oniomania

Oniomania, commonly called compulsive buying disorder or shopping addiction, is a behavioral impulse-control condition characterized by a persistent preoccupation with shopping and purchases, resulting in distress or impairment. People with oniomania experience urges to buy that feel irresistible, followed by relief or euphoria after the purchase and guilt or regret later. The behavior causes financial, relational, or legal problems and interferes with daily functioning.

The causes are thought to be multifactorial, involving neurobiological factors affecting reward pathways and a range of psychosocial contributors, including mood or anxiety disorders, low self-esteem, and maladaptive coping. Impulsivity, distress intolerance, and exposure to consumer culture and easy access to credit can sustain the pattern.

Diagnosis: There is no single, universally accepted DSM-5-TR diagnosis for oniomania. Clinicians use screening tools such as the Compulsive Buying Scale and structured interviews to assess criteria like persistent purchasing urges, inability to resist, resulting impairment, and unsuccessful efforts to control the behavior. Symptoms often co-occur with OCD, ADHD, substance use, or other impulse-control disorders, requiring differential diagnosis and comorbidity assessment.

Treatment: Management typically involves cognitive-behavioral therapy with relapse-prevention components, financial counseling, and strategies to avoid triggers and manage distress. Addressing co-occurring conditions is important. Evidence for medications is limited; some reports describe benefits from antidepressants or opioid antagonists in selected cases, but results vary and treatment is individualized.

Prognosis and epidemiology: Prevalence estimates vary; community studies suggest a few percent of adults are affected. Oniomania often co-occurs with mood and anxiety disorders. The course can be chronic and fluctuating, but improvement is possible with comprehensive treatment that combines psychotherapy, financial management, and treatment of comorbid conditions.