Les jeux de non-oxygénation et l’hypoxyphilie : de l’asphyxie volontaire passagère à l’addiction ?

Abstract

IntroductionThere are two forms of voluntary and temporary asphyxiation: the “fainting game” better known as “the choking game”, “blackout”, “space monkey” and the erotic asphyxiation. These conducts involve inducing cerebral hypoxia with the aim of developing an altered, euphoric-like state. Unlike the choking game, erotic asphyxiation implies a sexual activity. The objective of our work is to describe these two types of asphyxiation, which are little known by the medical world and nevertheless responsible of numerous complications, including death. MethodWe performed a systematic review (Medline, Science Direct) between January 1988 and August 2011 to identify the frequency, as well as the clinical and psychopathological data, and to present available ways of screening and management. ResultsThese practices correspond to two different categories. The fating game of concerns teenager risk behaviors. Erotic asphyxiation is a characteristic of young adult masochistic activity. Both of these practices pose the risk of evolving towards a behavioral addiction. According to the model of the affective-behavioral addiction, the fainting game has an addictive potential mainly for teenagers displaying mental and other addictive disorders. The erotic asphyxiation dependence is considered to be a paraphiliac addiction, which also features the tolerance mechanism. Consequently, dependent subjects experience the need to escalate exposure in order to reach the same level of pleasure. They increase the number, the time and the intensity of hypoxia, thus heightening the risk of death and complications. A behavioral addiction is therefore regarded as a risk factor. ConclusionWe encourage clinicians to acquaint themselves with the main alert signs (preexisting risk factors, behavior modifications, neck erythema, unexplained somatic disorders) to screen patients for this type of conduct and to take into account such an addictive component in clinical settings.