Davranışsal Bağımlılıklarda Ek Tanı
Özet
Davranışsal bağımlılıklar; başta diğer bağımlılık türleri olmak üzere birçok psikiyatrik hastalıkla yüksek oranda birlikte görülmektedir. Klinik değerlendirmelerde ek tanı olasılığının göz ardı edilmesi, hastaların etkili tedavi almasını engellemektedir. Akıllı telefon bağımlılığı; depresyon, anksiyete, uyku kalitesinde bozulma ve yeme bozukluklarıyla yakından ilişkilidir. Alışveriş bağımlılığı sıklıkla anksiyete bozuklukları, dürtüsel davranışlar ve madde kötüye kullanımı ile birlikte görülür. Çalışma bağımlılığı iş stresi, tükenmişlik ve obsesif kompulsif kişilik bozukluğu ile bağlantılıyken; egzersiz bağımlılığında yeme bozuklukları ve borderline kişilik bozukluğu önemli risk faktörleridir. İnternet bağımlılığı; DEHB, alkol kötüye kullanımı, anksiyete ve depresyon ile pozitif yönlü bir korelasyon gösterir; özellikle DEHB'li bireyler interneti anlık ödül sağladığı için tercih ederler. Kumar oynama bozukluğu olan kişilerin büyük çoğunluğunda en az bir psikiyatrik hastalık mevcuttur ve bu durum intihar riskini artırır. Seks bağımlılığı ile sosyal medya bağımlılığı da depresyon, anksiyete, TSSB ve uyku sorunlarıyla ilişkilendirilmiştir. Son olarak yeme bağımlılığı; dopaminerjik ödül sistemi mekanizmalarıyla madde bağımlılığına benzer özellikler taşır ve özellikle obez hastalarda, tıkınırcasına yeme bozukluğu olanlarda ve çocukluk çağı travması yaşamış bireylerde duygudurum bozuklukları ile TSSB sıklığını belirgin düzeyde artırarak tedavi başarısını olumsuz etkiler. Sonuç olarak, klinisyenlerin tedavi planlaması yaparken davranışsal bağımlılıklardaki yüksek komorbidite oranlarını mutlaka dikkate almaları gerekmektedir.
Behavioral addictions are highly comorbid with many psychiatric disorders, particularly other types of addictions. Ignoring the possibility of co-occurring diagnoses during a detailed psychiatric evaluation prevents individuals from receiving appropriate and effective treatment. Smartphone addiction is closely associated with depression, anxiety, impaired sleep quality, and eating disorders. Shopping addiction is frequently co-observed with anxiety disorders, impulsive behaviors, and substance abuse. While work addiction is linked to work stress, burnout, and obsessive-compulsive personality disorder, eating disorders and borderline personality disorder represent significant risk factors for exercise addiction. Internet addiction shows a positive correlation with ADHD, alcohol abuse, anxiety, and depression; individuals with ADHD particularly prefer internet use because it provides instant gratification. The vast majority of individuals with gambling disorder meet the diagnostic criteria for at least one psychiatric disorder, which increases the risk of suicide. Sex addiction and social media addiction have also been associated with depression, anxiety, PTSD, and sleep disturbances. Lastly, food addiction shares similar characteristics with substance addiction through dopaminergic reward system mechanisms and negatively impacts treatment outcomes by significantly increasing the prevalence of mood disorders and PTSD, especially in obese patients, individuals with binge eating disorder, and victims of childhood trauma. In conclusion, clinicians must definitively consider the high rates of comorbidity in behavioral addictions when designing treatment plans.
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