Can't keep from shopping? Help could be on the way

Compulsive buying is just as common in men as in women, a nationwide telephone survey has found, and in its extreme forms may be a psychiatric illness - an impulse control disorder associated with abnormal levels of depression and anxiety.

Researchers used a seven-item questionnaire to determine whether people felt a need to spend money, whether they were aware that their spending behavior was aberrant, whether they bought things to improve their mood and whether their buying habits had led to financial problems.

They followed up with three questions designed to determine the degree of loss of control: How often have you just wanted to buy things and did not care what you bought? How often have you bought something and when you got home were not sure why you bought it? How often have you gone on a buying spree and just could not stop?

A statistical analysis of the results found that 5.5 percent of men and 6.0 percent of women could be classified as compulsive shoppers - that is, people whose uncontrolled urges to spend money lead to serious negative consequences.

Addictive shopping

Compulsive buying, sometimes called compulsive or addictive shopping, is not a recognized psychiatric diagnosis, but it is now being considered for inclusion in the next edition of the Diagnostic and Statistical Manual of Mental Disorders. Dr. Lorrin Koran, the study's lead author and emeritus professor of psychiatry at Stanford, said compulsive buyers commonly suffer from other psychiatric disorders.

"Many of those who come in for treatment suffer from depression, anxiety disorders and other impulse control disorders like pathological gambling and binge eating," Dr. Koran said.

The results of the study were published last week in The American Journal of Psychiatry. Two of the paper's five authors report a financial relationship with several pharmaceutical companies.

An editorial published with the paper notes that the recognition of such a condition as a mental illness would be controversial and that some would criticize it as creating a trivial disorder in order to "medicalize" a moral issue or to invent a reason to sell more drugs.

But the editorial also points out that the same sorts of objections were raised about diagnoses like social anxiety disorder and attention deficit hyperactivity disorder, now widely considered common and treatable illnesses.

Behavioral addictions and impulse control problems, the editorialists write, can be considered from various perspectives - medical, moral, ethical, religious - and they vary widely in severity. But at their most serious, behavioral disorders can be seriously debilitating. "Compulsive buying, like pathological gambling, may lead to bankruptcy, divorce, loss of employment and even suicide attempts," Dr. Koran said.

Various biases

The authors acknowledge that their results are based only on a telephone survey, which is subject to various biases, and that without a structured clinical interview, an accurate diagnosis is not possible.

And the sample included a greater percentage of people over 55 than are in the general population, and a substantially higher percentage of women. They note that a structured and validated diagnostic interview administered to a large and representative sample of the population will still be required to determine exactly how many people suffer from the illness, and establish with certainty which if any treatments are clearly effective.

Still, Dr. Koran said, "the survey shows, surprisingly, that men and women are equally or nearly equally likely to suffer from this disorder, and that a troubling proportion of the population appear to be engaging in financially destructive behavior.

"My hope," he continued, "is that people who think they have this disorder will seek help because available studies suggest that psychotherapy or medications help many compulsive buyers to stop."

(New York Times)