![Punding](https://upload.wikimedia.org/wikipedia/commons/f/ff/Punding.jpg)
Punding is compulsive performance of repetitive, mechanical tasks, such as assembling and disassembling, collecting, or sorting household objects. The term was originally coined to describe complex prolonged, purposeless, and stereotyped behaviour in
phenmetrazine
Phenmetrazine ( INN, USAN, BAN) (brand name Preludin, and many others) is a stimulant drug first synthesized in 1952 and originally used as an appetite suppressant, but withdrawn from the market in the 1980s due to widespread abuse. It was initi ...
and chronic
amphetamine users, by Swedish forensic psychiatrist G. Rylander, in 1968. It was later described in Parkinson's disease, but mainly in cases of patients being treated with
dopaminergic drugs.
It has also been described in
methamphetamine and
cocaine
Cocaine (from , from , ultimately from Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly used recreationally for its euphoric effects. It is primarily obtained from the leaves of two Coca species native to South Ameri ...
users, as well as in some patients with
gambling addictions, and
hypersexuality
Hypersexuality is extremely frequent or suddenly increased libido. It is controversial whether it should be included as a clinical diagnosis used by mental healthcare professionals. Nymphomania and satyriasis were terms previously used for the c ...
.
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; or conducting extended monologues devoid of context.
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. Interrupting can lead to various responses, including anger or rage, sometimes to the point of violence.
Causes
Punding has been linked primarily to an overstimulation of the
dopamine D1 receptors and, to a lesser extent, of
D2 receptors, which has been proposed to lead to substantial changes in the
striatum (especially its dorsal and ventral areas) and the
nucleus accumbens
The nucleus accumbens (NAc or NAcc; also known as the accumbens nucleus, or formerly as the ''nucleus accumbens septi'', Latin for " nucleus adjacent to the septum") is a region in the basal forebrain rostral to the preoptic area of the hypot ...
, some of the main dopaminergic areas of the brain regulating psychomotoric 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
D3 receptors are the least likely to develop punding.
Treatment
Treatment is mostly the same as for the
dopamine dysregulation syndrome
Dopamine dysregulation syndrome (DDS) is a dysfunction of the reward system observed in some individuals taking dopaminergic medications for an extended length of time. It typically occurs in people with Parkinson's disease (PD) who have taken dop ...
, but will vary depending on the cause: for patients with Parkinson's disease, doses of dopaminergic drugs such as
levodopa must be reduced;
while people addicted to dopaminergic stimulants like cocaine or amphetamines should be counseled on their issues of addiction and referred to an appropriate drug rehabilitation program.
Medications that have proven effective in the treatment of punding are
atypical antipsychotics
The atypical antipsychotics (AAP), also known as second generation antipsychotics (SGAs) and serotonin–dopamine antagonists (SDAs), are a group of antipsychotic drugs (antipsychotic drugs in general are also known as major tranquilizers and ne ...
like
quetiapine
Quetiapine, sold under the brand name Seroquel among others, is an atypical antipsychotic medication used for the treatment of schizophrenia, bipolar disorder, and major depressive disorder. Despite being widely used as a sleep aid due to its ...
or
clozapine
Clozapine is a psychiatric medication and is the first atypical antipsychotic (also called second-generation antipsychotic). It is primarily used to treat people with schizophrenia and schizoaffective disorders who have had an inadequate respo ...
.
Amantadine
Amantadine, sold under the brand name Gocovri among others, is a medication used to treat dyskinesia associated with parkinsonism and influenza caused by type A influenzavirus, though its use for the latter is no longer recommended due to wi ...
has also reported to be fairly effective, while
memantine
Memantine is a medication used to slow the progression of moderate-to-severe Alzheimer's disease. It is taken by mouth.
Common side effects include headache, constipation, sleepiness, and dizziness. Severe side effects may include blood clots ...
, an analog of amantadine with a more targeted pharmacological profile has not been evaluated but would presumably have similar efficacy to amantadine.
Selective serotonin reuptake inhibitors
Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions.
SSRIs increase the extracellul ...
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
Sertraline, sold under the brand name Zoloft among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. The efficacy of sertraline for depression is similar to that of other antidepressants, and the differ ...
but only in high doses (the fact that sertraline also activates Dopamine D2 receptors is presumably involved).
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.
See also
*
Busywork
Busy work (also known as make-work and busywork) is an activity that is undertaken to pass time and stay busy but in and of itself has little or no actual value. Busy work occurs in business, military and other settings, in situations where peop ...
, any activity that undertaken to pass time
*
Grinding (video games)
Grinding in video games is the act of repeating an action or set of actions to achieve a desired result. Players usually perform these tasks to earn experience points / exp points, in-game items (loot), or to improve a character's level/stats. ...
, performing repetitive tasks in video games
*
Knolling
Tom Sachs (born July 26, 1966) is an American contemporary artist who lives and works in New York City.
Life and early career
Sachs was born in New York City on July 26, 1966. He grew up in Westport, Connecticut, attending high school at Greens ...
, arranging flat objects on a desk at right angles
*
Stimming
Self-stimulatory behavior, also known as "stimming" and self-stimulation, is the repetition of physical movements, sounds, words, moving objects, or other repetitive behaviors. Such behaviors (also scientifically known as 'stereotypies') are fou ...
, repetition of physical movements or sounds, particularly by autistic people
*
Stereotypy
A stereotypy (, or ) is a repetitive or ritualistic movement, posture, or utterance. Stereotypies may be simple movements such as body rocking, or complex, such as self-caressing, crossing and uncrossing of legs, and marching in place. They are ...
, any repetitive or ritualistic movement, posture, or utterance
Notes
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Addiction psychiatry
Medical signs