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'Makhalidwe Abwino Ogonana' Omwe Amasankhidwa Ngati Mental Health Disorder ndi World Health Organisation

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Pa 18th June 2018, olemba World Health Organisation a International Classification of Diseases, 11th Kukonzanso, ikani nkhani yolengeza kuti mtundu wakukhazikitsa wa ICD-11 ikupezeka pa intaneti. Zinaphatikizapo Compulsiveive Behaeve Disorder (CSBD) koyamba. Ngakhale mphekesera zochepa zabodza zotsutsana ndi izi, sizowona kuti WHO yakana "zolaula" kapena "chizolowezi chogonana".

Khalidwe lokakamiza lakhala likutchulidwa ndi mayina osiyanasiyana pazaka zambiri: "chiwerewere", "zolaula", "chizolowezi chogonana", "machitidwe ogonana osalamulirika" ndi zina zotero. M'ndandanda waposachedwa kwambiri wamatenda a WHO amatenga njira yololeza vutoli povomereza "Compulsive Sexual Behaeve Disorder" (CSBD) ngati matenda amisala. Malinga ndi katswiri wa WHO a Geoffrey Reed, matenda atsopanowa a CSBD "amalola anthu kudziwa kuti ali" ndi thanzi labwino "ndipo atha kupita kuchipatala."

  • Nkhani yofalitsa imapezeka pa tsamba la WHO Pano. Kuti tipeze mosavuta, tachilembapo mwatsatanetsatane.
  • Nkhani ya ICD-11 imatchula kuwonjezereka kwa maseŵera ngati matenda a matenda a m'maganizo, ndi momwe chikhalidwe cha chiwerewere chimagwiritsidwa ntchito panopa.
  • Zimatero musatchule matenda ena atsopano: "Kusokonezeka kwa khalidwe la kugonana"Zomwe zikuwonekera mu" Impulse control troubles ".
  • The "Kutulutsidwa Mfundo”Pachidziwitso chilichonse muli mawu awa: "Ma code a ICD-11 MMS ndi okhazikika."
  • Pano pali mawu omalizira a "Matenda opatsirana pogonana".

Kuthana ndi Magulu Okhudzana ndi Kugonana Kwachiwerewere ku World Health Organization

Matendawa

Kusokonezeka kwa khalidwe la kugonana [6C72], pomalizira pake amapereka akatswiri a zachipatala kuti azindikire kuti sangathetse khalidwe la chiwerewere ngakhale kuti zotsatira zake ndi zovuta. Kukonzekera kwenikweni kwa zizindikiro zatsopano zikusiyana paliponse, koma chofunikira ndikuti akatswiri azaumoyo padziko lapansi agwirizana kuti khalidwe lochita chiwerewere likuyenera kugwiritsidwa ntchito. Ndi ambulera yotalikira yomwe ingagwiritsidwe ntchito kwa aliyense amene ali ndi zoyenera zake. "Kuchita zachiwerewere" kumatchedwanso "kugonana kapena kugonana" mogwirizana ndi katswiri wodziŵa za matenda a maganizo, Jon E. Grant, JD, MD, MPH. Psychiatry Yamakono (February 2018: p.3). Sewero latsopano la CSBD lingagwiritsidwe ntchito kuti lizindikire omwe ali ndi zithunzi zolaula zosavuta kugwiritsa ntchito pa intaneti.

Oposa 80% a anthu omwe ali ndi khalidwe lochita zachiwerewere amanena kuti zolaula zimagwiritsidwa ntchito kwambiri kapena zovuta.

"Kugwiritsa ntchito zolaula zovuta kumatha kuwonetsa chiwerewere (chomwe chimadziwikanso kuti kukakamira kugonana, chizolowezi chogonana kapena mchitidwe wogonana mopitilira muyeso m'mabuku - Kafka, 2010; Karila et al., 2014; Wéry & Billieux, 2017) chifukwa m'maphunziro angapo oposa 80% a anthu omwe ali ndi chiwerewere awonetsa zolaula / zovuta (Kafka, 2010; Reid et al., 2012) ”. (Bőthe et al. 2018: 2)

Zolemba zofufuza monga WHO Mitundu Yonse ya Matenda (ICD-11) ndi American Psychiatry Association Buku Lophatikiza ndi Kuwerenga Buku la Mental Health (DSM-5) osa nenani kuti thanzi lamisala ndi "Zizolowezi" pa se. Amakonda kugwiritsa ntchito mawu oti "Matenda."

"Kuchita zachiwerewere" kumayambitsa matendawa kumachokera ku chitsanzo cholephera kuthetsa chilakolako chogonana, chilakolako cha kugonana, kapena chilakolako chogonana, chomwe chimayambitsa khalidwe la kugonana nthawi yambiri (mwachitsanzo, miyezi 6 kapena kuposa).

Kupanga matenda opatsirana pogonana

Otsutsa oyambirira anali ndi nkhawa kuti matenda aliwonse omwe angagwiritsidwe ntchito atha kugwiritsidwa ntchito kuthana ndi zachiwerewere ndi njira zina zogonana. Komabe, kuti akwaniritse njira zodziwira za CSBD, machitidwe ovuta ayenera kuyambitsa kupsinjika kosalekeza kapena kuwonongeka kwakukulu pamunthu, banja, chikhalidwe, maphunziro, ntchito, kapena magawo ena ofunikira. Mwanjira ina, matendawa sazindikira kuti odwala ali ndi vuto chani khalidwe lachiwerewere lomwe amamasuka mwachangu. Amadziwitsa odwala chifukwa cha kufooka kosalekeza ndi kupsinjika. Ngati khalidwe la chiwerewere, mtundu uliwonse womwe umatengera, sichidzachititsanso, chidziwitso chatsopano sichingagwiritsidwe ntchito.

Otsutsa ena anachenjeza kuti matenda a CSBD angayambitse matenda olakwika odwala omwe odwala omwe analibe khalidwe lawolo, omwe anali okhumudwa, komanso omwe anali ndi vuto labwino chifukwa cha odwala kapena akatswiri. Pofuna kupewa zoterezo, kachilombo ka HIV kamatulutsa kuti, "Mavuto omwe ali okhudzana ndi chikhalidwe cha makhalidwe abwino komanso osatsutsa zokhudzana ndi kugonana, zolimbikitsana, kapena makhalidwe omwe sali okwanira." Mwachidziwitso, wodwalayo sayenera kuthetsa zofuna zake ndikukhala kuchita mobwerezabwereza khalidwe la kugonana lomwe lakhala lovuta.

Kutsutsana kwa Mabuku Azidziwitso

Pali zotsutsana zambiri zomwe zikutsogolera kufalitsa mndandanda watsopano ku ICD-11. Matenda osokoneza bongo okhudzana ndi kugonana (omwe amatchulidwa ngati matenda a hypersexual) ankaganiziridwa kuti athandizidwe mu DSM-5 koma pomalizira pake sanatulukidwe. Malinga ndi akatswiri a sayansi ya zakuthambo, "Kulekerera uku kwalepheretsa kupewa, kufufuza, ndi ntchito zachipatala, ndipo anachoka kuchipatala popanda chidziwitso chothetsera vuto la chiwerewere." (Potenza et al. 2017)

Pakali pano, gulu la makolo la HIV / AIDS ndi Impulse Control Disorders, lomwe limaphatikizapo matenda monga Pyromania [6C70], Kleptomania [6C71] ndi Intermittent Explosive Disorder [6C73]. Komabe kukayikira kumakhalabe pa gulu loyenera. Monga Yale katswiri wa sayansi ya zaumoyo Marc Potenza MD PhD ndi Mateusz Gola PhD, wofufuzira pa Polish Academy of Sciences ndi University of California San Diego anati, "Njira yatsopano yothetsera matenda a CSB monga vuto lodzidzimutsa ndilotsutsana adakambirana ... Pali deta yomwe ikusonyeza kuti CSB imagawana zinthu zambiri ndi zizoloŵezi zoledzera. "(Kraus et al 2018)

Zingakhale zofunikira kudziwa kuti ICD-11 imaphatikizaponso matenda a Kutchova Juga pamavuto onsewa Chifukwa cha Ma Addictive Behaviors komanso pansi pa Impulse Control Disorder. Chifukwa chake, kugawa kwamagulu pazovuta sikuyenera kukhala kophatikizana nthawi zonse (Bőthe et al. 2018: 2). Magulu amatha kusintha nthawi. Kutchova Juga koyambirira kumadziwika kuti ndi vuto lazovuta mu DSM-IV komanso ICD-10, koma kutengera kupita patsogolo pakumvetsetsa kwamphamvu, Kutchova Juga kwatchulidwanso kuti "Matenda Okhudzana ndi Zinthu Zosokoneza Ubongo" (DSM-5) ndi "Kusokonezeka Chifukwa Chazomwe Zimachitika" (ICD-11). Ndizotheka kuti matenda atsopanowa a CSBD atha kutsatira njira yofananira yofanana ndi Kutchova Juga.

Zilibe kanthu momwe zokambiranazi zimasinthira m'kupita kwa nthawi, kuphatikizapo CSBD ku ICD-11 kumapereka chidziwitso chofunikira kuti pali anthu omwe akufunikira kuthandizira kuthandizira kuti athe kuwongolera khalidwe lawo logonana ndi zotsatira zake. Zidzathandizanso kuti pakhale kafukufuku wochuluka wokhudzana ndi chiwerewere.

"Zingakhale zofunikira kulingalira momwe DSM ndi International Classification of Diseases (ICD) zimagwirira ntchito pokhudzana ndi tanthauzo ndi magawidwe. Pochita izi, tikuganiza kuti ndikofunikira kuyang'ana kwambiri zovuta zamtundu wa juga (womwe umadziwikanso kuti njuga zamatenda) komanso momwe zimawerengedwera mu DSM-IV ndi DSM-5 (komanso ICD-10 ndi ICD-11 yomwe ikubwera). Mu DSM-IV, kutchova juga kwamatenda kunagawidwa ngati "Impulse-Control Disorder Osati Kwina Kwina." Mu DSM-5, idasinthidwa kukhala "Matenda Okhudzana ndi Zinthu Zosokoneza bongo."…. "Njira yomweyi iyeneranso kugwiritsidwa ntchito ku CSB, yomwe pakadali pano ikuwerengedwa kuti ikuphatikizidwa ngati vuto lodziletsa ku ICD-11 (Grant et al., 2014; Kraus et al., 2018) ". Mavesi awa achotsedwa Gola ndi Potenza 2018.

chithandizo

Pambuyo pa World Health Organization (WHO) yofotokoza vuto la masewera ndi CSBD monga zikhalidwe za umoyo, a lipoti mu Guardian nyuzipepala adanena kuti chipatala cha London chikukonzekera kukhazikitsa malo oyamba omwe amagwiritsidwa ntchito ndi a National Health Service omwe amalandira chithandizo kwa intaneti ndi achinyamata. Odwala opatsirana pogonana kumalo ena awona kuwonjezeka kwa makasitomala achinyamata omwe akukakamiza kugwiritsa ntchito mapulogalamu apakompyuta ndi zipinda zogwiritsa ntchito pa intaneti, ndi mavuto okhudza maganizo aumphawi.

Malinga ndi Phwando la Mateusz Gola, wofufuza pa Polish Academy of Sciences komanso ku University of California San Diego, kachilombo ka HIV kameneka kakupezekanso phindu lina. "Icho chimapereka ndondomeko yoyenera yowunikira. Komanso, akatswiri azachipatala ndi odwala matenda opaleshoni azaphunzira tsopano matendawa. Popanda kuzindikiritsa za HIV, akatswiri ambiri a zachipatala sankadziwa zambiri zokhudza nkhani zokhudzana ndi kugonana. Potsirizira pake, matendawa angaperekenso odwala ambiri kupeza chithandizo cha inshuwalansi. "Gola anawonjezera kuti, matenda atsopanowa," sathetsa vuto la momwe angagwiritsire ntchito CSBD mogwira mtima, koma amalola maphunziro ochuluka kwambiri, omwe angathe kuwatsogolera njira zovomerezeka, zodalirika. "

Kuwonjezeka kwa Odwala

Shane W. Kraus, Ph.D. Pulofesa Wothandizira wa Psychiatry ndi Director of the Behaeveal Addictions Clinic ku Edith Nourse Rogers Memorial Veterans Hospital, University of Massachusetts Medical School adati ponena za gulu latsopanoli: "Ichi ndi gawo loyambirira. Kuphatikizidwa kwa CSBD mu ICD-11 kumatha kuwonjezera mwayi wosamalira odwala (padziko lonse lapansi komanso ku US). Kuphatikiza apo, kuphatikizidwaku kudzawonjezeranso ndalama zofufuzira zomwe zakhala zikuyang'aniridwa kale pazovuta zakuchipatala. Kuphatikiza apo, ndikuganiza kuti zitha kuchepetsa kusalidwa kwa anthu omwe akhudzidwa ndikukweza maphunziro owonjezera pankhaniyi. ”

Kuphunzitsa Ophunzira Zaumoyo

Cholinga chenicheni cha kutulutsidwa kwa ICD-11 posachedwapa ndi kulola mayiko kuti aphunzitse akatswiri azaumoyo pamaphunziro a manual. Ochita kafukufuku akulimbikitsanso kuti madokotala ndi alangizi aphunzitsidwe ndi kumvetsetsa makhalidwe abwino okhudzana ndi kugonana:

"Ndikofunikanso kuti othandizira (mwachitsanzo, azachipatala ndi alangizi) omwe anthu angafune thandizo adziwa ma CSB. Pakati pa maphunziro athu opitilira 3,000 omwe akufuna chithandizo cha CSB, takhala tikumva kuti anthu omwe ali ndi CSB amakumana ndi zopinga zingapo akafuna thandizo kapena polumikizana ndi azachipatala (Dhuffar & Griffiths, 2016). Odwala amavomereza kuti madokotala angapewe mutuwo, nena kuti mavuto amenewa salipo, kapena amati munthu ali ndi chilakolako chachikulu chogonana, ndipo ayenera kulandira m'malo mochiza (ngakhale kuti kwa anthuwa, ma CSB angamve kuti ali ndi dystonic komanso amatsogolera ku zotsatira zoipa zambiri). Timakhulupirira kuti zofunikira zenizeni za matenda a CSB zimalimbikitsa khama la maphunziro kuphatikizapo chitukuko cha mapulogalamu a maphunziro momwe angayankhire ndi kuchiritsa anthu omwe ali ndi zizindikiro za matenda a CSB. Tikukhulupirira kuti mapulogalamu amenewa adzakhala mbali ya maphunziro a zachipatala kwa akatswiri a maganizo, odwala matenda a maganizo, ndi othandizira ena othandizira chithandizo chamankhwala, kuphatikizapo othandizira ena omwe amapereka chithandizo, monga madokotala ambiri. "(Kraus et al 2018)

Mphoto Yopindulitsa

The Mphoto ya Mphoto ndi sukulu yophunzitsa yopanga upainiya yomwe imapangitsa kuti sayansi yakugonana ndi chikondi ipezeke kwa anthu ambiri. Timayang'ana kwambiri pazokhudza zolaula za pa intaneti kwa achinyamata komanso achinyamata. Tavomerezedwa ndi Royal College of General Practitioners ku London kuti tichititse zokambirana zamasiku 1 kwa akatswiri pazokhudza zolaula pa intaneti paumoyo wamaganizidwe ndi thupi. Izi zikuthandizira zolinga za World Health Organisation yomwe atolankhani pansipa atsindika kufunika kophunzitsidwa pakati pa akatswiri. Timaphunzitsanso m'masukulu ndipo tidzakhala tikuphunzitsa maphunzilo ndi maphunziro kwa aphunzitsi kumapeto kwa chaka chino. Timapereka chithandizo kwa mabungwe omwe akufuna kupanga mapulogalamu odziwitsa zolaula.

Kuti mufunse mafunso kapena zambiri zowonjezera kuphatikizapo makope onse a magwero omwe atchulidwa, chonde tanani info@bwerenso.org.

FOOTNOTE

Malemba onse a ICD-11 Press Release.

WHO imatulutsa mitundu yatsopano ya matenda (ICD 11) 18 June 2018 News Release Geneva

Bungwe la World Health Organization (WHO) lero likumasula Chigwirizano Chake Chakumayiko cha Matenda (ICD-11).

ICD ndiye maziko ozindikiritsa mayendedwe azaumoyo ndi ziwerengero padziko lonse lapansi, ndipo ili ndi nambala 55 000 yapadera yovulala, matenda ndi zoyambitsa imfa. Amapereka chilankhulo chomwe chimalola akatswiri azaumoyo kuti azigawana zambiri zaumoyo padziko lonse lapansi.

"ICD ndi mankhwala omwe WHO amanyadira kwambiri," akutero Dr Tedros Adhanom Ghebreyesus, Mtsogoleri Wa bungwe la WHO. "Zimatithandiza kumvetsetsa zambiri zomwe zimapangitsa anthu kudwala ndi kufa, komanso kuti athetse mavuto ndikusunga miyoyo."

ICD-11, yomwe yakhala yoposa zaka khumi ndikupanga, imapereka kusintha kwakukulu pamitundu yapitayi. Kwa nthawi yoyamba, ndi yamagetsi kwathunthu ndipo ili ndi mawonekedwe osavuta kugwiritsa ntchito. Ndipo pakhala kuchitapo kanthu kosadalirika kwa ogwira ntchito zaumoyo omwe alowa nawo pamisonkhano yothandizana nawo ndikupereka malingaliro awo. Gulu la ICD ku likulu la WHO lalandila malingaliro opitilira 10 000 kuti awunikenso.

ICD-11 idzafotokozedwa pa World Health Assembly mu May 2019 kuti idzalandire ndi mayiko ena, ndipo idzayamba kugwira ntchito pa 1 January 2022. Kusulidwa uku ndiwonetseratu zamtsogolo zomwe zidzalola mayiko kukonzekera momwe angagwiritsire ntchito Baibulo latsopano, konzani kumasulira, ndi kuphunzitsa akatswiri azaumoyo padziko lonse.

ICD imagwiritsidwanso ntchito ndi ogulitsa inshuwalansi omwe kubwezeredwa kwawo kumadalira kulemba kwa ICD; oyang'anira ndondomeko ya zaumoyo; akatswiri osonkhanitsa deta; ndi ena omwe amayang'ana kupita patsogolo kwa thanzi la padziko lonse ndikudziwe kugawa kwa chuma.

ICD-11 yatsopano imasonyezanso kupita patsogolo kwa mankhwala ndi chitukuko mukumvetsetsa kwa sayansi. Mwachitsanzo, zizindikiro zotsutsana ndi antimicrobial resistance zikugwirizana kwambiri ndi Global Antimicrobial Resistance Monitoring System (GLASS). ICD-11 imathanso kulandira deta yokhudzana ndi chitetezo chaumoyo, zomwe zikutanthauza kuti zochitika zosafunikira zomwe zingawononge thanzi - monga ntchito zosagwiritsidwa ntchito mosalekeza kuchipatala - zikhoza kudziwika ndi kuchepetsedwa.

ICD yatsopano imaphatikizapo mitu yatsopano, imodzi pa mankhwala amtundu: ngakhale kuti anthu mamiliyoni ambiri amagwiritsira ntchito mankhwala amtundu wapadziko lonse lapansi, siinayambe yayikidwa mu dongosolo lino. Chaputala chatsopano chokhudzana ndi chiwerewere chimabweretsa pamodzi zinthu zomwe poyamba zinagawidwa mwa njira zina (mwachitsanzo, kusagwirizana kwa amuna ndi akazi kumatchulidwa pansi pazirombo) kapena kufotokozedwa mosiyana. Matenda a masewera awonjezeredwa ku gawo pa matenda osokoneza bongo.

"Mfundo yofunika kwambiri pazokonzanso izi inali yophweka kupanga zida zogwiritsira ntchito makina komanso zipangizo zamagetsi - izi zidzathandiza akatswiri a zaumoyo kuti azilemba mosavuta komanso kulembetsa zinthu mosavuta," anatero Dr. Robert Jakob, Mtsogoleri wa Mtsogoleri, Zomwe Zimalongosola Zomwe Amalemba ndi Malamulo, WHO.

Dokotala Lubna Alansari, Mthandizi Wachiwiri wa WHO wa Health Metrics ndi Measurement, akuti: "ICD ndi mwala wapangodya wokhudza zaumoyo ndipo ICD-11 idzawunikira momwe angayang'anire matenda."

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