Albayrak Ozgür, Wölfle Sebastian Mathias, Hebebrand Johannes
Department of Child and Adolescent Psychiatry, LVR-Klinikum Essen, University of Duisburg-Essen, Essen, Germany.
Obes Facts. 2012;5(2):165-79. doi: 10.1159/000338310. Epub 2012 Apr 19.
The relationship between overeating, substance abuse and (behavioral) addiction is controversial. Medically established forms of addiction so far pertain to substance use disorders only. But the preliminary Diagnostic and Statistical Manual for Mental Disorders V (DSM V) suggests replacing the previous category 'Substance-Related Disorders' with 'Addiction and Related Disorders', thus for the first time allowing the diagnosis of behavioral addictions. In the past psychiatrists and psychologists have been reluctant to systematically delineate and classify the term behavioral addiction. However, there is a broad overlap between chemical and behavioral addiction including phenomenological, therapeutic, genetic, and neurobiological aspects. It is of interest to point out that the hormone leptin in itself has a pronounced effect on the reward system, thus suggesting an indirect link between overeating and 'chemical' addiction. Thus, leptin-deficient individuals could be classified as fulfilling criteria for food addiction. In our overview we first review psychological findings in chemical (substance-based) and subsequently in behavioral addiction to analyze the overlap. We discuss the diagnostic validity of food addiction, which in theory can be chemically and/or behaviorally based.
暴饮暴食、物质滥用与（行为）成瘾之间的关系存在争议。目前医学上确定的成瘾形式仅涉及物质使用障碍。但《精神疾病诊断与统计手册》第五版（DSM V）初稿建议将之前的“物质相关障碍”类别替换为“成瘾及相关障碍”，从而首次允许对行为成瘾进行诊断。过去，精神病医生和心理学家一直不愿对行为成瘾这一术语进行系统的界定和分类。然而，化学成瘾和行为成瘾在现象学、治疗、遗传和神经生物学等方面存在广泛的重叠。值得指出的是，激素瘦素本身对奖赏系统有显著影响，因此提示暴饮暴食与“化学”成瘾之间存在间接联系。因此，瘦素缺乏的个体可被归类为符合食物成瘾的标准。在我们的综述中，我们首先回顾化学（基于物质）成瘾的心理学研究结果，随后回顾行为成瘾的相关结果，以分析两者的重叠之处。我们讨论食物成瘾的诊断有效性，理论上它可以基于化学和/或行为。
