Punding is complex, repetitive behavior done without a purpose. Also known as “stereotyped behavior,” the term was coined in the 1970s to describe the behavior of people abusing amphetamines.
Examples of punding behavior include:
- excessive fidgeting
- wandering for long periods of time
- excessively touching and sorting common objects
- intense fascination with machinery
Punding is most often seen in people being treated for Parkinson’s disease. However, it may also have connections to other mental health disorders and forms of psychosis.
Main Causes Of Punding
The most well-known cause of punding is dopamine dysregulation syndrome (DDS). DDS can often be seen in patients with Parkinson’s disease, a movement disorder often caused by a lack of dopamine.
A common treatment for Parkinson’s is taking dopaminergic medication, which increases dopamine in the nervous system. This is also known as dopamine replacement therapy (DRT), and there is evidence that medications such as Levodopa (also known as l-dopa) may cause DDS.
DDS has many side effects, including aggressive behavior, punding, dyskinesias (uncontrollable muscle movement), increased motor symptoms, and severe withdrawal from dopamine agonists.
Other Causes Of Punding
The highest prevalence of punding behavior is in Parkinson’s patients, or PD patients.
However, other studies have shown connections between punding and other neuropsychological dysfunctions, such as dementia and bipolar disorder. Still others have noticed punding behavior in patients recovering from strokes.
Examples of punding behavior in these studies include copying science books, obsessions with food, and intense focus on gardening.
These studies have questioned the link between punding and abnormal dopamine pathophysiology. They suggest that punding may have other potential causes. Further research is needed to confirm or deny these claims.
Punding Vs. OCD
Punding behavior and behavior of obsessive-compulsive disorder, or OCD, are both abnormal forms of behavior. However, they have many different causes and effects.
OCD is characterized by obsessions, or uncontrollable, repetitive thoughts that cause anxiety. People with OCD often do compulsive behaviors in response to these obsessive thoughts, with a goal of reducing their anxiety. These behaviors are defined by impulsivity, or a lack of control.
Punding behaviors are usually not a response to uncontrollable thoughts. They may cause anxiety, but only if they get in the way of a person’s schedule. Punding is different from OCD, as well as the several impulse control disorders that may affect movement.
Dealing With Punding Behaviors
Punding is a symptom, not a cause. It is often seen in people already being treated for Parkinson’s disease, which makes avoiding or reducing it difficult.
Punding is a relatively uncommon behavior. It is reported in between 1% to 14% of people taking dopaminergic medications, according to one study. The full scope of its causes and potential treatments are still unknown.
The connection between punding and Parkinson’s treatment remains strong. To learn more about Parkinson’s disease, as well as other movement and control disorders, talk to your healthcare professional.
AHA Journals - Punding as a Complication of Brain Stem Stroke?
Annals of General Psychiatry - Successful treatment of dopamine dysregulation syndrome with dopamine D2 partial agonist antipsychotic drug
The Journal of Neuropsychiatry and Clinical Neurosciences - Punding as a Transient Symptom in a Patient With an Early-Onset Form of Dementia
Journal of the Neurological Sciences - Punding in non-demented Parkinson's disease patients: Relationship with psychiatric and addiction spectrum comorbidity
National Institute of Mental Health - Obsessive-Compulsive Disorder
National Library of Medicine - Dopamine dysregulation syndrome in Parkinson's disease: a systematic review of published cases
National Library of Medicine - Punding in Parkinson's disease: its relation to the dopamine dysregulation syndrome
Practical Neurology - Punding in Parkinson's Disease
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