Impulse Control Disorders Outpatient Unit, Institute and Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
Compr Psychiatry. 2012 Jul;53(5):554-61. doi: 10.1016/j.comppsych.2011.09.005. Epub 2011 Nov 17.
Compulsive buying (CB) is currently classified as an impulse control disorder (ICD) not otherwise classified. Compulsive buying prevalence is estimated at around 5% of the general population. There is controversy about whether CB should be classified as an ICD, a subsyndromal bipolar disorder (BD), or an obsessive-compulsive disorder (OCD) akin to a hoarding syndrome. To further investigate the appropriate classification of CB, we compared patients with CB, BD, and OCD for impulsivity, affective instability, hoarding, and other OCD symptoms.
Eighty outpatients (24 CB, 21 BD, and 35 OCD) who were neither manic nor hypomanic were asked to fill out self-report questionnaires.
Compulsive buying patients scored significantly higher on all impulsivity measures and on acquisition but not on the hoarding subdimensions of clutter and "difficulty discarding." Patients with BD scored higher on the mania dimension from the Structured Clinical Interview for Mood Spectrum scale. Patients with OCD scored higher on obsessive-compulsive symptoms and, particularly, higher on the contamination/washing and checking dimensions from the Padua Inventory; however, they did not score higher on any hoarding dimension. A discriminant model built with these variables correctly classified patients with CB (79%), BD (71%), and OCD (77%).
Patients with CB came out as impulsive acquirers, resembling ICD- rather than BD- or OCD-related disorders. Manic symptoms were distinctive of patients with BD. Hoarding symptoms other than acquisition were not particularly associated with any diagnostic group.
强迫性购买(CB)目前被归类为冲动控制障碍(ICD),未另作分类。据估计,普通人群中约有 5%的人患有强迫性购买症。关于 CB 是否应归类为 ICD、亚综合征双相情感障碍(BD)或类似于囤积症的强迫症(OCD)存在争议。为了进一步探讨 CB 的适当分类,我们比较了患有 CB、BD 和 OCD 的患者的冲动性、情感不稳定、囤积和其他 OCD 症状。
80 名门诊患者(24 名 CB、21 名 BD 和 35 名 OCD)既非躁狂也非轻躁狂,他们被要求填写自我报告问卷。
强迫性购买患者在所有冲动性测量指标以及获取方面的得分明显更高,但在囤积的杂乱和“难以丢弃”子维度方面得分没有更高。BD 患者在心境障碍谱结构化临床访谈的躁狂维度上的得分更高。OCD 患者在强迫症状方面的得分更高,尤其是在帕多瓦清单的污染/洗涤和检查维度上的得分更高;然而,他们在任何囤积维度上的得分都没有更高。使用这些变量构建的判别模型正确地将 CB(79%)、BD(71%)和 OCD(77%)患者进行了分类。
CB 患者表现为冲动性获取者,类似于 ICD 相关障碍而非 BD 或 OCD 相关障碍。躁狂症状是 BD 患者的特征。除获取外的其他囤积症状与任何诊断组都没有特别相关。