Behavioural addictions are characterized by an inability to resist an urge or drive resulting in actions that are harmful to oneself or others. Behavioural addictions share characteristics with substance and alcohol abuse, and in areas such as natural history, phenomenology, and adverse consequences. Behavioural addictions include pathological gambling, kleptomania, pyromania, compulsive buying, compulsive sexual behaviour, Internet addiction, and binge eating disorder. Few studies have examined the efficacy of pharmacological and psychological treatment for the various behavioural addictions, and therefore, currently, no treatment recommendations can be made.
GrantJEPotenzaMNWeinsteinAIntroduction to behavioral addictions. Am J Drag Alcohol Abuse. 2010;36(5):233–244.
2.
BlumKGardnerEOscar-BermanM“Liking” and “wanting” linked to reward deficiency syndrome (RDS): Hypothesizing differential responsivity in brain reward circuitry. Curr Pharm Des. 2012;18(1):113–118.
3.
HoldenC.Psychiatry. Behavioral addictions debut in proposed DSM-V. Science. 2010;327(5968):935.
4.
American Psychiatric Association (APA)Diagnostic and statistical manual of mental disorders. 4th edition. Text revision. Washington (DC): APA; 2000.
5.
BrewerJAPotenzaMN. The neurobiology and genetics of impulse control disorders; relationships to drag addictions. Biochem Pharmacol. 2008;75(1):63–75.
6.
PetryNMAmmermanYBohlJCognitive-behavioral therapy for pathological gamblers. J Consul Clin Psychol. 2006;74(3):555–567.
7.
MitchellJEBurgardMBFaberRCognitive behavioral therapy for compulsive buying disorder. Behav Res Ther. 2006;44(12):1859–1865.
8.
GrantJEDonahueCBOdlaugBL. Treatments that work: Treating impulse control disorders: A cognitive-behavioral therapy program—therapist guide. Oxford (GB): Oxford University Press; 2011.
9.
GrantJEDonahueCBOdlaugBL. Treatments that work: Treating impulse control disorders: A cognitive-behavioral therapy program—patient workbook. Oxford (GB): Oxford University Press; 2011.
10.
KimSWGrantJEAdsonDEDouble-blind naltrexone and placebo comparison study in the treatment of pathological gambling. Biol Psychiatry. 2001;49:914–921.
11.
GrantJEKimSEOdlaugBL. A double-blind, placebo-controlled study of the opiate antagonist, naltrexone, in the treatment of kleptomania. Biol Psychiatry. 2009;65(7):600–606.
12.
OliveMFClevaRMKalivasPWGlutamatergic medications for the treatment of drag and behavioral addictions. Pharmacol Biochem Behav. 2012;100(4):801–810.
13.
GrantJEKimSWOdlaugBL. N-acetyle cysteine, a glutamate-modulating agent, in the treatment of pathological gambling: A pilot study. Biol Psychiatry. 2007;62(6):652–657.
14.
ClaudinoAMde OliveiraIRAppolnarioJCDouble-blind, randomized, placebo-controlled trial of topiramate plus cognitive-behavioral therapy in binge-eating disorder. J Clin Psychiatry. 2007;68(9):1324–1332.
15.
McElroySLHudsonJICapeceJATopiramate for the treatment of binge eating disorder associated with obesity: A placebo-controlled study. Biol Psychiatry. 2007;61(9):1039–1048.
GrantJEKimSW. Demographic and clinical features of 131 adult pathological gamblers. J Clin Psychiatry. 2001;62(12):957–953.
18.
GrantJESchreiberLOdlaugBLPathological gambling and bankruptcy. Compr Psychiatry. 2010;51(2):115–120.
19.
DowlingNSmithDThomasT.The family functioning of female pathological gamblers. Int J Ment Hlalth Addict. 2009;7:29–44.
20.
National Gambling Impact Study Commission (NGISC)Report. Washington (DC): NGISC; 1999 Jun.
21.
PetryNMStinsonFSGrantBF. Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2005;66(5):564–574.
22.
VolbergRA. The prevalence and demographics of pathological gamblers: Implications for public health. Am J Public Health. 1994;84(2):237–241.
23.
NelsonSELaPlanteDALaBrieRAThe proxy effect: Gender and gambling problem trajectories of Iowa Gambling Treatment Program participants. J Gambl Stud. 2006;22:221–240.
24.
TavaresHMartinSSLoboDSFactors at play in faster progression for females pathological gamblers: An exploratory analysis. J Clin Psychiatry. 2003;64(4):433–438.
25.
GrantJEPotenzaMN. Impulse control disorders: Clinical characteristics and pharmacological management. J Gambl Stud. 2003;19(1):85–109.
26.
SlutskeWSBlaszczynskiAMartinNG. Sex differences in the rates of recovery, treatment-seeking, and natural recovery in pathological gambling: Results from an Australian community-based twin survey. Twin Res Hum Genet. 2009;12(5):425–432.
27.
PotenzaMNSteinbergMAMcLaughlinSDIllegal behaviors in problem gambling: Analysis of data from a gambling helpline. J Am Acad Psychiatry Law. 2000;28(4):389–403.
28.
ArgoTABlackDW. Clinical characteristics. In: GrantJEPotenzaMN, editors. Pathological gambling: A clinical guide to treatment. Washington (DC): American Psychiatric Publishing, Inc; 2004. p 39–53.
29.
PetryNMKilukBD. Suicidal ideation and suicide attempts in treatment-seeking pathological gamblers. J Nerv Ment Dis. 2002;190(7):462–469.
30.
ChouKLAfifiTO. Disordered (pathologic or problem) gambling and axis I psychiatric disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Am J Epidemiol. 2011;173(11):1289–1297.
31.
KimSW. Opioid antagonists in the treatment of impulse-control disorders. J Clin Psychiatry. 1998;59(4):159–164.
32.
KimSWGrantJE. An open naltrexone treatment study in pathological gambling disorder. Int Clin Psychopharmacol. 2001;16(5):285–259.
33.
GrantJEPotenzaMNHollanderEMulticenter investigation of the opioid antagonist nalmefene in the treatment of pathological gambling. Am J Psychiatry. 2006;163(2):303–312.
34.
GrantJEKimSWHartmanBK. A double-blind, placebo-controlled study of the opiate antagonist naltrexone in the treatment of pathological gambling urges. J Clin Psychiatry. 2008;69(5):783–789.
35.
GrantJEOdlaugBLPotenzaMNNalmefene in the treatment of pathological gambling: Multicentre, double-blind, placebo-controlled study. Br J Psychiatry. 2010;197(4):330–331.
36.
ToneattoTBrandsBSelbyP.A randomized, double-blind, placebo-controlled trial of naltrexone in the treatment of concurrent alcohol use disorder and pathological gambling. Am J Addict. 2009;18(3):219–225.
37.
GrantJEPotenzaMN. Treatments for pathological gambling and other impulse control disorders. In: NathanPEGormanJM, editors. Treatments that work. 3rd ed.New York (NY): Oxford University Press, Inc; 2007. p 561–577.
38.
HollanderEPallantiSAllenADoes sustained-release lithium reduce impulsive gambling and affective instability versus placebo in pathological gamblers with bipolar spectrum disorders?Am J Psychiatry. 2005;162(1):137–145.
39.
BerlinHABraunASimeonDA double-blind, placebo-controlled trial of topiramate for pathological gambling. World J Biol Psychiatry. 2011 Apr 12; Epub ahead of print.
40.
FongTKalechsteinABernhardBA double-blind, placebo-controlled trial of olanzapine for the treatment of video poker pathological gamblers. Pharmacol Biochem Behav. 2008;89(3):298–303.
41.
McElroySLNelsonEBWelgeJAOlanzapine in the treatment of pathological gambling: A negative randomized placebo-controlled trial. J Clin Psychiatry. 2008;69(3):433–440.
42.
LadouceurRSylvainCBoutinCCognitive treatment of pathological gambling. J Nerv Ment Dis. 2001;189(11):774–780.
43.
PetryNM. Gamblers anonymous and cognitive-behavioral therapies for pathological gamblers. J Gambl Stud. 2005;21(1):27–33.
44.
LadouceurRSylvainCBoutinCGroup therapy for pathological gamblers: A cognitive approach. Behav Res Ther. 2003;41(5):587–596.
45.
DickersonMHinchyJEnglandSL. Minimal treatments and problem gamblers: A preliminary investigation. J Gambl Stud. 1990;6(1):87–102.
46.
McConaghyNArmstrongMSBlaszczynskiAControlled comparison of aversive therapy and imaginal desensitization in compulsive gambling. Br J Psychiatry. 1983;142:366–372.
47.
McConaghyNBlaszczynskiAFrankovaA.Comparison of imaginal desensitization with other behavioural treatments of pathological gambling: A two- to nine-year follow-up. Br J Psychiatry. 1991;159:390–393.
48.
GrantJEDonahueCBOdlaugBLImaginal desensitization plus motivational interviewing for pathological gambling: Randomized controlled trial. Br J Psychiatry. 2009;195(3):266–267.
49.
OdlaugBLGrantJE. Impulse-control disorders in a college sample: Results from the self-administered Minnesota Impulse Disorders Interview (MIDI). Prim Care Companion J Clin Psychiatry. 2010;12(2). pii: PCC.09m00842. doi: 10.4088/PCC.09m00842whi.
50.
GoldmanMJ. Kleptomania: Making sense of the nonsensical. Am J Psychiatry. 1991;148(8):986–996.
51.
McElroySLHudsonJIPopeHGKleptomania: Clinical characteristics and associated psychopathology. Psychol Med. 1991;21(1):93–108.
52.
GrantJE. Understanding and treating kleptomania: New models and new treatments. Isr J Psychiatry Relat Sci. 2006;43(2):81–87.
53.
SarasaloEBergmanBTothJ.Personality traits and psychiatric and somatic morbidity among kleptomaniacs. Acta Psychiatr Scand. 1996;94(5):358–364.
54.
GrantJEKimSW. Clinical characteristics and associated psychopathology of 22 patients with kleptomania. Compr Psychiatry. 2002;43(5):378–384.
55.
PrestaSMarazzitiDDell'OssoLKleptomania: Clinical features and comorbidity in an Italian sample. Compr Psychiatry. 2002;43(1):7–12.
56.
OdlaugBLGrantJEKimSW. Suicide attempts in 107 adolescents and adults with kleptomania. Arch Suicide Res. 2012;16(4):348–359.
57.
GrantJE. Impulse control disorders: A clinician's guide to understanding and treating behavioral addictions. New York (NY): W W Norton & Company; 2008.
58.
KoranLMAboujaoudeENGamelNN. Escitalopram treatment of kleptomania: An open-label trial followed by double-blind discontinuation. J Clin Psychiatry. 2007;8(3):422–427.
59.
GrantJEKimSW. An open label study of naltrexone in the treatment of kleptomania. J Clin Psychiatry. 2002;63:349–356.
60.
GrantJEKimSWOdlaugBL. A double-blind, placebo-controlled study of the opiate antagonist, naltrexone, in the treatment of kleptomania. Biol Psychiatry. 2009;65(7):600–606.
61.
GrantJELevineLKimDImpulse control disorders in adult psychiatric inpatients. Am J Psychiatry. 2005;162(11):2184–2188.
62.
LejoyeuxMArbaretazMMcLoughlinMImpulse control disorders and depression. J Nerv Ment Dis. 2002;190(5):310–314.
63.
GrantJEKimSW. Clinical characteristics and psychiatric comorbidity of pyromania. J Clin Psychiatry. 2007;68(11):1717–1722.
64.
GrantJEOdlaugBL. Assessment and treatment of pyromania. In: GrantJEPotenzaMN, editors. The Oxford Library of Psychology: Oxford handbook of impulse control disorders. Oxford (GB): Oxford University Press; 2011. p 353–359.
65.
GrantJE. SPECT imaging and treatment of pyromania. J Clin Psychiatry. 2006;67(6):998.
66.
McElroySLKeckPEJrPopeHGJrCompulsive buying: A report of 20 cases. J Clin Psychiatry. 1994;55(6):242–248.
67.
KoranLMFaberRJAboujaoudeEEstimated prevalence of compulsive buying behavior in the United States. Am J Psychiatry. 2006;163(10):1806–1812.
68.
BlackDW. A review of compulsive buying disorder. World Psychiatry. 2007;6(1):14–18.
SchlosserSBlackDWRepertingerSCompulsving buying: Demography, phenomenology, and comorbidity in 46 subjects. Gen Hosp Psychiatry. 1994;16(3):205–212.
71.
BlackDWRepertingerSGaffneyGRFamily history and psychiatric comorbidity in persons with compulsive buying: Preliminary findings. Am J Psychiatry. 1998;155(7):960–963.
72.
BlackDWMonahanPGabelJ.Fluvoxamine in the treatment of compulsive buying. J Clin Psychiatry. 1997;54(4):159–163.
73.
KoranLMBullockKDHartstonHJCitalopram treatment of compulsive shopping: An open-label study. J Clin Psychiatry. 2002;63(8):704–708.
74.
GrantJE. Three cases of compulsive buying treated with naltrexone. Int J Psychiatry Clin Pract. 2003;7:223–225.
75.
GrantJEOdlaugBLMooneyMOpen-label pilot study of memantine in the treatment of compulsive buying. Ann Clin Psychiatry. 2012;24(2):118–126.
76.
NinanPTMcElroySLKaneCPPlacebo-controlled study of fluvoxamine in the treatment of patients with compulsive buying. J Clin Psychopharmacol. 2000;20(3):362–366.
77.
BlackDWGabelJHansenJA double-blind comparison of fluvoxamine versus placebo in the treatment of compulsive buying disorder. Ann Clin Psychiatry. 2000;12(4):205–211.
78.
KoranLMChuongHWBullockKDCitalopram for compulsive shopping disorder: An open-label study followed by double-blind discontinuation. J Clin Psychiatry. 2003;64(7):793–798.
79.
KoranLMAboujaoudeENSolvasonBEscitalopram for compulsive buying disorder: A double-blind discontinuation study. J Clin Psychopharmacol. 2007;27(2):225–227.
80.
DonahueCBOdlaugBLGrantJE. Compulsive buying treated with motivational interviewing and imaginal desensitization. Ann Clin Psychiatry. 2011;23(3):226–227.
81.
MitchellJEBurgardMBFaberRCognitive behavioral therapy for compulsive buying disorder. Behav Res Ther. 2006;44(12):1859–1865.
82.
MüllerAArikianAde ZwaanMCognitive-behavioural group therapy versus guided self-help for compulsive buying disorder: A preliminary study. Clin Psychol Psychother. 2013;20(1):28–35.
83.
MuellerAMuellerUSilbermannAA randomized, controlled trial of group cognitive-behavioral therapy for compulsive buying disorder: Posttreatment and 6-month follow-up results. J Clin Psychiatry. 2008;69:1131–1138.
84.
KafkaMP. Hypersexual disorder: A proposed diagnosis for DSM-V. Arch Sex Behav. 2010;39(2):377–400.
85.
CarnesPJ. Don't call it love: Recovery from sexual addiction. New York (NY): Bantam Publishing; 1991.
86.
ColemanE.Is your patient suffering from compulsive sexual behavior?Psychiatr Annu. 1992;22(6):320–325.
87.
OdlaugBLLustKSchreiberLRNCompulsive sexual behavior in young adults. Ann Clin Psychiatry. Forthcoming 2013.
88.
BlackDWKerhbergLLDFlumerfeltDLCharacteristics of 36 subjects reporting compulsive sexual behavior. Am J Psychiatry. 1997;154:243–249.
89.
KafkaMPPrentkyRA. A comparative study of nonparaphilic sexual addictions and paraphilias in men. J Clin Psychiatry. 1992;53(10):345–350.
90.
SchreiberLRNOdlaugBLGrantJE. Compulsive sexual behavior: Phenomenology and epidemiology. In: GrantJEPotenzaMN, editors. The Oxford handbook of impulse control disorders. Oxford (GB): Oxford University Press; 2011. p 165–175. The Oxford Library of psychology of psychology.
91.
SchneiderJPSchneiderBH. Couple recovery from sexual addiction/co-addiction: Results of a survey of 88 marriages. Sex Addict Compuls. 1996;3(2):111–126.
92.
WainbergMLMuenchFMorgensternJA double-blind study of citalopram versus placebo in the treatment of compulsive sexual behaviors in gay and bisexual men. J Clin Psychiatry. 2006;67(12):1968–1973.
93.
CooperASchererCRBoiesCSOnline sexual compulsivity: Getting tangled in the net. Sex Addict Compuls. 1999;6(2):79–104.
94.
GoodmanA.Sexual addiction. An integrated approach. Madison (CT): International Universities Press; 1998.
95.
SbragaT PenixO'DonohueWT. The sex addiction workbook. Proven strategies to help you regain control of your life. Oakland (CA): New Harbinger Publications; 2003.
96.
McConaghyNArmstrongMSBlaszczynskiA.Expectancy, covert sensitization and imaginal desensitization in compulsive sexuality. Acta Psychiatr Scand. 1985;72:176–187.
97.
BrownEM. Affairs. A guide to working through the repercussions of infidelity. San Francisco (CA): Jossey-Bass; 1999.
98.
BlackDWBelsareGSchlosserS.Clinical features, psychiatric comorbidity, and health-related quality of life in persons reporting compulsive computer use behavior. J Clin Psychiatry. 1999;60(12):839–844.
99.
ShapiraNALessigMCGoldsmithTDProblematic internet use: Proposed classification and diagnostic criteria. Depress Anxiety. 2003;17(4):207–216.
100.
DurkeeTKaessMCarliVPrevalence of pathological internet use among adolescents in Europe: Demographic and social factors. Addiction. 2012;107(12):2210–2222.
101.
ShortenMA. The costs and benefits of computer addiction. Behav Inform Technol. 1991;10:219–230.
102.
ShapiraNAGoldsmithTDKeckPEJrPsychiatric features of individuals with problematic internet use. J Affect Disord. 2000;57(1–3):267–272.
103.
HadleySJBakerBRHollanderD.Efficacy of escitalopram in treatment of compulsive-impulsive computer use disorder. Biol Psychiatry. 2006;59:261S.
104.
HanDLeeYNaCThe effect of methylphenidate on Internet video game play in children with attention-deficit/hyperactivity disorder. Compr Psychiatry. 2009;50(3):251–256.
105.
ShawMBlackDS. Internet addiction: Definition, assessment, epidemiology, and clinical management. CNS Drugs. 2009;22(5):353–365.
106.
YoungKS. Cognitive behavioral therapy with Internet addicts: Treatment outcomes and implications. Cyberpsychol Behav. 2007;10(5):671–679.
107.
McElroySLKotwalR.Binge eating. In: HollanderESteinDJ, editors. Clinical manual of impulse-control disorders. Washington (DC): American Psychiatric Publishing, Inc; 2006. p 115–148.
108.
HayP.The epidemiology of eating disorder behaviors: An Australian community-based survey. In J Eat Disord. 1998;23(4):371–382.
109.
HayPFairburnC.The vailidity of the DSM-IV scheme for classifying bulimic eating disorders. Int J Eat Disord. 1998;23(1):7–15.
110.
SpitzerRLStunkardAYanovskiSBinge eating disorder should be included in DSM-IV: A reply to Fairburn et al's “the classification of recurrent overeating: The binge eating disorder proposal”. Int J Eat Disord. 1993;13(2):161–169.
111.
HudsonJIHiripiEPopeHGJrThe prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007;61(3):348–358.
112.
DingemansAEBrunaMJvan FurthEF. Binge eating disorder: A review. Int J Obes Relat Metab Disord. 2002;26(3):299–307.
113.
McElroySLArnoldLMShapiraNATopiramate in the treatment of binge eating disorder associated with obesity: A randomized placebo-controlled trial. Am J Psychiatry. 2003;160(2):255–261.
114.
AppolinarioJCBacaltchukJSichieriRA randomized, double-blind, placebo-controlled study of sibutramine in the treatment of binge-eating disorder. Arch Gen Psychiatry. 2003;60(11):1109–1116.
115.
BrownleyKABerkmanNDSedwayJABinge eating disorder treatment: A systematic review of randomized controlled trials. Int J Eat Disord. 2007;40(4):321–348.
