable genetics The tendency is related;
(4) Among those patients who were previously diagnosed with BSDs, the results of PD treatment were affected
.

Among the 2660 PD patients who were followed up for at least 6 years (6-27), 250 (BSD-PD) had BSD 6-20 years before the diagnosis of PD; 48%-43% had a family history of PD or BSD, and 34 Carry glucocerebrosidase (GBA) and Parkin (PRKN) mutations
.

They found that: Compared with PD patients, BSD-PD showed: (1) Family history of PD (probability ratio [OR]3.

(2) The incidence of impulse control disorders is higher (hazard ratio [HR] 5.
95, 3.
89-9.
09);

(3) The frequency of dysfunction before PD treatment is higher (HR, 5.
67, 3.
95-8.
15);

(4) Early occurrence of delusions or mild dementia (HR, 7.
70, 5.
55-10.
69; HR, 1.
43, 1.
16-1.
75); and (5) Early death (1.
48; 1.
11-1.
97)
.

Subjects with hereditary BSD-PD showed the same clinical characteristics as subjects with non-hereditary BSD-PD
.

Original source:
Onofrj M, Di Iorio A, Carrarini C, et al.
P reexisting Bipolar Disorder Influences the Subsequent Phenotype of Parkinson's Disease.
Mov Disord .
Published online August 24, 2021:mds.
28745.
doi:10.
1002/mds.
28745