Discussion questions about the therapy of nonchemical addictions

Today there are no international standards for the treatment of non-chemical (behavioral) addiction (NA). This is largely due to the vagueness of their existence as nosological units and, as a consequence, their place in international classifications. This article discusses the forms of NA that are or will be included in DSM-V and ICD-11. It has been shown that NA research has sparked discussions about the spectrum of addictive disorders, expands the multidisciplinary understanding of the etiology and pathogenesis of addictive disorders, and promotes the study of new forms and expansion of therapeutic approaches. The criticism of the addictive spectrum concept is analyzed. The modern approaches of non-drug and pharmacological therapy of different forms of NA are presented.

The following conclusions are drawn.

1. The existence of NA is confirmed by the inclusion of a part of them in the International Classifications of Diseases.
2. NA have high comorbidity with other mental disorders, in respect of which pharmacotherapy and psychotherapy are not in doubt.
3. Taking into account the general neurobiological mechanisms of the formation of addictive disorders, the possible pharmacotherapy of non-chemical addictions, officially recognized in the ICD and DSM, should proceed from the currently available approaches to the therapy of substance use disorders.
4. Treatment of non-chemical addictions that are not included in the International Classifications can only be carried out within the framework of therapy for confirmed comorbid mental disorders. In its absence, psychological correction seems to be possible.
5. There is an obvious need to continue researching the problem of non-chemical addictions to expand new approaches to their therapy and psychological correction.