L’addiction amoureuse existe-t-elle ?

Abstract

Aims The relations between amorous passion and addiction have long been noted. Recent advances in neurobiology have allowed us to reexamine the relations between these two states and to better understand their clinical symptoms. Methods We compare clinical, neuropsychological, neurobiological and neuroimaging data in love passion versus substance addictions. Results The clinical description of the amorous state includes: unrestrained desire and sexual pleasure; feeling of euphoria; powerful motivation to the “object of his love”; a cognitive mechanism characterised by a focalised attention, pervasive memories, intrusive thoughts; emotional exacerbation and emotional dependence with need for the other, aroused by his absence. Criteria for love addiction (differing from love passion), including the notion of suffering and continued behaviour despite adverse consequences, inspired from the DSM-IV criteria could be evaluated. The neurophysiological model for all addictions can be applied to love addicts: the desired object is overrated. The rewarding value and its memory trigger a major motivation: simple desire has become a need; cortical control has become insufficient. For love as well as addictions, dopamine codes the value of pleasure. Love and drugs are potent pleasure modulators of dopamine flux. Oxytocin pathways, clearly implicated in love attachment, are also an important pathway towards understanding the mechanisms of dependence. Imagery data on various drug addictions and imagery data on sexual desire, orgasm and amorous relationships, enable their mechanisms and activated circuits to be compared and their similarities analysed. Conclusion Love and addictions are comprised of liking, wanting and needing. Refining of clinical, neurobiological and neuro-imaging studies will further elucidate these similarities and should provide a better understanding and improved treatment of these states.