CAJ | 학술논문

非药物成瘾又称“非物质相关性成瘾”或“行为成瘾”。特征性表现包括对成瘾对象的渴望、受损的冲动控制、对成瘾对象的耐受、撤退反应和高复发率等。目前发现的非药物成瘾类型包括病理性赌博、网络成瘾、购物成瘾、游戏成瘾、性瘾以及贪食等。非药物成瘾与药物成瘾在症状学上表现出很高的相似性且具有较高的共病率，提示二者之间可能存在着共同的发病机制。从遗传学和神经生物学的角度探讨非药物成瘾的机制具有重要的理论价值和临床应用价值。家庭研究和双生子研究发现，男性的病理性赌博和贪食障碍具有中度以上的遗传度。分子遗传学研究发现，单胺能神经递质相关基因，如5-羟色胺转运体基因、多巴胺受体基因和单胺氧化酶A基因等，与非药物成瘾有关。神经影像学研究发现，非药物成瘾者脑内负责奖赏，线索加工和冲动控制的神经通路活动性异于正常对照。未来研究需要进一步从多个角度入手，探讨非药物成瘾与药物成瘾的共性和特性。
비약물성은우칭“비물질상관성성은”혹“행위성은”。특정성표현포괄대성은대상적갈망、수손적충동공제、대성은대상적내수、철퇴반응화고복발솔등。목전발현적비약물성은류형포괄병이성도박、망락성은、구물성은、유희성은、성은이급탐식등。비약물성은여약물성은재증상학상표현출흔고적상사성차구유교고적공병솔，제시이자지간가능존재착공동적발병궤제。종유전학화신경생물학적각도탐토비약물성은적궤제구유중요적이론개치화림상응용개치。가정연구화쌍생자연구발현，남성적병이성도박화탐식장애구유중도이상적유전도。분자유전학연구발현，단알능신경체질상관기인，여5-간색알전운체기인、다파알수체기인화단알양화매A기인등，여비약물성은유관。신경영상학연구발현，비약물성은자뇌내부책장상，선색가공화충동공제적신경통로활동성이우정상대조。미래연구수요진일보종다개각도입수，탐토비약물성은여약물성은적공성화특성。
Non-drug addictions, which are also referred to as behavioral addictions, or non-su0stance- related addictions, include disorders such as pathological gambling, internet addiction, shopping addiction, cyber game addiction, sex addiction and binge-eating. These disorders are characterized by craving for certain behaviors, impaired impulse controls, tolerance, withdraw and high relapse rates. High phenomenological similarities and comorbidity between non-drug addictions and drug addictions indicate that these two types of addictions may share some common etiological mechanisms. Family and twin studies revealed moderate to large genetic influence on non-drug addictions, such as binge-eating and pathological gambling in male. Molecular genetic studies found that serotonin （5-HT） system genes, dopamine receptor genes and MAOA genes might be involved in the etiology of non-drug addictions. Furthermore, brain activities of non-drug addicts were different from those of the control groups, especially in the neural pathway for reward, cue processing and impulsive control. Investigating the underlying genetic and neurobiological mechanisms of non-drug addictions has both theoretical and practical implications. Studies from multiple perspectives are needed to illustrate the similarities and heterogeneity of the non-drug addictions and drug addictions.