Zakeri Kourosh, Potenza Marc N
Department of Psychiatry, Yale University School of Medicine.
Curr Psychiatry Rev. 2012 Feb 1;8(1). doi: 10.2174/157340012798994911.
Pathological gambling (PG) is an impulse control disorder with prevalence estimates in the range of 0.2-2% in the general population. PG can significantly impact one's ability to function as it may negatively influence social, financial, and occupational aspects of life. Historically, PG has received relatively little attention from researchers and clinicians, and few treatments, particularly pharmacological, have been both validated and widely employed. Given the clinical relevance of PG, it is important that researchers examine pharmacological and behavioral treatments for their safety and efficacy and that clinicians use empirically validated therapies. Multiple neurochemicals, including serotonin, dopamine, norepinephrine, and opioids, and related neurocircuitry, particularly ventral cortico-striatal pathways, have been implicated in PG. The neurobiological rationale for therapies, particularly pharmacological ones, is reviewed with a perspective on the generation of improved prevention and treatment strategies for PG.
病理性赌博(PG)是一种冲动控制障碍,据估计在普通人群中的患病率为0.2%-2%。PG会显著影响一个人的功能能力,因为它可能会对生活的社会、财务和职业方面产生负面影响。从历史上看,PG相对较少受到研究人员和临床医生的关注,很少有治疗方法,特别是药物治疗方法,得到验证并广泛应用。鉴于PG的临床相关性,研究人员检查药物和行为治疗的安全性和有效性,以及临床医生使用经过实证验证的疗法非常重要。多种神经化学物质,包括血清素、多巴胺、去甲肾上腺素和阿片类物质,以及相关的神经回路,特别是腹侧皮质-纹状体通路,都与PG有关。本文从为PG制定更好的预防和治疗策略的角度,对治疗方法,特别是药物治疗方法的神经生物学原理进行了综述。