Cathelain Sarah, Brunault Paul, Ballon Nicolas, Réveillère Christian, Courtois Robert
Université François-Rabelais de Tours, département de psychologie, EA 2114, « psychologie des âges de la vie », 37041 Tours, France.
Université François-Rabelais de Tours, département de psychologie, EA 2114, « psychologie des âges de la vie », 37041 Tours, France; CHRU de Tours, équipe de liaison et de soins en addictologie, 37044 Tours cedex 09, France; CHRU de Tours, clinique psychiatrique universitaire, 37044 Tours cedex 09, France.
Presse Med. 2016 Dec;45(12 Pt 1):1154-1163. doi: 10.1016/j.lpm.2016.03.014. Epub 2016 Jul 7.
Addictions, which are characterized by the inability to control a behavior despite existence of physical or psychological consequences, have biological, psychological and social determinants. Although the possibility of developing an addiction to some psychoactive substances (e.g. alcohol, tobacco, cannabis) and to gambling (i.e., gambling disorder) is now well demonstrated, the possibility to develop a non-drug addiction (i.e., behavioral addiction) to certain behaviors which provide pleasure (e.g. eating, having sex, buying things) is still in debate. The concept of food addiction, which refers to people who exhibit substance dependence criteria in relation to some high-fat and high-sugar foods, was recently proposed by applying substance dependence DSM criteria to eating behavior. To assess food addiction, the Yale Food Addiction Scale is now the only self-administered questionnaire (diagnosis and estimate of the number of symptoms of food addiction). Prevalence for food addiction is higher in overweight and obese patients, and in patients with certain psychopathological characteristics (i.e., depression, Attention Deficit Hyperactivity Disorder, high impulsivity), in patients who are single and in patients with neurobiological alterations in the reward system. However, it is still unclear whether food addiction is necessary associated with subsequent increase in body weight and/or obesity. An increasing number of studies demonstrated that drug addiction and food addiction shares some similar clinical, neurobiological and psychopathological and sociocultural risk factors. To test the pertinence to include food addiction as an addiction, it would be interesting to conduct future studies in patients who may experience harms related to their food addiction, including not only patients with obesity, but also patients with metabolic syndrome, type 2 diabetes, hypertension, dyslipidemia, atherosclerosis, stroke, or coronary heart disease. Food addiction is a clinical and multidimensional concept which requires integrated care with psychotherapy, pharmacological and social lines of approach. This concept has also practical implications in terms of prevention and public health (e.g., prevention, brief interventions, possible law enforcement regarding some kinds of food which could present some addictive properties).
成瘾的特征是尽管存在生理或心理后果，却无法控制某种行为，它具有生物学、心理学和社会决定因素。虽然现在已经充分证明了对某些精神活性物质（如酒精、烟草、大麻）以及赌博（即赌博障碍）产生成瘾的可能性，但对某些能带来愉悦感的行为（如进食、性行为、购物）产生非药物成瘾（即行为成瘾）的可能性仍存在争议。食物成瘾的概念是最近通过将物质依赖的《精神疾病诊断与统计手册》标准应用于饮食行为而提出的，它指的是那些在某些高脂肪和高糖食物方面表现出物质依赖标准的人。为了评估食物成瘾，耶鲁食物成瘾量表是目前唯一的自我管理问卷（用于诊断和估计食物成瘾症状的数量）。超重和肥胖患者、具有某些心理病理特征（如抑郁症、注意力缺陷多动障碍、高冲动性）的患者、单身患者以及奖励系统存在神经生物学改变的患者中食物成瘾的患病率更高。然而，食物成瘾是否必然与随后体重增加和/或肥胖相关仍不清楚。越来越多的研究表明，药物成瘾和食物成瘾有一些相似的临床、神经生物学、心理病理和社会文化风险因素。为了检验将食物成瘾纳入成瘾范畴的相关性，未来对可能因食物成瘾而受到伤害的患者进行研究将会很有意思，这些患者不仅包括肥胖患者，还包括患有代谢综合征、2型糖尿病、高血压、血脂异常、动脉粥样硬化、中风或冠心病的患者。食物成瘾是一个临床和多维度的概念，需要综合心理治疗、药物治疗和社会治疗方法进行护理。这个概念在预防和公共卫生方面也有实际意义（例如，预防、简短干预、可能对某些具有成瘾特性的食物实施执法）。
