SUNDAY, Oct. 1, 2006 (HealthDay News) -- One in 20 American adults said they find themselves unable to stop shopping for items they may not even want or need.
And men are just as likely as women to suffer from "compulsive buying," according to the largest survey of its kind ever conducted.
"That's the biggest surprise -- that men engage in this behavior almost as commonly as women," said Dr. Lorrin Koran, emeritus professor of psychiatry at Stanford University.
He said the finding runs counter to the conventional view of compulsive buying as a "woman's disease." That impression grew out of the fact that women have typically made up the vast majority of volunteers for studies looking at the disorder.
However, Koran said men who obsessively shop are probably more reluctant than women to come forward and admit they have a problem. "Generally, in psychiatry, men seek care less often than women," he pointed out. "It's not 'manly' to seek help."
The study, published in the October issue of the American Journal of Psychiatry, also found that compulsive shopping usually begins in a person's teens or early 20s, and is associated with lower -- not higher -- incomes.
According to Koran, compulsive shopping is more than the occasional splurge, later regretted.
Instead, the urge to shop becomes constant and overwhelming. For most, the act of browsing and buying gradually takes the place of time spent at work, with family or in other pursuits. To qualify as a disorder, "the behavior has to be associated with marked distress and interfere with functioning," Koran said.
The typical compulsive shopper usually feels a sense of euphoria while engaged in shopping, but that "high" later gives way to remorse and distress. "It's afterward, when you realize that you spent money that you didn't have or you argue with your husband about why you have all these clothes in your closet that you never wear," Koran said. "That's when you regret it."
The root causes of shopping addiction remain unclear. But British researcher Helga Dittmar, a senior lecturer of psychology at the University of Sussex, said two factors -- highly materialistic values and poor self-image -- appear to be risk factors. In this scenario, buying things is viewed as a path to self-improvement.
"They'll buy those consumer goods that symbolize a part of their ideal self," Dittmar explained.
But just how prevalent is compulsive buying? Previous estimates, based on small samples, had ranged from about 2 percent to 16 percent of the population.
In this new study, Koran's team conducted a nationwide phone survey of more than 2,500 adults. After gathering data on demographics and income, the researchers used a standard screening instrument called the Compulsive Buying Scale to determine whether a person fit the criteria for the disorder.
They discovered that 5.8 percent of those interviewed did, in fact, meet the threshold for compulsive buying. Rates differed little between women (6 percent) and men (5.5 percent). Compulsive buyers tended to be younger than people unaffected by the disorder and more likely to make less than $50,000 a year, the study found.
The finding that compulsive buying affects men just as much as women didn't come as a big surprise to Dittmar. She said that British studies had shown little evidence of a gender gap, especially among younger people. And she noted that clinical studies into the disorder have typically recruited participants via women's magazines and similar outlets, boosting the participation of females.
Koran said men who compulsively shop tend to purchase different items than women. "Men tend to buy tech items, cameras, CDs, books, tools and gadgets," he said. "Women tend to buy clothes, jewelry, makeup, items for the homes, craft goods."
There's also "some suggestion in the research literature that men are more likely to be pathological collectors and become addicted to auctions," Dittmar said.
Whatever their gender, compulsive buyers are usually not made any happier by their ceaseless spending, the experts said. In fact, many find themselves deeply in debt and filled with remorse and shame as they hide their addiction from family and friends. Some studies have even linked the condition to a heightened risk for suicide, Koran said.
That's why he and Dittmar are advocating formal inclusion of compulsive buying in the next Diagnostic and Statistical Manual of Mental Disorders -- the standard guidebook for psychological and psychiatric treatment worldwide.
Based on the new study numbers, "compulsive buying is at least as prevalent as many other clinical disorders," Dittmar noted. "I think, in the end, that I would favor its inclusion in the DSM, given that it would acknowledge and help raise public consciousness about the severity of compulsive buying."
She added that, up until now, "there has been a tendency to belittle 'shopping addicts.' It's time that the serious consequences of compulsive buying -- psychological, social, financial -- are highlighted."
Koran agreed, noting that effective treatments, which include antidepressant drugs and psychotherapy, do exist. But he said those affected must first come forward.
"It's always important to encourage people who have these types of disorders to seek treatment," he said. "There are things we can do to help."
For more on compulsive buying, visit the Illinois Institute for Addiction Recovery.