[Development of diagnosis criteria for physical activity abuse and dependence: a qualitative study]

The purpose of this work was to search for criteria of physical activity abuse and dependence, patterned after abuse and dependence criteria for psychoactive substances described in DSM IV and CIM10, and to determine whether these criteria could be found in individuals practising sports. This preliminary work was designed as the first step in the search for a possible physical activity dependence syndrome.

Operational criteria for physical activity abuse and dependence were defined by using the DSM IV and CIM 10 criteria for psychoactive substances abuse and dependence as a pattern. We searched for these criteria among a group of 8 persons (4 men and 4 women, aged 17-25 years) who practised 7 different sports. The subjects participated in a qualitative interview during which the defined criteria were not mentioned directly. The script of the interview was analyzed with a pre-established grid in order to search for the operational diagnostic criteria.

All of the defined operational criteria except two concerning physical activity abuse were identified in the interview scripts. All of the participants fulfilled at least one of the defined criteria. The importance of physical activity dependence criteria spontaneously mentioned by the participants was notable; abuse criteria were found less often.

Based on the findings of this qualitative study, the development of diagnostic criteria for physical activity abuse or dependence patterned after psychoactive abuse and dependence criteria appears to be a realistic possibility. The operational criteria we defined were found in all of the participants in this study, irrespective of the sports they practised. Although a large number of dependence criteria were found for each participant, this study was not designed to determine the number of participants for whom the diagnosis of physical activity dependence could be retained. This would require search for notions such as duration of the manifestations, changing functional behavior, or clinically significant suffering in order to identify the pathological nature of the behavior. Other studies are now needed to determine whether individual subjects who present a sufficient number of criteria simultaneously can be identified as presenting physical activity abuse or dependence.