The prevalence and clinical characteristics of pathological gambling in Parkinson's disease: an evidence-based review

Large prospective studies in the USA and Canada have estimated the prevalence of pathological gambling (PG) in the general population at 0.43% and 1% respectively. Studies using equivalent methodology in patients with Parkinson's disease (PD) have reported markedly higher prevalence rates. A total of 1032 patients with PD have been included in clinical studies in North America, Great Britain and Italy. Of these, 3.2% met diagnostic criteria for PG. The prevalence of PG was found to be higher in men than in women with PD, although the difference was not statistically significant. A younger age at onset of PD, increased novelty-seeking behaviour and a history of alcohol misuse have been found to be associated with PG in this population. Pathological gambling has been associated with dopamine agonist use, and the prevalence of the association has been found to be 5.7% in patients with PD. Although the literature suggests a high incidence of psychiatric co-morbidity, particularly depression and other impulse control disorders, this is yet to be confirmed by case-control studies.