Egorov A Yu, Grechanyi S V
Sechenov Institute of Evolutionary Physiology and Biochemistry the Russian Academy of Sciences, St.-Petersburg, Russia; St.-Petersburg State University, St.-Petersburg, Russia; Mechnikov North-West State Medical University, St.-Petersburg, Russia.
St.-Petersburg State Pediatric Medical University, St.-Petersburg, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2019;119(6):152-159. doi: 10.17116/jnevro2019119061152.
According to WHO consensus decision, gambling disorder, including the form of Internet addiction (IA), should be included in the section 'Impulsive disorders and behavioral addictions' of ICD-11. Population studies in the USA and Europe show the prevalence of IA from 1.5 to 8.2%, and in the countries of Southeast Asia it reaches 20-30% among young people. All this raises questions about the development of standardized approaches to the treatment and correction of this disorder. The review covers pharmacological and non-pharmacological approaches. Several studies and clinical observations have been devoted to pharmacological methods for treating IA, including the successful use of antidepressants such as escitalopram, clomipramine, and bupropion. There are data on the effectiveness of quetiapine, clonazepam, naltrexone and methylphenidate. In general, research was limited to methodological deficiencies, including small sample sizes, lack of control groups etc. Of non-pharmacological and psychotherapeutic approaches, in particular, cognitive-behavioral therapy (CBT) is the most studied. Special programs CBT are developed focused on children and teenagers. In addition to CBT, other psychotherapeutic approaches were used for the correction of IA: reality therapy, Internet interventions, acceptance and responsibility therapy, family therapy, complex methods. In many countries educational medical camps have been established (for example, sports or other outdoor activities) for adolescents with IA. Further studies in the field are needed to develop treatment approaches and diagnostic classification of IA.
根据世界卫生组织的共识决定,赌博障碍,包括网络成瘾(IA)形式,应纳入国际疾病分类第11版(ICD - 11)的“冲动障碍和行为成瘾”章节。美国和欧洲的人群研究显示,IA的患病率为1.5%至8.2%,而在东南亚国家,年轻人中的患病率达到20% - 30%。所有这些都引发了关于制定针对这种障碍的标准化治疗和矫正方法的问题。本综述涵盖了药物治疗和非药物治疗方法。已有多项研究和临床观察致力于IA的药物治疗方法,包括成功使用抗抑郁药,如艾司西酞普兰、氯米帕明和安非他酮。也有关于喹硫平、氯硝西泮、纳曲酮和哌甲酯有效性的数据。总体而言,研究受到方法学缺陷的限制,包括样本量小、缺乏对照组等。在非药物和心理治疗方法中,特别是认知行为疗法(CBT)研究得最多。针对儿童和青少年开发了专门的CBT项目。除了CBT,还使用其他心理治疗方法来矫正IA:现实疗法、网络干预、接受与责任疗法、家庭疗法、综合方法。在许多国家,已经为患有IA的青少年设立了教育医疗营(例如体育或其他户外活动)。该领域需要进一步研究以开发IA的治疗方法和诊断分类。