Last month, the World Health Organisation (WHO) announced that it was planning to include ‘Gaming Disorder’ (GD) in the latest edition of the International Classification of Diseases. This followed the American Psychiatric Association’s decision to include ‘Internet Gaming Disorder’ in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders in 2013. According to the WHO, an individual with GD is a person who lets playing video games “take precedence over other life interests and daily activities,” resulting in “negative consequences” such as “significant impairment in personal, family, social, educational, occupational or other important areas of functioning.”
I have been researching videogame addiction for nearly 30 years, and during that time I have received many letters, emails, and telephone calls from parents wanting advice concerning videogames. Typical examples include ‘Is my child playing too much?’, ‘Will playing videogames spoil my pupils’ education?’, ‘Are videogames bad for children’s health? and ‘How do I know if a child is spending too long playing videogames?’ To answer these and other questions in a simple and helpful way, I have written this article as a way of disseminating this information quickly and easily.
To begin with parents should begin by finding out what videogames their children are actually playing! Parents might find that some of them contain material that they would prefer them not to be having exposure to. If they have objections to the content of the games they should facilitate discussion with children about this, and if appropriate, have a few rules. A few aims with children should be:
- To help them choose suitable games which are still fun
- To talk with them about the content of the games so that they understand the difference between make-believe and reality
- To discourage solitary game playing
- To guard against obsessive playing
- To follow recommendations on the possible risks outlined by videogame manufacturers
- To ensure that they have plenty of other activities to pursue in their free time besides the playing of videogames
Parents need to remember that in the right context videogames can be educational (helping children to think and learn more quickly), can help raise a child’s self-esteem, and can increase the speed of their reaction times. Parents can also use videogames as a starting point for other activities like painting, drawing, acting or storytelling. All of these things will help a child at school. It needs to be remembered that videogame playing is just one of many activities that a child can do alongside sporting activities, school clubs, reading and watching the television. These can all contribute to a balanced recreational diet.
The most asked question a parent wants answering is ‘How much videogame playing is too much? To help answer this question I devised the following checklist. It is designed to check if a child’s videogame playing is getting out of hand. Ask these simple questions. Does your child:
- Play videogames every day?
- Often play videogames for long periods (e.g., 3 to 6 hours at a time)?
- Play videogames for excitement or ‘buzz’ or as a way of forgetting about other things in their life?
- Get restless, irritable, and moody if they can’t play videogames?
- Sacrifice social and sporting activities to play videogames?
- Play videogames instead of doing their homework?
- Try to cut down the amount of videogame playing but can’t?
If the answer is ‘yes’ to more than four of these questions, then your child may be playing too much. But what can you do if your child is playing videogames too much?
- First of all, check the content of the games. Try and give children games that are educational rather than the violent ones. Parents usually have control over what their child watches on television – videogames should not be any different.
- Secondly, try to encourage video game playing in groups rather than as a solitary activity. This will lead to children talking and working together.
- Thirdly, set time limits on children’s playing time. Tell them that they can play for a couple of hours after they have done their homework or their chores – not before.
- Fourthly, parents should always get their children to follow the recommendations by the videogame manufacturers (e.g., sit at least two feet from the screen, play in a well-lit room, never have the screen at maximum brightness, and never play videogames when feeling tired).
I have spent many years examining both the possible dangers and the potential benefits of videogame playing. Evidence suggests that in the right context videogames can have positive health and educational benefits to a large range of different sub-groups. What is also clear from the case studies displaying the more negative consequences of playing is that they all involved children who were excessive users of videogames. From prevalence studies in this area, there is little evidence of serious acute adverse effects on health from moderate play. In fact, in some of my studies, I found that moderate videogame players were more likely to have friends, do homework, and engage in sporting activities, than those who played no videogames at all.
For excessive videogame players, adverse effects are likely to be relatively minor, and temporary, resolving spontaneously with decreased frequency of play, or to affect only a small subgroup of players. Excessive players are the most at-risk from developing health problems although more research is needed. If care is taken in the design, and if they are put into the right context, videogames have the potential to be used as training aids in classrooms and therapeutic settings, and to provide skills in psychomotor coordination, and in simulations of real life events (e.g., training recruits for the armed forces).
Every week I receive emails from parents claiming that their sons are addicted to playing online games or that their daughters are addicted to social media. When I ask them why they think this is the case, they almost all reply “because they spend most of their leisure time in front of a screen.” This is simply a case of parents pathologising their children’s behaviour because they think what they are doing is “a waste of time.” I always ask parents the same three things in relation to their child’s screen use. Does it affect their schoolwork? Does it affect their physical education? Does it affect their peer development and interaction? Usually parents say that none of these things are affected so if that is the case, there is little to worry about when it comes to screen time. Parents also have to bear in mind that this is how today’s children live their lives. Parents need to realise that excessive screen time doesn’t always have negative consequences and that the content and context of their child’s screen use is more important than the amount of screen time.
(N.B. This article is an extended version of an article that was originally published by Parent Zone)
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Griffiths, M.D. (2003). Videogames: Advice for teachers and parents. Education and Health, 21, 48-49.
Griffiths, M.D. (2009). Online computer gaming: Advice for parents and teachers. Education and Health, 27, 3-6.
Griffiths, M.D., Kuss, D.J. & King, D.L. (2012). Video game addiction: Past, present and future. Current Psychiatry Reviews, 8, 308-318.
Griffiths, M.D., Kuss, D.J. & Pontes, H. (2016). A brief overview of Internet Gaming Disorder and its treatment. Australian Clinical Psychologist, 2(1), 20108.
Griffiths, M.D. & Meredith, A. (2009). Videogame addiction and treatment. Journal of Contemporary Psychotherapy, 39(4), 47-53.
King, D.L., Delfabbro, P.H. & Griffiths, M.D. (2012). Clinical interventions for technology-based problems: Excessive Internet and video game use. Journal of Cognitive Psychotherapy: An International Quarterly, 26, 43-56.
King, D.L., Delfabbro, P.H., Griffiths, M.D. & Gradisar, M. (2012). Cognitive-behavioural approaches to outpatient treatment of Internet addiction in children and adolescents. Journal of Clinical Psychology, 68, 1185-1195.
Király, O., Nagygyörgy, K., Griffiths, M.D. & Demetrovics, Z. (2014). Problematic online gaming. In K. Rosenberg & L. Feder (Eds.), Behavioral Addictions: Criteria, Evidence and Treatment (pp.61-95). New York: Elsevier.
Kuss, D.J. & Griffiths, M.D. (2012). Online gaming addiction in adolescence: A literature review of empirical research. Journal of Behavioral Addictions, 1, 3-22.
Kuss, D.J. & Griffiths, M.D. (2012). Internet gaming addiction: A systematic review. International Journal of Mental Health and Addiction, 10, 278-296.
One of things I am very proud of in my academic career is the coining of the term ‘technological addiction’ back in 1995 (an umbrella term that I invented to describe a number of different person-machine addictions including slot machine addictions, video game addiction, television addiction, etc.). I’m also proud of coining the term ‘aca-media’ (relating to academics like myself that use the media to disseminate our research). A neologism (i.e., the name for a newly coined term) is often (according to Wikipedia) directly attributable to a specific event, person, publication, or period.
In the 1980s and early 1990s, there seemed to be a real upsurge is the naming of ‘new syndromes’ in the medical literature including many relating to excessive use of technology (such as ‘Space Invader’s Wrist’) and other leisure activities (such as ‘Cuber’s Thumb’ relating to excessive use of the Rubik’s Cube) – both of which made their appearance in 1981 issues of the New England Journal of Medicine. Other videogame medical complaints include ‘Pseudovideoma’ (in a 1984 issue of the Journal of Hand Surgery), ‘Pac-Man Phalanx’ (in a 1983 issue of Arthritis and Rheumatism) and ‘Joystick Digit’ (in a 1987 issue of the Journal of the American Medical Association). Another videogame-related medical complaint (in this case an infection), was reported in a 1987 issue of the Western Journal of Medicine by Dr. G.B. Soe and colleagues:
“We wish to focus WJM readers’ attention on another complication associated with video games-one that originally presented as an “infected spider bite. A 17-year-old right-handed boy noted progressive swelling and redness of his left hand seven days before admission. Two days before admission he was given penicillin intramuscularly and oral cephalexin to take at home. The swelling did not subside and the hand became very painful, so he came to the medical center for treatment. On admission his mother reported that she had seen many spiders around the house with a violin pattern on their backs, and that her son had probably been bitten by a spider…After seven days of parenteral antibiotic therapy, the edema, erythema and fever had disappeared and the patient was discharged home. Further questioning revealed that the young man was spending almost all of his time playing his favorite video game, which involved a fighting kung fu character. The patient used his left hand in manipulating a ball-shaped joystick to move the figure up, down, left and right, and his right in operating buttons to kick and jab. Extensive use of the joystick resulted in blisters on his left palm. He rubbed the blisters off, and an infection resulted that progressed to abscess formation. Neuromuscular complications of video games (‘pseudovideoma’, ‘Pac-Man phalanx’, ‘firing-finger syndrome’ and ‘Space Invaders wrist’) have been reported, as well as video game-induced seizures, but we have not come across any reports of an infectious complication of video games. Perhaps video game players should wear gloves to protect their palms, similar to ones worn by golfers and baseball players, who also need to get a firm grip on their respective sticks”.
Another one that I’d never heard of is ‘Nurd Knuckles’ coined by Dr. J.B. Martin in the Canadian Medical Association Journal in 1982:
“I wish to describe a case of painful knuckles associated with the use and manipulation of a new, allegedly therapeutic product, a Nurd. A Nurd is a head 10 cm across with a smiling face and large ears, reminiscent of the character Yoda of ‘Star Wars’. It is made of malleable material that can be stretched, twisted or deformed in any direction, yet with release of tension quickly resumes its original shape without a trace of distortion. A 32-year-old public school teacher presented with painful knuckles of his right hand. His students, perhaps feeling that their teacher was under increased stress during the marking of exams, had given him a Nurd for Christmas, and during a particularly trying day he had found occasion to use it. He repeatedly stretched its ears and twisted its neck without ill effect; however, on punching it he suffered sharp pain of his fourth and fifth metacarpophalangeal joints. On examination the joints were found to be reddened, with point tenderness over the fifth metacarpal head; there was no evidence of deformity. He was advised to stop beating his Nurd, and the pain subsided. While the Nurd is very plastic, yielding to the linear tension of stretching and twisting, it is very resistant to compression. Punching a Nurd does not cause the surface to give way, and, since the force of the blow is returned to the fist, it is conceivable that a fracture might result. Therefore, although stretching and twisting Nurds does not cause any harm, users should be cautioned against punching their Nurd. The Nurd is advertised as being a ‘punchable, stretchable, pushable and likeable alternative to tension, migraine headaches, drug abuse, alcoholism and manic depression’, but these claims are unsubstantiated. A MEDLINE search of the medical literature shows that no retrospective or prospective case control studies or controlled double blind crossover studies have been undertaken. Before the clinical efficacy of the Nurd can be taken seriously in the treatment of this broad spectrum of disease, full clinical trials must be completed. Subjects entering into trials must, however, be duly informed of the hazards of punching Nurds”.
Another one that caught my attention was a new affliction (‘Breaker’s Neck’) caused by the craze of ‘break dancing’ reported by Dr. Bertha Ramirez and her colleagues in a 1984 issue of the Journal of the American Medical Association. (The reason why I say it caught my eye is that I am currently involved in some research on ‘dancing addiction’ with some of my Hungarian colleagues and we have just had a new paper accepted in the journal PLoS ONE concerning the development of our ‘Dancing Motives Inventory’ – see ‘Further Reading’ below).
“To be added to the rapidly growing list of socially acquired injuries, we report a case of traumatic cervical subluxation caused by a new dance technique. This technique, labeled ‘breaking’ by its devotees, involves a modified head stand, in which the dancer, using his arms and hands for balance, spins rapidly on his head, neck, or shoulders to the rhythm of disco music. He then lowers his body to the floor and performs a series of rotational motions using his arms as a fulcrum…A 15-year-old boy was seen in our pediatric emergency room complaining that, on awakening two days previously, he felt a ‘snap’ in his neck, followed by persistent neck stiffness. He reported having ‘danced on his head’ the night prior to this incident. On physical examination, his head was tilted to the left with an inability to flex”.
Engaging in excessive sporting activity has given rise to a number of medical syndromes. One such consequence is ‘Rower’s Rump’ reported by Drs. K Tomecki and J. Mikesell in a 1987 issue of the Journal of the American Academy of Dermatology. In a previous blog I examined addiction to cycling. In the 1980s there were many medical complaints reported as a result of excessive cycling. One such complaint (given the name of ‘Bicycling nipples’) was highlighted by Dr. B. Powell in a 1983 issue of the Journal of the American Medical Association:
“Bicyclists are likely to suffer from a number of maladies, including dysuria, numb penises, and more. During cool or cold weather, another problem, bicyclist’s nipples, may occur. This condition is similar to jogger’s nipples, but it is primarily a thermal injury instead of an irritation secondary to friction, as with the jogger’s complaint. Often the rider is out in the cold weather for some time, and his or her undershirt, jersey, and jacket can become moist from perspiration. Evaporation and the chill of the wind lower the temperature of the nipples. They get downright cold, and they hurt. The pain continues after the ride is over. Indeed, it can continue for several days. The nipples are sore, sensitive to both temperature change and touch”.
After reading this I found out that Dr. Fred Levit had reported a case of ‘Jogger’s Nipples’ in a 1977 issue of the New England Journal of Medicine. All of these related nipple conditions are all examples of fissure of the nipple as they are all caused by friction resulting in soreness, dryness or irritation to, or bleeding of, one or both nipples. The Wikipedia entry also notes that “the condition is also experienced by women who breastfeed, and by surfers who do not wear rash guards”. The article also noted that:
“Jogger’s nipple is caused by friction from the repeated rubbing of a t-shirt or other upper body clothing against the nipples during a prolonged period of exercise. The condition is suffered mainly by runners. Long-distance runners are especially prone, because they are exposed to the friction on the nipple for the greatest period of time. However, it is not only suffered by athletes; the inside of a badge, a logo on normal items of clothing, or breastfeeding can also cause the friction which results in this condition”.
Outside of the leisure sphere, there were two case study reports of ‘Diaper Doer’s Hand’ in a 1987 issue of the journal Clinical Rehabilitation by Dr. J.L. Cosgrove and colleagues:
“Three cases of stenosing tenosynovitis occurred three to six months postpartum. Childcare activities aggravated the symptoms of pain and swelling in both patients. In two cases, a specific method of carrying the child was implicated as the mechanism of injury. Although there was no evidence of generalized inflammatory arthritis, all patients had very low positive titres of anti-nuclear antibodies. While it is likely that tenosynovitis was caused by mechanical factors, the possibility of increased susceptibility to inflammatory disease in the postpartum period cannot be discounted. The patients were successfully treated with a low temperature plastic splint, superficial heat and gentle mobilization”.
All of these new syndromes lead to why I put this article together in the first place. I found this letter in the British Medical Journal by Dr. E.P. Hoare entitled ‘New Syndrome Syndrome’ that I found both funny and poignant:
“Your readers will be familiar with tennis elbow, brazier’s ague, and soap packer’s jig not to mention Achilles’ heel. More recently we have heard of Space Invader’s wrist, jogger’s nipples, and the ultimate futility of Cuber’s thumb. May I point out another occupational disease which I have noticed among patrons of the reading room medical journal correspondence column reader’s neck or, more succinctly, the new syndrome syndrome. Symptoms usually begin with muscular contraction of the eyebrows, hyperventilation, and involuntary utterances, which in severe cases can lead to coprolalia. These may be followed by drowsiness, disorientation, hysterical amblyopia, and double vision (of the deja vu variety). If untreated the condition can result in a chronic pain in the neck. Treatment is 200 ml of gin and tonic stat by mouth and complete rest; music can also be helpful. The long-term prognosis is poor, however, unless journal editors can be persuaded to ban further reports of occupational afflictions or at least print a health warning at the head of their correspondence columns”.
Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Behr, J.T. (1984). Pseudovideoma. Journal of Hand Surgery, 9(4), 613.
Cosgrove, J. L., Welch, D. A., Richardson, G. S., & Nicholas, J. J. (1987). Diaper doer’s hand: stenosing tenosynovitis in the postpartum period. Clinical Rehabilitation, 1(3), 219-223.
Gibofsky, A. (1983). Pac‐Man phalanx. Arthritis and Rheumatism, 26(1), 120.
Griffiths, M.D. (1995). Technological addictions. Clinical Psychology Forum, 76, 14-19.
Griffiths, M.D. (1995). Pop psychology and “aca-media”: A reply to Mitchell. The Psychologist: Bulletin of the British Psychological Society, 8, 537-538.
Griffiths, M.D. (2001). A moral obligation in aca-media? The Psychologist: Bulletin of the British Psychological Society, 14, 460.
Hite, P. R., Greene, K. A., Levy, D. I., & Jackimczyk, K. (1993). Injuries resulting from bungee-cord jumping. Annals of emergency medicine, 22(6), 1060-1063.
Hoare, E.P. (1982). Points: New syndrome syndrome. British Medical Journal, 285(6352), 1429.
Levit, F. (1977). Jogger’s nipples. New England Journal of Medicine, 297(20), 1127.
Maraz, A., Király, O., Urbán, R., Griffiths, M.D., Demetrovics, Z. (2015). Why do you dance? Development of the Dance Motivation Inventory (DMI). PLoS ONE, in press.
Martyn, J. B. (1983). Nurd knuckles. Canadian Medical Association Journal, 129(3), 228.
McCowan, T.C. (1981). Space Invader’s wrist. New England Journal of Medicine, 304,1368.
Osterman, A. L., Weinberg, P., & Miller, G. (1987). Joystick digit. Journal of the American Medical Association, 257(6), 782.
Powell, B. (1983). Bicyclist’s nipples. Journal of the American Medical Association, 249(18), 2457-2457.
Ramirez, B., Masella, P. A., Fiscina, B., Lala, V. R., & Edwards, M. D. (1984). Breaker’s neck. Journal of the American Medical Association, 252(24), 3366-3367.
Soe, G.B., Gersten, L. M., Wilkins, J., Patzakis, M. J., & Harvey, J.P. (1987). Infection associated with joystick mimicking a spider bite. Western Journal of Medicine, 146(6), 748.
Tomecki, K. J., & Mikesell, J. F. (1987). Rower’s rump. Journal of the American Academy of Dermatology, 16(4), 890-891.
Torre, P. R., Williams, G. G., Blackwell, T., & Davis, C. P. (1993). Bungee jumper’s foot drop peroneal nerve palsy caused by bungee cord jumping. Annals of emergency medicine, 22(11), 1766-1767.
Waugh, D. (1981). Cuber’s thumb. New England Journal of Medicine, 305, 768.
In previous blogs, I have examined lots of strange types of addictive and compulsive behaviours including compulsive singing, compulsive hoarding, carrot eating addiction, Argentine tango addiction, compulsive nose-picking, compulsive punning, compulsive helping, obsessive teeth whitening, compulsive list-making, chewing gum addiction, hair dryer addiction, wealth addiction, and Google Glass addiction (to name just a few).
However, while doing some research for a paper I am writing on ‘fishing addiction’ (yes, honestly), I came across an interesting paper on unusual compulsive behaviours caused by individuals receiving medication for Parkinson’s disease ([PD] a degenerative disorder of the central nervous system) and multiple system atrophy ([MSA] a degenerative neurological disorder in which nerve cells inside the brain start to degenerate and with symptoms similar to Parkinson’s disease).
In the gambling studies field there are now numerous papers that have been published showing that some Parkinson’s patients develop compulsive gambling after being treated for PD. According to the Parkinsons.co.uk website, those undergoing PD treatment can have many side effects including addictive gambling, obsessive shopping, binge eating, and hypersexuality. The website also notes other types of compulsive behaviour that have been associated with PD medication including “punding or compulsive hobbyism [when someone does things such as collecting, sorting or continually handling objects]. It may also be experienced as (i) a deep fascination with taking technical equipment apart without always knowing how to put it back together again, (ii) hoarding things, (iii) pointless driving or walking, and (iv) talking in long monologues without any real content”.
The paper that caught my eye was published in a 2007 issue of the journal Parkinsonism and Related Disorders by Dr. Andrew McKeon and his colleagues. They reported seven case studies of unusual compulsive behaviours after treating their patients with dopamine agonist therapy (i.e., treatment that activates dopamine receptors in the body). The paper described some compulsive behaviours that most people would not necessarily associate with being problematic. Below is a brief description of the seven cases that I have taken verbatim from the paper.
- Patient 1: “A 65-year-old female with PD for 9 years developed compulsive eating, and also felt compelled to repetitively weigh herself at frequent intervals during the day and at night. She found her behavior both purposeless and repetitive. Obsessive thoughts were also a feature, as the patient ‘had to’ weigh herself three times each occasion she used the weighing scales”.
- Patient 2: “A 67-year-old female with PD for 8 years played computer games and solitaire card games for hours on end, often continuing to do so through the night. She did not enjoy the experience and found it purposeless, but did so as she felt she had ‘to be doing something’. She also developed compulsive eating and gambling”.
- Patient 3: “A 48-year-old male with PD for 5 years, with little prior interest, developed an intense interest and fascination with fishing. His wife was concerned that he fished incessantly for days on end, and his interest did not abate despite never catching anything. This patient also developed compulsive shopping, spending large amounts of time and money in thrift stores”.
- Patient 4: “A 53-year-old male with PD for 13 years became intensely interested in lawn care. He would use a machine to blow leaves for 6h without rest, finding it difficult to disengage from the activity, as he found the repetitive behavior soothing. He also developed compulsive gambling”.
- Patient 5: “The wife of a 52-year-old male with an 11-year history of PD complained that her husband now spent all of his time on his hobbies, to the detriment of their marriage. The patient made small stained glass windows, day and night. In addition, he would frequently stay awake arranging rocks into piles in their yard, intending to build a wall, but never doing so. He would start multiple projects but complete nothing. He was also noted to have become hypersexual, demanding sexual intercourse from his wife several times daily”.
- Patient 6: “This 60-year-old male, with a history of alcohol abuse and ultimately diagnosed with MSA, relentlessly watched the clock, locked and unlocked doors and continually arranged and lined up small objects on his desk. He also became hyperphagic and hypersexual, developing an intense fascination with pornographic films”.
- Patient 7: “The wife of a 59-year-old male with PD for 1 year described how her husband dressed and undressed several times daily. On one occasion, while guests were at their house for dinner, he spent most of his time in his bedroom repeatedly changing from one pair of trousers into another. This behavior deteriorated considerably on increasing levodopa dose to 1100mg/day, and on a subsequent occasion after reducing quetiapine from 100 to 75 mg/day”.
These cases highlight that the compulsive behaviours that develop following dopamine agonist therapy often co-occur with one or more other compulsive behaviour and that much of these behaviours are repetitive and unwanted. As the authors noted:
“The temporal association between medication initiation and the onset of these behaviors led to our suspicion that medications were causative. In the aggregate, these patients illustrate that the behaviors provoked by drug therapy in parkinsonism cover a broad spectrum, ranging from purposeless and repetitive to complex, reward-oriented behaviors. Punding is the term typically applied to the former, and was seen in Patient 5 (arranging rocks into piles) and Patient 6 (lining up small objects on a desk)…Previous descriptions of pathological behaviors occur- ring with dopaminergic therapy in PD have been notable for the absence of obsessive thoughts accompanying compulsive behaviors, unlike Patient 1 who was remark- able for a counting ritual accompanying repetitive use of a weighing scale. In six of the seven cases, other reward- seeking behaviors (gambling, shopping, hypersexuality or overeating) were present and contemporaneous with these other unusual compulsive behaviors. This suggests that all of these behaviors, while phenomenologically distinct, are all part of the range of psychopathology encapsulated by obsessive-compulsive spectrum disorders”.
According to the Parkinsons.co.uk website, PD sufferers are more likely to experience impulsive and compulsive behaviour if the person is (i) diagnosed with Parkinson’s at a young age, (ii) male, (iii) single and live alone, (iv) a smoker, and (v) someone with a personal or family history of addictive behaviour. The same article also notes that if the PD sufferer has “a history of ‘risk-taking’, such as gambling, drug abuse or alcoholism, [they] may be more likely to develop dopamine addiction”. This is where the PD sufferer takes more of their medication than is needed to control their Parkinson’s symptoms (and known as dopamine dysregulation syndrome). Similarly, Dr. McKeon and colleagues concluded:
“Previously described associated clinical features include a prior history of depressed mood (four patients in this series), disinhibition, irritability and appetite disturbance…A history of problems with impulse control prior to the diagnosis of PD may be a risk factor for developing compulsive behaviors with dopaminergic therapies…although this only pertained to Patient 6…The compulsions were not found to be troublesome by three patients, with complaints regarding behavioral change coming from the patient’s spouse. Our observations affirm the need to check with both patient and family at follow-up visits for the emergence of a variety of troublesome pathological behaviors that may result from dopaminergic therapy, particularly dopamine agonists”.
Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Dodd, M. L., Klos, K. J., Bower, J. H., Geda, Y. E., Josephs, K. A., & Ahlskog, J. E. (2005). Pathological gambling caused by drugs used to treat Parkinson disease. Archives of Neurology, 62, 1377-1381.
Griffiths, M.D. (1996). Behavioural addictions: An issue for everybody? Journal of Workplace Learning, 8(3), 19-25.
Griffiths, M.D. (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10, 191-197.
Klos, K. J., Bower, J. H., Josephs, K. A., Matsumoto, J. Y., & Ahlskog, J. E. (2005). Pathological hypersexuality predominantly linked to adjuvant dopamine agonist therapy in Parkinson’s disease and multiple system atrophy. Parkinsonism and Related Disorders, 11, 381-386.
McKeon, A., Josephs, K. A., Klos, K. J., Hecksel, K., Bower, J. H., Michael Bostwick, J., & Eric Ahlskog, J. (2007). Unusual compulsive behaviors primarily related to dopamine agonist therapy in Parkinson’s disease and multiple system atrophy. Parkinsonism and Related Disorders, 13(8), 516-519.
Nirenberg, M. J., & Waters, C. (2006). Compulsive eating and weight gain related to dopamine agonist use. Movement Disorders, 21, 524-529.
Pontone, G., Williams, J. R., Bassett, S. S., & Marsh, L. (2006). Clinical features associated with impulse control disorders in Parkinson disease. Neurology, 67, 1258-1261.
Voon, V., Hassan, K., Zurowski, M., De Souza, M., Thomsen, T., Fox, S.,…& Miyasaki, J. (2006). Prevalence of repetitive and reward-seeking behaviors in Parkinson disease. Neurology, 67, 1254-1257.