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{{Short description|Punding is a compulsive fascination with and performance of repetitive, mechanical tasks}}[[File:Punding.jpg|right|thumb|275px|Punding, a possible symptom of [[dopamine dysregulation syndrome]] (DDS), is the repetition of complex motor behaviours such as collecting or arranging objects.]] |
{{Short description|Punding is a compulsive fascination with and performance of repetitive, mechanical tasks}}{{medref|date=December 2019}}[[File:Punding.jpg|right|thumb|275px|Punding, a possible symptom of [[dopamine dysregulation syndrome]] (DDS), is the repetition of complex motor behaviours such as collecting or arranging objects.]] |
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'''Punding''' is a term that was coined originally to describe complex prolonged, purposeless, and stereotyped behaviour in [[phenmetrazine]] and chronic [[amphetamine]] users, by Swedish forensic psychiatrist G. Rylander, in 1968.<ref>{{cite |
'''Punding''' is a term that was coined originally to describe complex prolonged, purposeless, and stereotyped behaviour in [[phenmetrazine]] and chronic [[amphetamine]] users, by Swedish forensic psychiatrist G. Rylander, in 1968.<ref>{{cite journal|url=https://books.google.com/books?id=T_nBAAAAIAAJ&q=Punding|title=Clinical and Medico-criminological aspects of addiction to Central Stimulating Drugs|journal=Abuse of Central Stimulants: Symposium Arranged by the Swedish Committee on International Health Relations, Stockholm, November 25–27, 1968|editor1=Folke Sjöqvist |editor2=Malcolm Tottie |publisher=Almqvist & Wiksell|date=1969|page=257}}</ref> It was later described in Parkinson's disease.<ref>{{cite journal | pmid = 15077237 | doi=10.1002/mds.20045 | volume=19 | title=Punding in Parkinson's disease: its relation to the dopamine dysregulation syndrome | date=April 2004 |author1=Evans AH |author2=Katzenschlager R |author3=Paviour D | journal=Mov. Disord. | issue=4 | pages=397–405| s2cid=23886073 |display-authors=etal}}</ref> It has also been described in [[methamphetamine]] and [[cocaine]] users, as well as in some patients with [[gambling addiction]]s, and [[hypersexuality]].<ref>{{cite journal | pmc = 2735437 | pmid=19720785 | doi= 10.4065/84.9.846| volume=84 | title=Drug-induced compulsive behaviors: exceptions to the rule | year=2009 | journal=Mayo Clin. Proc. | pages=846–7; author reply 847 |vauthors=Graham NA, Hammond CJ, Gold MS | issue=9 }}</ref> |
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Punding activity is characterized by compulsive fascination with and performance of repetitive, mechanical tasks, such as assembling and disassembling, collecting, or sorting household objects. For example, punding may consist of activities such as: |
Punding activity is characterized by compulsive fascination with and performance of repetitive, mechanical tasks, such as assembling and disassembling, collecting, or sorting household objects. For example, punding may consist of activities such as: |
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* trying but failing to systematically remove the entire contents of all the drawers and shelves in the home and sort through all their contents. |
* trying but failing to systematically remove the entire contents of all the drawers and shelves in the home and sort through all their contents. |
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People engaging in punding find immersion in such activities comforting, even when it serves no purpose, and generally find it very frustrating to be diverted from them. They are not generally aware that there is a compulsive element, but will continue even when they have good reason to stop. Rylander describes a burglar who started punding and could not stop, even though he was suffering from an increasing apprehension of being caught.<ref>{{ |
People engaging in punding find immersion in such activities comforting, even when it serves no purpose, and generally find it very frustrating to be diverted from them. They are not generally aware that there is a compulsive element, but will continue even when they have good reason to stop. Rylander describes a burglar who started punding and could not stop, even though he was suffering from an increasing apprehension of being caught.<ref>{{Cite book|page=[https://archive.org/details/speedcultureamph0000grin/page/104 104]|title=The Speed Culture: Amphetamine Use and Abuse in America|series=Harvard Paperbacks Series|author1=Lester Grinspoon|author2=Peter Hedblom|publisher=Harvard University Press|date=1975|isbn=9780674831926|url=https://archive.org/details/speedcultureamph0000grin/page/104}}</ref> |
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Interrupting can lead to various responses, including violent rage.<ref>{{Cite book|title=The Amphetamine Debate: The Use of Adderall, Ritalin and Related Drugs for Behavior Modification, Neuroenhancement and Anti-Aging Purposes|series=McFarland health topics|volume=10|author=Elaine A. Moore|publisher=McFarland|date=2010|isbn=9780786480128|page=186}}</ref> |
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Punding has been linked primarily to an overstimulation of the [[Dopamine D1 receptor|Dopamine D1 receptors]] and, to a lesser extent, of [[Dopamine D2 receptor|Dopamine D2 receptors]] which has been proposed to lead to substantial changes in the [[striatum]], especially its dorsal and ventral areas and the [[nucleus accumbens]] which are some of the main dopaminergic areas of the brain and regulate psychomotor functions and reward mechanisms; on the other hand, it has been noted that patients with Parkinson's disease treated with dopaminergic drugs that selectively activate only [[Dopamine D3 receptor|Dopamine D3 receptors]] are the least likely to develop punding.<ref name="molpsy" /> |
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Regarding treatment, this is mostly the same as for dopamine dysregulation syndrome but will vary depending on the cause: for patients with Parkinson's disease, their doses of dopaminergic drugs like levodopa must be reduced;<ref>{{cite book |editor1-first=Dag |editor1-last=Aarsland |editor2-first=Jeffrey |editor2-last=Cummings |editor3-first=Daniel |editor3-last=Weintraub |editor4-first=K. Ray |editor4-last=Chaudhuri |title=Neuropsychiatric and Cognitive Changes in Parkinson's Disease and Related Movement Disorders: Diagnosis and Management |url=https://books.google.com/books?id=pUIoAAAAQBAJ&printsec=frontcover |via=[[Google Books]] |date=29 August 2013 |publisher=[[Cambridge University Press]] |publication-place=[[Cambridge]], [[Massachusetts]], United States of America |series=Cambridge medicine |isbn=9781107039223 |chapter=13. Impulse control disorders and related behaviors (Section 3 - Specific neuropsychiatric disorders) |first1=Daniel |last1=Weintraub |first2=Irena |last2=Rektorova |page=146 |chapter-url=https://books.google.com/books?id=pUIoAAAAQBAJ&pg=PA146 }}</ref><ref name="davide">{{cite book |title=Disorders of Movement: A Guide to Diagnosis and Treatment |doi=10.1007/978-3-662-48468-5 |lccn=2015955471 |via=[[Google Books]] |url=https://books.google.com/books?id=Y18-CwAAQBAJ&printsec=frontcover |date=17 December 2015 |edition=1st |chapter-url=https://books.google.com/books?id=Y18-CwAAQBAJ&pg=PA127 |chapter=3. Unvoluntary Motor Behaviours (3.4 Punding: 3.4.3 How to treat) |first1=Davide |last1=Martino |first2=Alberto J. |last2=Espay |first3=Alfonso |last3=Fasano |first4=Francesco |last4=Morgante |isbn=978-3-662-56925-2 |publisher=[[Springer Science+Business Media]] |publication-place=[[Berlin]], Germany }}</ref> while people addicted to dopaminergic stimulants like cocaine or amphetamines should be counseled on their issues of addiction and referred to an appropriate drug rehabilition program.<ref name="journeur">{{cite journal |title=Management of punding in Parkinson’s disease: an open-label prospective study |first1=A. |last1=Fasano |first2=L. |last2=Ricciardi |first3=M. |last3=Pettorruso |first4=A.R. |last4=Bentivoglio |date=12 December 2010 |journal=[[Journal of Neurology]] |pages=656-660 |doi=10.1007/s00415-010-5817-8 |url=https://link.springer.com/article/10.1007%2Fs00415-010-5817-8 |issn=0340-5354 |oclc=00938795 |publisher=[[Springer Science+Business Media]] |publication-place=[[Berlin]], Germany |editor1-first=R.A. |editor1-last=Barker |editor2-first=M. |editor2-last=Filippi |editor3-first=M. |editor3-last=Strupp |pmid=21072531 |volume=258 |issue=4 |access-date=8 October 2021 }}</ref> |
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Medications that have proven effective in the treatment of punding are [[atypical antipsychotics]] like [[quetiapine]] or [[clozapine]].<ref>{{cite journal |oclc=290641801 |lccn=2007233446 |volume=19 |title=Clozapine as a potential treatment for refractory impulsive, compulsive, and punding behaviors in Parkinson’s disease |issue=6 |doi=10.1080/13554794.2012.713490 |pages=587-591 |url=https://www.tandfonline.com/doi/abs/10.1080/13554794.2012.713490 |issn=1355-4794 |publisher=[[Taylor & Francis|Psychology Press (Taylor & Francis)]] |editor1-first=Bruce L. |editor1-last=Miller |editor2-first=Hans J. |editor2-last=Markowitsch |publication-place=[[London]], [[England]], United Kingdom of Great Britain |journal=[[Neurocase]] |first1=A. |last1=Hardwick |first2=H. |last2=Ward |first3=A. |last3=Hassan |first4=J. |last4=Romrell |first5=M.S. |last5=Okun |date=1 December 2013 |access-date=8 October 2021 }}</ref><ref name="journeur" /> [[Amantadine]] has also reported to be fairly effective, while [[memantine]], an analog of amantadine with a more targeted pharmacological profile has not been evaluated but would presumably have similar efficacy to amantadine.<ref name="journeur" /><ref name="molpsy" /><ref>{{cite journal |url=https://movementdisorders.onlinelibrary.wiley.com/doi/abs/10.1002/mds.21780 |publisher=International Parkinson and Movement Disorder Society/[[Wiley (publisher)|Wiley]] |publication-place=[[Milwaukee]], [[Wisconsin]], United States of America |editor1-first=Julie |editor1-last=Nash |editor2-first=A. Jon |editor2-last=Stoessl |issn=1531-8257 |title=Amantadine may reverse punding in Parkinson's disease—Observation in a patient |first1=Kenichi |last1=Kashihara |first2=Takaki |last2=Imamura |volume=23 |issue=1 |date=1 January 2008 |pages=129-130 |doi=10.1002/mds.21780 |pmid=17960816 }}</ref> [[Selective serotonin reuptake inhibitors]] have been found to be of virtually no use, although in a handful of cases they have led to the resolution of symptoms, especially [[sertraline]] but only in high doses (the fact that sertraline also activates Dopamine D2 receptors is presumably involved.<ref name="davide" /> |
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While treating the root cause is considered to be the mainstay of treatment, in cases where a reduction in the consumption of dopaminergic substances of any kind (medications or drugs) is unacceptable (such as when reducing the dose of levodopa in a patient with Parkinson's disease would lead to an unacceptable worsening of the symptoms), are the type of situations when medications are most frequently considered, usually as add-on therapies.<ref name="davide" /> |
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==See also== |
==See also== |
Revision as of 19:40, 11 October 2021
![](https://web.archive.org/web/20220613015139im_/https://upload.wikimedia.org/wikipedia/commons/thumb/f/ff/Punding.jpg/275px-Punding.jpg)
Punding is a term that was coined originally to describe complex prolonged, purposeless, and stereotyped behaviour in phenmetrazine and chronic amphetamine users, by Swedish forensic psychiatrist G. Rylander, in 1968.[1] It was later described in Parkinson's disease.[2] It has also been described in methamphetamine and cocaine users, as well as in some patients with gambling addictions, and hypersexuality.[3]
Punding activity is characterized by compulsive fascination with and performance of repetitive, mechanical tasks, such as assembling and disassembling, collecting, or sorting household objects. For example, punding may consist of activities such as:
- collecting pebbles and lining them up as perfectly as possible,
- disassembling wristwatches and putting them back together again,
- building hundreds of small wooden boxes
- trying but failing to systematically remove the entire contents of all the drawers and shelves in the home and sort through all their contents.
People engaging in punding find immersion in such activities comforting, even when it serves no purpose, and generally find it very frustrating to be diverted from them. They are not generally aware that there is a compulsive element, but will continue even when they have good reason to stop. Rylander describes a burglar who started punding and could not stop, even though he was suffering from an increasing apprehension of being caught.[4]
Interrupting can lead to various responses, including violent rage.[5]
See also
Notes
- ^ Folke Sjöqvist; Malcolm Tottie, eds. (1969). "Clinical and Medico-criminological aspects of addiction to Central Stimulating Drugs". Abuse of Central Stimulants: Symposium Arranged by the Swedish Committee on International Health Relations, Stockholm, November 25–27, 1968. Almqvist & Wiksell: 257.
- ^ Evans AH; Katzenschlager R; Paviour D; et al. (April 2004). "Punding in Parkinson's disease: its relation to the dopamine dysregulation syndrome". Mov. Disord. 19 (4): 397–405. doi:10.1002/mds.20045. PMID 15077237. S2CID 23886073.
- ^ Graham NA, Hammond CJ, Gold MS (2009). "Drug-induced compulsive behaviors: exceptions to the rule". Mayo Clin. Proc. 84 (9): 846–7, author reply 847. doi:10.4065/84.9.846. PMC 2735437. PMID 19720785.
- ^ Lester Grinspoon; Peter Hedblom (1975). The Speed Culture: Amphetamine Use and Abuse in America. Harvard Paperbacks Series. Harvard University Press. p. 104. ISBN 9780674831926.
- ^ Elaine A. Moore (2010). The Amphetamine Debate: The Use of Adderall, Ritalin and Related Drugs for Behavior Modification, Neuroenhancement and Anti-Aging Purposes. McFarland health topics. Vol. 10. McFarland. p. 186. ISBN 9780786480128.