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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

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Psychoplasty and integrated management of addictions: A neurobiological algorithm for remodeling the reward pathway using the ASAM criteria

PSYCHOPLASTY IN ADDICTIONS AND INTEGRATED MANAGEMENT: A NEUROBIOLOGICAL ALGORITHM OF REMODELING REWARD PATHWAY USING ASAM CRITERIA

The poster presents a three-step algorithm that combines the ASAM 2024 multidimensional assessment with neurobiological staging to guide targeted treatment selection according to the predominant symptom pattern (impulsivity or compulsivity).

The aim is to define a standardized clinical framework combining multidimensional addiction assessment (ASAM 2024, fourth edition) with neurobiological interventions tailored to the patient's predominant stage of addiction. The authors define psychoplasty as the targeted stimulation of structural and functional neuroplasticity in mesolimbic and corticostriatal pathways to reverse the pathological remodeling caused by chronic substance use or behavioral addiction. The design is not an empirical patient study but a literature-based algorithm proposal consisting of three sequential steps: multidimensional assessment using the six dimensions of ASAM 2024, neurobiological scoring and classification of symptom predominance using validated scales (ICDS and OCDUS), and a subsequent targeted treatment plan. The classification branches into two pathways: Pathway 1, impulsivity and pleasure seeking (targeting the nucleus accumbens and prefrontal cortex), and Pathway 2, compulsivity and pain avoidance (targeting the dorsal striatum and extended amygdala). Treatment matching proposes contingency management and, as an example, naltrexone for Pathway 1, and CBT and acceptance and commitment therapy (ACT), with buprenorphine or acamprosate as example medications, for Pathway 2. The poster also lists example processes involved in remodeling the reward pathway: increased receptor sensitivity through digital or substance detoxification, increased BDNF and new synapse formation through physical exercise, and glymphatic system clearance and greater clarity in decision-making through deep sleep. In conclusion, the authors argue that a neurobiological circuit-based model may offer greater treatment precision than a one-size-fits-all approach, and that successful treatment must address both the biological rewiring of the brain and the socioenvironmental barriers defined in the sixth dimension. The poster includes no numerical results, sample, or statistical comparisons.

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