What is the treatment approach for shopping addiction, also known as compulsive buying disorder?

Treatment of Shopping Addiction (Compulsive Buying Disorder)

Cognitive-behavioral therapy (CBT) in a group format is the most promising first-line treatment for compulsive buying disorder, with selective serotonin reuptake inhibitors (SSRIs) as an adjunctive pharmacological option when needed. 1, 2

Initial Treatment Framework

• Begin with group cognitive-behavioral therapy as the primary intervention, as this approach has shown the most promise in available treatment studies for compulsive buying disorder 3, 4, 5
• Individual CBT can be used when group therapy is unavailable, though group formats appear particularly effective for this condition 4, 5
• Psychoeducation should be provided early, explaining that compulsive buying disorder is a recognized condition affecting approximately 5-6% of the general population, with onset typically in the late teens or early twenties 3, 1, 4

Pharmacological Treatment Considerations

• SSRIs may help regulate buying impulses and should be considered, particularly when comorbid mood or anxiety disorders are present 5, 2
• Naltrexone represents an alternative pharmacological option worth considering, especially given the conceptualization of compulsive buying as a behavioral addiction 2
• Higher doses typical for OCD treatment may not be necessary here, as the evidence base differs from pure OCD 5

Essential Adjunctive Interventions

• Financial counseling and debt consolidation are critical components that must be addressed alongside psychological treatment 4, 5, 2
• Family or marital therapy should be incorporated when family dynamics contribute to or are affected by the buying behavior 3, 4
• Self-help resources including bibliotherapy and 12-step programs (such as Debtors Anonymous) can provide additional support 3, 4, 5
• Simplicity circles offer peer support specifically focused on reducing consumption patterns 3, 4

Addressing Psychiatric Comorbidity

• Screen for and aggressively treat comorbid conditions, as mood disorders, anxiety disorders, substance use disorders, eating disorders, and personality disorders are extremely common in this population 3, 1, 4, 5
• When major depression is present, prioritize treating the depression first, as this may reduce the compulsive buying behavior 3, 4
• Substance use disorders require concurrent treatment, as they frequently co-occur and can worsen impulse control 3, 4

Treatment Structure and Duration

• The disorder is typically chronic or intermittent, requiring long-term management rather than brief intervention 1, 4
• Regular monitoring and reassessment are necessary given the chronic nature and high relapse potential 1, 2
• Family involvement improves outcomes, particularly given the familial clustering of mood and substance use disorders in affected families 3, 4

Critical Clinical Pitfalls

• Do not dismiss this as simply "poor financial management" or a personality flaw—it is a legitimate psychiatric condition requiring structured treatment 1, 2
• Avoid focusing solely on debt management without addressing the underlying psychological drivers, as this will lead to relapse 2
• The apparent female predominance (80% in clinical samples) may be artifactual due to help-seeking patterns; do not overlook this diagnosis in men 3, 4
• Recognize that most affected individuals meet criteria for personality disorders, which will influence treatment approach and prognosis 3

Public Health and Prevention Measures

• Educational initiatives targeting vulnerable populations (late teens/early twenties) may help with early identification 2
• Legislative protections and family-based interventions can reduce harm for those already affected 2
• Credit counseling should be recommended proactively to prevent escalating financial consequences 5, 2