Daidaita daidaito, mai amfani da kuma lafiyar lafiyar jama'a a cikin haddasa saboda yanayin haɓaka

Stein, DJ, Billieux, J., Bowden-Jones, H., Grant, JE, Fineberg, N., Higuchi, S., Hao, W., Mann, K., Matsunaga, H., Potenza, MN, Rumpf , HM, Veale, D., Ray, R., Saunders, JB, Reed, GM da Poznyak, V. (2018),

Daidaita daidaito, mai amfani da kuma lafiyar lafiyar jama'a a cikin haddasa saboda yanayin haɓaka.

Duniyar Maganin Hauka, 17: 363-364. doi:10.1002 / wps.20570

An gabatar da manufar "ƙwarewar hali" (ba tare da sinadaran) ba a kusa da shekaru talatin da suka wuce, kuma yawancin wallafe-wallafen ya fito a kwanan nan a kan wannan kuma abubuwan ginawa1, 2. A lokaci guda, wasu mawallafa sun lura cewa rarraba dabi'un halayyar dabi'un na bukatar ƙarin kokarin3, 4. A nan za mu samar da sabuntawa a kan wannan yanki, muyi jaddada ayyukan da aka yi a lokacin ci gaban ICD-11, da kuma magance wannan tambaya akan ko yana da amfani don samun ɓangaren ɓangare a kan cuta saboda yanayin haɓaka a wannan rarraba.

Dukansu tsarin DSM da ICD sun yi watsi da kalmar nan "jaraba" don neman gina "abin dogara". Duk da haka, DSM-5 ya hada da matsalar caca a cikin sura ta kan cututtukan da suka shafi maɗaukaka da kuma jaraba, kuma ya samar da ma'auni don matsalar labarun Intanit, yin la'akari da shi mahallin da ake buƙata ƙarin nazarin, da kuma nuna alamunta ga abubuwan da ke tattare da cuta.5-7. A cikin zartarwar ICD-11, Hukumar Lafiya ta Duniya ta gabatar da batun "lalacewa saboda yanayin haɓaka" don haɗawa da caca da kuma lalacewar wasanni.2, 8. Wadannan rikice-rikicen suna tattare da rashin iya sarrafawa game da tsunduma cikin halayyar maye, halayyar da ke taka muhimmiyar rawa a rayuwar mutum, da ci gaba da shiga cikin halayyar duk da mummunan sakamako, tare da haɗuwa da haɗari ko mahimmancin lahani a cikin mutum, iyali, zamantakewa, da sauransu mahimman wuraren aiki2, 8.

Babban muhimmiyar mayar da hankali a yayin ci gaban DSM-5 ya kasance akan masu bincike masu bincike. Tabbas, akwai wasu alamun nuna matsala tsakanin abubuwa masu amfani da cututtukan abubuwa da cututtuka saboda dabi'un haɗari, irin su matsalar caca, a kan maɓallai masu mahimmanci ciki har da comorbidity, hanyoyin nazarin halittu, da amsa maganin5-7. Saboda matsalar wasan kwaikwayo, akwai ƙarin bayani game da siffofin asibiti da kuma neurobiological. Don wani bangare daban-daban na additattun abubuwa masu tasowa, rashin shaidar akwai. Bugu da ari, da yawa daga cikin waɗannan ka'idodin na iya nunawa tare da rikitarwa na rikici (a cikin DSM-IV da ICD-10), ciki har da comorbidity, hanyoyin nazarin halittu, da amsa maganin9.

Groupsungiyoyin da ke aiki a kan ICD-11 sun fahimci mahimmancin masu tabbatar da rikicewar hankali da halayyar mutum, saboda ba da tsarin ƙididdigewa tare da ingantacciyar hanyar bincike na iya haifar da ingantaccen sakamakon magani. A lokaci guda, ƙungiyoyin aiki na ICD-11 sun mai da hankali musamman kan amfani na asibiti da kuma kula da lafiyar jama'a a cikin shawarwarin su, tare da bayyane kan inganta ingantaccen kulawa a cikin saitunan marasa ƙwarewa, daidai da ƙarfin ICD-11 akan lafiyar ƙwaƙwalwar duniya. Kyakkyawan bambance-bambancen rikice-rikice da ƙananan nau'ikan rikice-rikice, koda kuwa an tallafa su ta hanyar ƙwarewar aiki akan ingancin bincike, ba shakka ba masu amfani bane a cikin mahallin inda waɗanda ba kwararru ke ba da kulawa ba. Koyaya, nakasar nakasu da nakasa sune mahimman batutuwan a cikin wannan mahangar, tallafawa hada caca da rikicewar caca a cikin ICD-112, 8.

Akwai dalilai da yawa da ya sa fahimtar cututtuka saboda yanayin haɓaka da haɗuwa da su cikin haɗin kai tare da maganin amfani da kayan abu zasu taimaka wajen inganta lafiyar jama'a. Abu mai mahimmanci, tsarin kiwon lafiya na jama'a don rigakafi da sarrafa kayan da ake amfani da kayan abu yana iya dacewa da matsalar caca, matsalar cinikayya, da kuma wasu wasu cututtuka saboda dabi'un haɗari (ko da yake rubutun ICD-11 ya nuna cewa yana iya zama wanda bai dace ba ya hada da da rarraba kowace cuta ta hanyar lalacewa ta waje ba tare da caca da harkar wasanni ba).

Tsarin kiwon lafiyar jama'a don yin la'akari da rashin lafiya saboda dabi'un halayya da ake jayayya yana da wadata da dama. Musamman ma, yana sanya hankali a kan: a) bakan daga bambance-bambance mai haɗari ba tare da wata damuwa ga lafiyar ta hanyar halayen da ke da alaƙa ba; b) buƙatar ƙididdiga masu kyau na kima da kuma halin kaka da halayen waɗannan halayen, da kuma c) yin amfani da manufofi na manufofi don tabbatar da cutar.

Kodayake wasu suna damuwa game da maganin maganin rayuwar rayuwa da salon rayuwa, irin wannan tsarin ya fahimci cewa wasu dabi'un da ba su da haɓaka ba dole ba ne kuma bazai zama magungunan asibiti ba, kuma yana jaddada cewa rigakafin da raguwa na kiwon lafiya da zamantakewar zamantakewa tare da nakasa saboda halin kwaikwayo na addinan za'a iya samuwa ta hanyoyi masu ma'ana ta hanyar ayyukan da ke waje da bangaren kiwon lafiya.

Sauran wasu sukar da ke tattare da halayen halayyar halayya ko rashin lafiya saboda halayyar haɗari suna iya samuwa don tattaunawa. Mun riga mun nuna a cikin wannan mujallar cewa an bukaci ƙarin aikin don yin ƙididdiga mai karfi game da amincin bincike9, kuma zartarwar ICD-11 a halin yanzu kuma ya bada jerin sunayen caca da kuma lalacewar wasanni a cikin sashin "matsalolin motsa jiki". Dangane da haka, akwai damuwa da damuwa cewa iyakokin wannan rukuni na iya zama ba tare da dace ba fiye da caca da matsalar cinikayya don haɗawa da sauran nau'o'in ayyukan ɗan adam. Wasu daga cikin wadannan muhawara sun hada da wadanda ke janyo hankalin haɗari na likitaccen likita na maganin cuta.

Yayinda yake san muhimmancin wadannan batutuwa, ra'ayinmu shine cewa babban nauyin cututtukan cuta saboda lalacewar hali yana buƙatar amsawa daidai, kuma tsarin mafi kyau shine lafiyar jama'a.

A nan muna da dalilai na dalilan da ya sa tsarin kiwon lafiyar jama'a da ke amfani dashi don maganin rikitarwa mai amfani zai iya amfani da ita don amfani da caca, matsalar cinikayya da, yiwuwar, wasu yanayin kiwon lafiya saboda yanayin haɓaka. Wannan hujja tana bayar da tallafi don haɗawa da cututtuka na kayan aiki, matsalar caca da rikitarwa a cikin ɓangaren sashe na babi a kan batutuwa, tunanin halayen ko ciwon kwakwalwa a cikin ICD-11.

Masu marubuta kadai suna da alhakin ra'ayoyin da aka bayyana a cikin wannan wasika kuma ba su wakilci yanke shawara, manufofin ko ra'ayi na Ƙungiyar Lafiya ta Duniya ba. Harafin ya samo asali ne a kan aikin daga Action CA16207 "Cibiyar Turai don Ƙarƙashin Amfani da Intanit", da goyon bayan Ƙungiyar Turai a kimiyya da fasaha (COST).