For the first time substance use will not be required for the diagnosis of addiction in diagnostic classification manuals, such as DSM and ICD. The DSM-5 has included gambling disorder, along with substance use disorders, as forms of addictions in a new chapter named "Substancerelated and addictive disorders", thus reflecting evidence that gambling behaviors activate reward systems similarly to drugs of abuse. However, there is still debate on whether other less recognized forms of impulsive behaviors, such as compulsive buying (oniomania), compulsive sex, and kleptomania can be conceptualized as addictions. In this review, we critically evaluate the literature on these behaviors with a focus on socio-demographic and clinical characteristics, underlying neurobiology and treatment response, and their potential overlap with substance use disorders. We were unable to find a substantial number of studies supporting a relationship of the aforementioned reward-based conditions to substance use disorders, thus supporting the contention not to include compulsive buying, compulsive sex, and kleptomania in DSM-5 as behavioral addictions.

ResumoOs processos de saúde e adoecimento são influenciados por fatores biológicos, psicológicos e sociais. A obesidade é comumente associada aos transtornos mentais, como depressão e ansiedade. Esta associação é constatada em ambas as direções. Transtornos mentais, como os alimentares, a depressão e ansiedade, favorecem o desenvolvimento da obesidade, assim como a obesidade aumenta a incidência dos transtornos mentais. Quando ocorre a ruptura da estabilidade e da homeostase pelo estresse crônico e fatores determinados geneticamente, pelo meio ambiente e pelas relações afetivas e suporte psicossocial, há uma sobrecarga alostática. Através desta sobrecarga alteram-se múltiplos sistemas e surgem doenças clínicas, como hipertensão, diabetes, síndrome metabólica e também doenças psíquicas, tais como a depressão e a ansiedade. O diagnóstico dos transtornos mentais é feito pela combinação de sintomas, queixas somáticas e psíquicas. Queixas físicas por vezes inexplicáveis e sintomas genéricos como humor depressivo, tristeza, impaciência, irritação, inquietação, além da alteração do sono e do apetite, podem estar presentes em diversos transtornos físicos ou mentais. Essa combinação muitas vezes dificulta o correto diagnóstico em pacientes obesos. Os profissionais da atenção básica devem alertar-se para queixas físicas e para os sofrimentos psíquicos presentes em quadros orgânicos. A compreensão dos efeitos fisiopatoló-gicos do estresse e dos transtornos mentais no adoecimento físico reforça a necessidade de que o cuidado efetivo às doenças crônicas não transmissíveis, incluindo a obesidade, seja organizado a partir de modelos que possam abordar também estes aspectos. O tratamento necessita ser integral para que o cuidado seja realmente efetivo. Deve ser centrado na pessoa, na família e na comunidade ao invés de se organizar ao redor da doença. Isso é fundamental no tratamento da obesidade, pois esta se relaciona diretamente a hábitos de vida, estado emocional e nível de estresse, dependendo de uma transformação do indivíduo e de sua forma de viver para que se alcance a resposta desejada. Através dessa abordagem, a atenção básica pode promover a saúde e prevenir agravos. Descritores:Obesidade; Transtorno da compulsão alimentar; Carga alostática; Atenção primária à saúde. AbstractHealth and disease processes are developed due to biological, psychological and social determinants. Obesity is usually associated with mental disorders, such as depression and anxiety. This association is evidenced in both directions. Mental disorders, such as depression, anxiety and eating disorders, contribute to the development of obesity, as well as obesity increases the incidence of mental disorders. When stability and homeostasis are disrupted, due to chronic stress and factors such as genetics, environment, affective relationships and psychosocial support, allostatic overload is evidenced. Through this overload, multiple systems are misbalanced and clinical diseases, such as hypertension, diabetes and metabolic syndrome, and mental disord...

Due to the Irretrievable impacts of the COVID-19 pandemic on society, this study aimed to analyze the barriers and reasons for the Iranian people’s implementation of public health measures during the COVID-19 pandemic in 2021. The study explores the barriers and reasons for non-compliance by Iranian people in following and maintaining the health guidelines to combat the spread of the coronavirus in 2021. This research is qualitative and recorded participants’ feedback from the Ardabil province of Iran. The study used a purposeful sampling method and lasted from April to May 2021 to collect the data through semi-structured interviews with 45 participants based on their gender, education, employment status, and marital status. The researchers analyzed the qualitative content until the required data-target through interviews implementation. This study incorporated MAXQDA version 10 to analyze the data and followed Goba and Lincoln’s criteria to ensure quality research results. After analyzing the data, two main categories (internal and external barriers) and seven subcategories were obtained. The internal barriers exhibited further classified subcategories, such as mental, belief, and awareness barriers. The results indicated that external barriers included social, political, managerial, and economic barriers. The study results designated that a set of internal and external factors might cause individuals' non-compliance with health guidelines and standard SOPs in the advent of the pandemic COVID-19. Recognition of such factors, identified following the social, cultural, and political context and individuals' characteristics during the COVID-19 outbreak, can be used effectively to plan educational and management programs. As a result, elimination and eradication of obstacles and the relevant dimensions may facilitate disease control. Moreover, the high prevalence and spread of the disease can be managed by reducing the influence of factors preventing proper health behaviors.

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Delusional misidentification syndromes (DMS) have been rarely reported in patients with conditions other than schizophrenia-related disorders, diffuse brain disease (dementia) and focal neurological illness. In this report, we describe DMS (i.e. Capgras and Fregoli syndromes) in two patients with severe and treatment resistant obsessive-compulsive disorder (OCD), one with paranoid personality disorder (PPD) and the other with a pervasive developmental disorder (PDD) not otherwise specified. While our findings highlight an interesting phenomenon (the occurrence of DMS in OCD), it is presently unclear whether this association is rare or underreported. Misidentification syndromes might be the ultimate result of a combination of obsessive fears and preexisting cognitive bias/deficits, such as mistrustfulness (in PPD) or poor theory of mind (in PDD).

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