Black Donald W, Shaw Martha, Blum Nancee
Department of Psychiatry, University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa 52242, USA.
Dialogues Clin Neurosci. 2010;12(2):175-85. doi: 10.31887/DCNS.2010.12.2/dblack.
Both compulsive buying (CB) and pathological gambling (PG) have been proposed as members of a spectrum of disorders related to obsessive-compulsive disorder (OCD). The spectrum hypothesis originated in the early 1990s and has gained considerable support, despite the lack of empirical evidence. Interest in this hypothesis has become critical because some investigators have recommended the creation of a new category that includes these disorders in DSM-5, now under development. In this article, the authors describe the origin of the obsessive-compulsive (OC) spectrum and its theoretical underpinnings, review both CB and PG, and discuss the data both in support of and against an OC spectrum. Both disorders are described in terms of their history, definition, classification, phenomenology family history, pathophysiology, and clinical management. The authors conclude that: (i) CB and PG are probably not related to OCD, and there is insufficient evidence to place them within an OC spectrum in DSM-V; (ii) PG should stay with the impulse-control disorders (ICDs); and (iii) a new diagnosis of CB should be created and be classified as an ICD.
强迫性购物（CB）和病态赌博（PG）都被认为是与强迫症（OCD）相关的一系列障碍的成员。这种谱系假说起源于20世纪90年代初，尽管缺乏实证证据，但已获得了相当多的支持。对这一假说的关注变得至关重要，因为一些研究者建议在正在制定的《精神疾病诊断与统计手册》第5版（DSM-5）中创建一个新类别，将这些障碍纳入其中。在本文中，作者描述了强迫观念与强迫行为（OC）谱系的起源及其理论基础，回顾了CB和PG，并讨论了支持和反对OC谱系的相关数据。这两种障碍都从其历史、定义、分类、现象学、家族史、病理生理学和临床管理等方面进行了描述。作者得出结论：（i）CB和PG可能与OCD无关，没有足够的证据将它们列入DSM-V中的OC谱系；（ii）PG应保留在冲动控制障碍（ICD）类别中；（iii）应创建CB的新诊断，并将其归类为ICD。
