The relationship between overeating, substance abuse and (behavioral) addiction is controversial. Medically established forms of addiction so far pertain to substance use disorders only. But the preliminary Diagnostic and Statistical Manual for Mental Disorders V (DSM V) suggests replacing the previous category ‘Substance-Related Disorders’ with ‘Addiction and Related Disorders’, thus for the first time allowing the diagnosis of behavioral addictions. In the past psychiatrists and psychologists have been reluctant to systematically delineate and classify the term behavioral addiction. However, there is a broad overlap between chemical and behavioral addiction including phenomenological, therapeutic, genetic, and neurobiological aspects. It is of interest to point out that the hormone leptin in itself has a pronounced effect on the reward system, thus suggesting an indirect link between overeating and ‘chemical’ addiction. Thus, leptin-deficient individuals could be classified as fulfilling criteria for food addiction. In our overview we first review psychological findings in chemical (substance-based) and subsequently in behavioral addiction to analyze the overlap. We discuss the diagnostic validity of food addiction, which in theory can be chemically and/or behaviorally based.

Only a limited number of national surveys have investigated both somatic and mental health service use in children and adolescents. The current study aimed to assess service use in Germany as based on at least a single contact with a somatic (pediatrician, general practitioner, nonmedical practitioner) and/or mental health (psychiatrist, psychologist, youth welfare) care specialist within the last 12 months. Questionnaire responses of 6,475 children and adolescents aged 11.0-17.9 years and their parents were analyzed based on data ascertained by the German Child and Adolescent Health Survey (KiGGS) conducted between 2003 and 2006. For assessment of mental symptom loading the Strengths and Difficulties Questionnaire (SDQ) was completed by parents, thus allowing the determination of the relationship between symptom loading and service use. ANOVA and logistic regression were performed to determine help-seeking behavior overall and of different health professional groups upon inclusion of the SDQ Total Difficulties score, gender, age and socio-economic status (SES). A total of 81.9 % of all children and adolescents had used any kind of service within the past 12 months. Seventy-seven percent and 0.8 % used only the somatic and mental health services, respectively; 4.1 % had frequented both services. Amongst youths with a 'borderline' and 'abnormal' Total Difficulties score, 11.8 and 18.6 %, respectively, sought help from mental health partners. Age, SES and Total Difficulties score were predictors of any service use; the logistic regression model explained 7.6 % of the variance. Use of mental health service was significantly predicted by only age and Total Difficulties score, the respective model explained 26.2 % of the variance. The comparison of health services use on an international level is rendered difficult by national differences in health-care provision. Nevertheless, several of our findings are similar to results obtained in other nationally representative surveys.

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