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首页> 外文期刊>Journal of affective disorders >Delineating the psychic structure of substance abuse and addictions: Should anxiety, mood and impulse-control dysregulation be included?
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Delineating the psychic structure of substance abuse and addictions: Should anxiety, mood and impulse-control dysregulation be included?

机译：描述药物滥用和成瘾的心理结构：是否应包括焦虑，情绪和冲动控制失调？

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Current "official" nosology (e.g. DSM IV) is largely limited to physical manifestations of addiction that can be objectively observed and are suited to the maintaining of an "atheoretical" perspective. However, addicted subjects display additional psychiatric symptoms that affect their well-being and social functioning and, in accordance with DSM IV, are typically relegated to the domain of psychiatric "comorbidity." We contend that the relationship of these psychiatric symptoms with addiction is very close, as demonstrated by the high frequency of association observed. We further assert that substance use may modify pre-existing psychic structures such as temperament and related subthreshold conditions and lead to addiction as a specific mental disorder, inclusive also of symptoms pertaining to mood/anxiety, or impulse-control dimensions. The present contribution addresses the weaknesses of the current DSM-based nosology of addiction-related mental comorbidity. We highlight the overlap of the biological substrates and the neurophysiology of addictive processes and psychiatric symptoms associated with addiction, and propose the inclusion of specific mood, anxiety, and impulse-control dimensions in the psychopathology of addictive processes. We postulate that addiction reaches beyond the mere result of drug-elicited effects on the brain and cannot be peremptorily equated only with the use of drugs despite the adverse consequences produced. We infer that mood, anxiety and impulse-control dysregulation is at the very core of both the origins and clinical manifestations of addiction and should be incorporated into the nosology of the same, emphasising how addiction is a relapsing chronic condition in which psychiatric manifestations play a crucial role. To conclude, addictionology cannot be severed from its psychopathological connotations, in view of the undeniable presence of symptoms, of their manifest contribution to the way addicted patients feel and behave, and to the role they play in maintaining the continued use of substances.
机译：当前的“官方”疾病学（例如，DSM IV）很大程度上限于可以客观地观察到并且适合于维持“理论上的”观点的成瘾的身体表现。然而，上瘾的受试者表现出影响其健康和社会功能的其他精神病症状，并且根据DSM IV，通常被归类为精神病“合并症”。我们认为，这些精神病症状与成瘾的关系非常密切，正如观察到的高关联频率所证明的那样。我们进一步断言，使用毒品可能会改变诸如气质和相关的阈下条件等先前存在的心理结构，并导致成瘾成为一种特定的精神障碍，包括与情绪/焦虑或冲动控制有关的症状。本文稿致力于解决当前基于DSM的与成瘾相关的精神合并症的疾病学的缺点。我们强调了成瘾过程和与成瘾有关的精神病学症状的生物学底物和神经生理学的重叠，并提出了成瘾过程的心理病理学中包括特定的情绪，焦虑和冲动控制维度。我们假设成瘾已经超出了药物对大脑造成的影响的纯粹结果，尽管产生了不良后果，但不能仅仅将其等同于使用药物。我们推断，情绪，焦虑和冲动控制失调是成瘾的起源和临床表现的核心，应纳入成瘾的学说中，强调成瘾是一种复发性的慢性病，​​在这种情况下，精神病表现起着重要作用。关键的角色。总而言之，鉴于无可否认的症状，成瘾患者对上瘾患者的感觉和行为方式的明显贡献以及他们在维持药物的持续使用中所起的作用，成瘾学不能从其心理病理学意义上割裂开来。

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