SYMPOSIA
SYMPOSIA
SYMPOSIA
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Pathological gambling: review of recent data<br />
Ömer Şenormancı<br />
Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, İstanbul, Turkey<br />
E-mail: senorman_7@hotmail.com<br />
Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org<br />
Abstracts of the Invited Speakers<br />
Gambling, which could also be defined as risking one’s chances for a possible outcome, is a cultural phenomenon as old as humanity. While<br />
gambling is a form of entertainment without any drawbacks for the great majority, pathological gambling develops in a small minority.<br />
The prevalence (0.2%- 5.3%) in the adult population is gradually increasing due to the ease of accessibility such as Internet gambling. This<br />
increase and the accessibility of gambling becoming easier, have led to some sociodemographic changes in the population who have<br />
trouble with gambling. Recent studies have shown pathological gambling to be higher in the psychiatric patient population compared<br />
to the normal population (with no assigned psychiatric diagnosis) and that it is necessary to be included as part of the questioning in a<br />
psychiatric evaluation.<br />
Some drugs once thought to be a new hope in the pharmacological treatment of pathological gambling, have been proven ineffective<br />
in recent randomized, double-blind, and placebo-controlled studies. Current studies are testing GABAergic and antiglutamatergic drugs,<br />
that are thought to be effective in chemical and behavioral addictions, in the treatment of pathological gambling.<br />
Two large meta-analysis studies have reported that non-pharmacological therapy approaches are more effective in the treatment<br />
of pathological gambling. Behavioral therapy, cognitive behavioral therapy and short, motivational, individualized approaches are<br />
demonstrated to be effective. Although it is suggested that behaviorial therapy + cognitive behavioral therapy and short, motivational,<br />
and individualized approaches are equally effective, combining the two may improve the efficacy of the treatment. This presentation aims<br />
to describe pathological gambling accompanied by contemporary information with respect to treatment.<br />
Key words: Pathological gambling, impulse control disorder, pharmacotherapy, psychotherapy<br />
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S53<br />
Is binge eating a type of addiction?<br />
Fulya Maner<br />
Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, İstanbul, Turkey<br />
E-mail: fmaner@ttmail.com<br />
Binge eating is characterized by recurrent episodes of eating, in a discrete period of time, an amount of food that is much larger than most<br />
people would eat in a similar time period under similar circumstances. There is a sense of lack of control over eating during the episode.<br />
Eating is much more rapid than normal and one eats until feeling uncomfortably full. After overeating one feels disgusted, depressed or<br />
guilty. Binge eating disorder is included in eating disorders not elsewhere specified in the DSM-IV and is a symptom of bulimia nervosa<br />
and anorexia nervosa.<br />
Research has shown that patients with eating disorders have high rates of co-occuring substance use disorders. The substance of abuse<br />
and food appear to compete for sites in the brain and abstinence from substance use causes craving for the substance and also for food.<br />
Addictions involving food and substances share similar etiologies and behavioral symptoms. Individuals suffering from binge eating<br />
disorder are more likely to have first degree relatives with a substance abuse disorder. According to retrospective reports of patients,<br />
the initiation of disordered eating usually began before substance abuse. The general reward pathway includes the ventral tegmental<br />
area and basal forebrain. Substance abuse has been shown to change the neural processes around these connections. The mesolimbic<br />
dopamine system connects the ventral tegmental area to the basal forebrain and is critical for the self-administration of psychomotor<br />
stimulants. Dopamine deficiency has been suggested to be a common characteristic of individuals who are prone to substance or food<br />
addiction. Striatal dopamine receptor (DRD2) availability is significantly lower in obese individuals than in controls. Body mass index is<br />
shown to correlate inversely with measures of D2 receptors.<br />
Functional neuroimaging studies have revealed that pleasant smelling, looking, and tasting food has reinforcing characteristics similar<br />
to drugs of abuse. Many of the brain changes reported for hedonistic eating are also seen in various types of addiction. Overeating may<br />
have an acquired drive similar to drug addiction with respect to motivation and incentive craving. In both cases, the desire and continued<br />
satisfaction occur after early and repeated exposure to stimuli.<br />
Addictive behavior manifests itself in permanent preoccupation with food and eating, withdrawal symptoms, continuation of disturbed<br />
S53