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行为成瘾的当前进展:从基础研究到临床实践

Current Advances in Behavioral Addictions: From Fundamental Research to Clinical Practice.

作者信息

Brand Matthias, Antons Stephanie, Bőthe Beata, Demetrovics Zsolt, Fineberg Naomi A, Jimenez-Murcia Susana, King Daniel L, Mestre-Bach Gemma, Moretta Tania, Müller Astrid, Wegmann Elisa, Potenza Marc N

机构信息

General Psychology-Cognition, Faculty of Computer Science, University of Duisburg-Essen, Germany (Brand, Antons, Wegmann); Center for Behavioral Addiction Research, Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Germany (Brand, Antons, Wegmann); Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany (Brand, Antons); Department of Psychology, University of Montreal, Montreal (Bőthe); Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Montreal (Bőthe); College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia (Demetrovics, King); Institute of Psychology, ELTE Eötvös Loránd University, Budapest (Demetrovics); Center of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar (Demetrovics); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK (Fineberg); Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK (Fineberg); University of Cambridge School of Clinical Medicine, Cambridge, UK (Fineberg); Department of Clinical Psychology, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona (Jimenez-Murcia); Ciber Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Barcelona (Jimenez-Murcia); Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, IDIBELL, Barcelona (Jimenez-Murcia); Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona (Jimenez-Murcia); Psychology Services of the University of Barcelona, Barcelona (Jimenez-Murcia); Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, La Rioja, Spain (Mestre-Bach); Department of General Psychology, University of Padova, Padua, Italy (Moretta); Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany (Müller); Departments of Psychiatry, Neuroscience, and Child Study and Wu Tsai Institute, Yale University School of Medicine, New Haven, CT (Potenza); Connecticut Council on Problem Gambling, Wethersfield, CT (Potenza); Connecticut Mental Health Center, New Haven, CT (Potenza).

出版信息

Am J Psychiatry. 2025 Feb 1;182(2):155-163. doi: 10.1176/appi.ajp.20240092. Epub 2024 Dec 11.

Abstract

Gambling disorder is the only behavioral addiction recognized as a clinical disorder in DSM-5, and Internet gaming disorder is included as a condition requiring further research. ICD-11 categorizes gambling and gaming disorders as disorders due to addictive behaviors. Additional behavioral addictions may include compulsive sexual behavior disorder, compulsive buying-shopping disorder, and problematic use of social media. This narrative review summarizes the current state of knowledge regarding these five (potential) disorders due to addictive behaviors. All five (potential) disorders are clinically relevant and prevalent. Behavioral addictions frequently co-occur with other mental and behavioral problems, such as depression, anxiety, and attention deficit hyperactivity disorder. Validated diagnostic instruments exist, with empirical support varying across conditions. No medications have approved indications from regulatory bodies for behavioral addictions, and cognitive-behavioral therapy has the most empirical support for efficacious treatment. Given that behavioral addictions are prevalent, frequently co-occur with psychiatric disorders, may often go undiagnosed and untreated, and have been linked to poorer treatment outcomes, active screening and treatment are indicated. Public health considerations should be expanded, and impacts of modern technologies should be investigated more intensively. Treatment optimization involving pharmacotherapy, psychotherapy, neuromodulation, and their combination warrants additional investigation.

摘要

赌博障碍是《精神疾病诊断与统计手册》第5版(DSM-5)中唯一被认可的行为成瘾性临床疾病,而网络游戏障碍则被列为需要进一步研究的病症。《国际疾病分类》第11版(ICD-11)将赌博和游戏障碍归类为成瘾行为所致的疾病。其他行为成瘾可能包括强迫性行为障碍、强迫性购买-购物障碍以及社交媒体使用问题。这篇叙述性综述总结了关于这五种(潜在)成瘾行为所致疾病的当前知识状况。所有这五种(潜在)疾病在临床上都具有相关性且较为普遍。行为成瘾常常与其他心理和行为问题共同出现,如抑郁、焦虑和注意力缺陷多动障碍。存在经过验证的诊断工具,但其在不同情况下的实证支持有所不同。尚无药物获得监管机构批准用于治疗行为成瘾,认知行为疗法在有效治疗方面得到的实证支持最多。鉴于行为成瘾较为普遍,常常与精神疾病共同出现,可能常常未被诊断和治疗,并且与较差的治疗结果相关联,因此需要进行积极的筛查和治疗。应扩大公共卫生方面的考量,更深入地研究现代技术的影响。涉及药物治疗、心理治疗、神经调节及其联合应用的治疗优化值得进一步研究。

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