Skip to main content Accessibility help

Expanding the definition of addiction: DSM-5 vs. ICD-11

  • Jon E. Grant (a1) and Samuel R. Chamberlain (a2)


While considerable efforts have been made to understand the neurobiological basis of substance addiction, the potentially “addictive” qualities of repetitive behaviors, and whether such behaviors constitute “behavioral addictions,” is relatively neglected. It has been suggested that some conditions, such as gambling disorder, compulsive stealing, compulsive buying, compulsive sexual behavior, and problem Internet use, have phenomenological and neurobiological parallels with substance use disorders. This review considers how the issue of “behavioral addictions” has been handled by latest revisions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD), leading to somewhat divergent approaches. We also consider key areas for future research in order to address optimal diagnostic classification and treatments for such repetitive, debilitating behaviors.


Corresponding author

*Address for correspondence: Jon E. Grant, JD, MD, MPH, Professor, Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, 5841 S. Maryland Avenue, MC 3077, Chicago, IL 60637, USA. (Email:


Hide All
1. Holden, C. “Behavioral” addictions: do they exist? Science. 2001; 294(5544): 980982.
2. el-Guebaly, N, Mudry, T, Zohar, J, Tavares, H, Potenza, MN. Compulsive features in behavioural addictions: the case of pathological gambling. Addiction. 2012; 107(10): 17261734.
3. Frascella, J, Potenza, MN, Brown, LL, Childress, AR. Shared brain vulnerabilities open the way for nonsubstance addictions: carving addiction at a new joint? Ann N Y Acad Sci. 2010; 1187: 294315.
4. Potenza, MN. Should addictive disorders include non-substance-related conditions? Addiction. 2006; 101(Suppl 1): 142151.
5. Grant, JE, Potenza, MN, Weinstein, A, Gorelick, DA. Introduction to behavioral addictions. Am J Drug Alcohol Abuse. 2010; 36(5): 233241.
6. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: American Psychiatric Association; 2013.
7. de Castro, V, Fong, T, Rosenthal, RJ, Tavares, H. A comparison of craving and emotional states between pathological gamblers and alcoholics. Addict Behav. 2007; 32(8): 15551564.
8. el-Guebaly, N, Patten, SB, Currie, S, et al. Epidemiological associations between gambling behavior, substance use & mood and anxiety disorders. J Gambl Stud. 2006; 22(3): 275287.
9. Brewer, JA, Potenza, MN. The neurobiology and genetics of impulse control disorders: relationships to drug addictions. Biochem Pharmacol. 2008; 75(1): 6375.
10. Grant, JE, Brewer, JA, Potenza, MN. The neurobiology of substance and behavioral addictions. CNS Spectr. 2006; 11(12): 924930.
11. Potenza, MN. Review. The neurobiology of pathological gambling and drug addiction: an overview and new findings. Philos Trans R Soc Lond B Biol Sci. 2008; 363(1507): 31813189.
12. Stein, DJ, Phillips, KA, Bolton, D, Fulford, KW, Sadler, JZ, Kendler, KS. What is a mental/psychiatric disorder? From DSM-IV to DSM-V. Psychol Med. 2010; 40(11): 17591765.
13. Grant, JE, Odlaug, BL, Kim, SW. Kleptomania: clinical characteristics and relationship to substance use disorders. Am J Drug Alcohol Abuse. 2010; 36(5): 291295.
14. Grant, JE, Atmaca, M, Fineberg, NA, et al. Impulse control disorders and “behavioural addictions” in the ICD-11. World Psychiatry. 2014; 13(2): 125127.
15. International Advisory Group for the Revision of the ICD-10 Mental and Behavioural Disorders. A conceptual framework for the revision of the ICD-10 classification of mental and behavioural disorders. World Psychiatry. 2011; 10(2): 8692.
16. Hollander, E, Pallanti, S, Allen, A, Sood, E, Baldini Rossi, N. Does sustained-release lithium reduce impulsive gambling and affective instability versus placebo in pathological gamblers with bipolar spectrum disorders? Am J Psychiatry. 2005; 162(1): 137145.
17. Cowlishaw, S, Merkouris, S, Dowling, N, et al. Psychological therapies for pathological and problem gambling. Cochrane Database Syst Rev. 2012; 11: CD008937.
18. Ziauddeen, H, Fletcher, PC. Is food addiction a valid and useful concept? Obes Rev. 2013; 14(1): 1928.
19. Martin, PR, Petry, NM. Are non-substance-related addictions really addictions? Am J Addict. 2005; 14(1): 17.
20. Fong, TW, Reid, RC, Parhami, I. Behavioral addictions: where to draw the lines? Psychiatr Clin North Am. 2012; 35(2): 279296.
21. Grant, JE, Chamberlain, SR. Gambling disorder and its relationship with substance use disorders: implications for nosological revisions and treatment. Am J Addict. 2015; 24(2): 126131.
22. Grant, JE, Odlaug, BL, Schreiber, LR, Kim, SW. The opiate antagonist, naltrexone, in the treatment of trichotillomania: results of a double-blind, placebo-controlled study. J Clin Psychopharmacol. 2014; 34(1): 134138.


Related content

Powered by UNSILO

Expanding the definition of addiction: DSM-5 vs. ICD-11

  • Jon E. Grant (a1) and Samuel R. Chamberlain (a2)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.