University of Minnesota School of Medicine, Minneapolis, USA.
Am J Drug Alcohol Abuse. 2010 Sep;36(5):233-41. doi: 10.3109/00952990.2010.491884.
Several behaviors, besides psychoactive substance ingestion, produce short-term reward that may engender persistent behavior, despite knowledge of adverse consequences, i.e., diminished control over the behavior. These disorders have historically been conceptualized in several ways. One view posits these disorders as lying along an impulsive-compulsive spectrum, with some classified as impulse control disorders. An alternate, but not mutually exclusive, conceptualization considers the disorders as non-substance or "behavioral" addictions.
Inform the discussion on the relationship between psychoactive substance and behavioral addictions.
We review data illustrating similarities and differences between impulse control disorders or behavioral addictions and substance addictions. This topic is particularly relevant to the optimal classification of these disorders in the forthcoming fifth edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-V).
Growing evidence suggests that behavioral addictions resemble substance addictions in many domains, including natural history, phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment, supporting the DSM-V Task Force proposed new category of Addiction and Related Disorders encompassing both substance use disorders and non-substance addictions. Current data suggest that this combined category may be appropriate for pathological gambling and a few other better studied behavioral addictions, e.g., Internet addiction. There is currently insufficient data to justify any classification of other proposed behavioral addictions.
Proper categorization of behavioral addictions or impulse control disorders has substantial implications for the development of improved prevention and treatment strategies.
除了精神活性物质摄入外，还有几种行为会产生短期的奖励，这些行为可能会导致持续的行为，尽管人们知道会产生不良后果，即行为失去控制。这些障碍在历史上有多种概念化方式。一种观点认为，这些障碍沿着冲动-强迫的谱系存在，其中一些被归类为冲动控制障碍。另一种但不相互排斥的概念化方法则认为这些障碍是非物质或“行为”成瘾。
为精神活性物质与行为成瘾之间的关系讨论提供信息。
我们回顾了说明冲动控制障碍或行为成瘾与物质成瘾之间相似性和差异性的数据。这个话题对于即将出版的美国精神病学协会《精神疾病诊断与统计手册》（DSM-V）第五版中这些障碍的最佳分类尤为重要。
越来越多的证据表明，行为成瘾在许多领域与物质成瘾相似，包括自然史、表现、耐受性、共病、重叠的遗传贡献、神经生物学机制和对治疗的反应，支持 DSM-V 工作组提出的涵盖物质使用障碍和非物质成瘾的新的“成瘾及相关障碍”类别。目前的数据表明，这个综合类别可能适用于病理性赌博和其他一些研究较好的行为成瘾，例如网络成瘾。目前还没有足够的数据支持将其他提议的行为成瘾进行任何分类。
正确分类行为成瘾或冲动控制障碍对于制定改善预防和治疗策略具有重要意义。
