YBOP yayi sharhi: Ya ƙunshi wani ɓangare game da "Rikicin halayen halayen jima'i":
Harkokin halayen jima'i mai tsanani
Halin halayen halayen jima'i yana da alaƙa da rashin cin nasara akan halayen jima'i ko jarabawa, wanda ya haifar da halayen jima'i na tsawon lokacin (misali, watanni shida ko fiye) wanda ke haifar da wahala ko rashin lafiyar mutum, iyali, zamantakewa , ilimi, sana'a ko wasu muhimman wuraren da suke aiki.
Abubuwan da ke iya faruwa a bayyane na tsarin ci gaba sun hada da: maimaita ayyukan jima'i ya zama babban abin da ya shafi rayuwar mutum har zuwa rashin kulawa da lafiya da kulawar mutum ko wasu bukatu, ayyuka da nauyi; mutumin da ke yin ƙoƙari da yawa ba tare da nasara ba don sarrafawa ko rage halayen maimaita jima'i; mutumin da ke ci gaba da maimaita halayen jima'i duk da mummunan sakamako kamar lalata maimaita dangantaka; kuma mutum yana ci gaba da maimaita halayen jima'i koda kuwa lokacin da ya daina samun gamsuwa daga gare ta.
Kodayake wannan nau'in halitta yayi kama da mahimmancin abu, an haɗa shi a cikin ɓangaren ƙwayoyin cuta na ICD-11 don gane rashin rashin bayani game da ko matakan da ke tattare da ci gaba da kulawa da cutar sun kasance daidai da wadanda aka lura a cikin cuta masu amfani da kuma cin zarafin hali. Harkokinsa a cikin ICD-11 zai taimaka wajen magance matsalolin kula da marasa lafiya da kuma yiwuwar rage rashin kunya da laifin da ke tare da taimakon taimako tsakanin masu wahala50.
Reed, GM, Na farko, MB, Kogan, CS, Hyman, SE, Gureje, O., Gaebel, W., Maj, M., Stein, DJ, Maercker, A., Tyrer, P. da Claudino, A., 2019.
World Psychiatry, 18 (1), pp.3-19.
Abstract
Bayan amincewa da ICD-11 ta Majalisar Kiwon Lafiya ta Duniya a watan Mayu 2019, mambobin kungiyar Lafiya ta Duniya (WHO) mambobin kasashe za su sauya daga ICD-10 zuwa ICD-11, tare da bayar da rahoton alkalumman kiwon lafiya dangane da sabon tsarin da za a fara Janairu 1, 2022. Ma'aikatar Lafiya ta Shafi ta Duniya da Abuse na Abubuwan Lafiya na WHO za su buga kwatancin Magunguna da Ka'idodin Bincike (CDDG) don ICD M 11 Mental, Behavioral and Neurodevelopmental Disorders bin ICD-11 ta amince. Ci gaban ICD-11 CDDG a cikin shekaru goma da suka gabata, dangane da ƙa'idodin amfani da asibiti da kuma amfani da duniya, ya kasance mafi yawan ƙasashe masu yawa, harsuna da yawa, ɗabi'a da yawa kuma tsarin sake dubawa da aka taɓa aiwatarwa don rarrabuwar rikicewar ƙwaƙwalwa. Kirkirar kirkire-kirkire a cikin ICD-11 sun hada da samar da daidaitattun bayanai da tsari, daukar tsarin rayuwa, da kuma al'adun da suka shafi kowace cuta. An sanya hanyoyin girma zuwa cikin rarrabuwa, musamman don rikicewar halin mutum da rikicewar rikice-rikice na farko, ta hanyoyin da suka dace da shaidun yanzu, sun fi dacewa da hanyoyin dawo da tushen, kawar da cututtukan wucin gadi, kuma mafi saurin ɗaukar canje-canje cikin lokaci. Anan zamu bayyana manyan canje-canje ga tsarin tsarin ICD-11 rarrabuwa na rikicewar hankali idan aka kwatanta da ICD-10, da haɓaka sabon sabon babin ICD-11 guda biyu masu dacewa da aikin kiwon lafiyar hankali. Muna kwatanta saitin sababbin nau'ikan da aka kara zuwa ICD-11 kuma suna gabatar da mahimmin dalilin haɗa su. A ƙarshe, muna ba da kwatancen mahimman canje-canje waɗanda aka yi a cikin kowace ƙungiyar cuta ta ICD-11. An tsara wannan bayanin don zama mai amfani ga likitoci da masu bincike don fuskantar kansu zuwa ICD-11 da kuma shirya don aiwatarwa a cikin abubuwan da suka dace.
A cikin Yuni 2018, Hukumar Lafiya ta Duniya (WHO) ta fitar da wata mahimmanci na juyin juya halin 11th na Kayan Kayan Ƙasa na Duniya da Magunguna na Lafiya ta Duniya (ICD-11) don yawan mace-mace da kididdigar ƙwayoyin cuta ga kasashe mambobin 194, domin nazari da shiri don aiwatarwa1. Majalisar Dokokin Lafiya ta duniya, wadda ta hada da ministocin lafiya na dukkan jihohi, ana sa ran za ta amince da ICD-11 a taron na gaba, a watan Mayu 2019. Bayan amincewa, kasashe mambobin za su fara aiki daga ICD-10 zuwa ICD-11, tare da bayar da rahotanni game da labarun kiwon lafiya ga WHO ta amfani da ICD-11 don fara ranar Janairu 1, 20222.
Sashin Lafiya na Hauka da Abuse na WHO ya kasance da alhakin daidaita ci gaban babi huɗu na ICD-11: larurar hankali, ɗabi'a da rashin ci gaban jiki; rikicewar bacci ‐; cututtuka na tsarin mai juyayi; da yanayin da suka shafi lafiyar jima'i (tare da Sashen Kula da Lafiya da Bincike na WHO).
Sashin ƙananan lahani na ICD-10, halin yanzu na ICD, shi ne mafi yawan amfani da jinsi na ƙwayar cuta a duniya3. A lokacin ci gaba da ICD-10, Cibiyar Harkokin Kiwon Lafiyar Harkokin Kiwon Lafiyar Harkokin Kiwon Lafiyar Harkokin Kiwon Lafiya ta Duniya da WHO ta yi la'akari da cewa za a samar da iri daban-daban na ƙayyadewa don cika bukatun masu amfani da shi. Harshen ICD-10 don rahotanni na kididdiga ya ƙunshi fassarar taƙaitacciyar fasali ga kowane ɓangaren ƙwayar cuta, amma wannan ya zama kasa don amfani da masu sana'a na kiwon lafiya a cikin asibiti.4.
Ga masu kwararrun likita na kwakwalwa, Sashen ya ƙaddamar da Bayanan Clinical da Jagoran Hannun (CDDG) don Hakanan na ICD-10 da Yanayin Buka.4, sananne da aka sani da "littafin blue", wanda aka nufa don asibiti na gaba, ilimi da sabis. Ga kowace cuta, an bayar da bayanin bayanin babban asibiti da haɗin gwiwar, sannan kuma ƙarin jagororin binciken da aka tsara don taimakawa likitocin kiwon lafiya na tunanin mutum don yin ganewar asali. Bayani daga binciken da aka yi kwanan nan5 ya nuna cewa likitoci sukan yi amfani da kayan cikin CDDG akai-akai kuma sukan duba shi a hankali lokacin da aka gano asali na farko, wanda ya sabawa imani da yaduwar cewa likitocin kawai sunyi amfani da ƙayyadewa don manufar samun lambobin bincike don ƙaddarawa da kuma lissafin lissafin kuɗi. Sashen za su wallafa wani nauyin CDDG na ICD-11 nan da nan bayan an amince da tsarin da tsarin lafiya na duniya ya amince.
Fiye da shekaru goma na aiki mai zurfi ya shiga cikin ci gaban ICD-11 CDDG. Ya ƙunshi daruruwan masana kimiyya a matsayin membobin Shawarar da Kungiyoyin Ayyuka da kuma masu ba da shawara, tare da haɗin kai tare da mambobin kungiyar WHO, hukumomin kudade, da kuma masana'antu da kimiyya. Ci gaban ICD-11 CDDG ya kasance mafi yawan tsarin duniya, harshe harshe, multidisciplinary da kuma tsarin saiti wanda ya taɓa aiwatarwa don ƙaddamar da ƙwayar cuta.
GANIN ICD ‐ 11 CDDG: AIKI DA FIFITA
Mun bayyana a baya bayanin muhimmancin mai amfani da asibiti a matsayin tsarin shiryawa a cikin ƙaddamar da ICD-11 CDDG6, 7. Rahoton kiwon lafiya yana wakiltar ƙirar tsakanin masu fuskantar lafiyar jiki da bayanin kiwon lafiya. Tsarin da ba ya samar da bayanai masu amfani da asibiti a matakin lafiyar jiki ba za'a aiwatar da shi da aminci ba daga likitoci don haka ba zai iya samar da wata mahimmanci don tushen bayanai na kiwon lafiya da aka yi amfani da su wajen yanke shawara a tsarin kiwon lafiya, na kasa da na duniya.
Sabili da haka, mai amfani da asibiti ya karfafa mahimmanci a cikin umarnin da aka bayar zuwa jerin Rukunin Ƙungiyoyi, wanda aka tsara ta hanyar haɗa kai, wanda Ma'aikatar Harkokin Kiwon Lafiyar Harkokin Kiwon Lafiyar Jama'a da Abubuwan Abubuwa ta Majalisar Dinkin Duniya ta tsara su don yin shawarwari akan tsarin da abun ciki na ICD-11 CDDG .
Tabbas, ban da kasancewa mai amfani a asibiti kuma ana amfani da shi a duniya, ICD-11 dole ne ya zama ingantaccen ilimin kimiyya. Hakanan, an kuma nemi Workingungiyoyin Masu Aiki su sake nazarin wadatattun shaidun kimiyya da suka dace da wuraren ayyukansu a matsayin tushen haɓaka shawarwarinsu na ICD-11.
Muhimmancin amfani da duniya6 an kuma ƙarfafa shi sosai ga Workingungiyoyin Aiki. Dukkanin kungiyoyin sun hada da wakilai daga dukkanin yankuna na duniya na WHO - Afirka, Amurka, Turai, Gabashin Bahar Rum, kudu maso gabashin Asiya, da Yammacin Pacific - da kuma adadi mai yawa na mutane daga ƙasashe masu ƙasƙanci da masu matsakaicin ƙarfi, waɗanda ke da fiye da 80% na yawan mutanen duniya8.
Wani gajeren ICD-10 CDDG shi ne rashin daidaito a cikin kayan da aka bayar a fadin ƙungiyoyi masu cuta9. Don ICD-11 CDDG, an nemi Workingungiyoyin Masu aiki su sadar da shawarwarinsu azaman "siffofin abun ciki", gami da daidaitattun bayanai na yau da kullun game da kowane cuta wanda ya ba da tushen jagororin bincike.
Mun riga mun buga cikakken bayani game da aikin aiki da tsarin tsarin jagorancin ICD-119. Ci gaban ICD-11 CDDG ya faru a lokacin da ya ɓace sosai tare da samar da DSM-5 ta Ƙungiyar Ƙwararrun Ƙwararrun Amurka, kuma yawancin Ƙungiyoyin Ayyuka na ICD-11 sun haɗa da mambobi tare da ƙungiyoyin da ke aiki a kan DSM-5. An tambayi Ƙungiyoyin Ayyukan ICD-11 don bincika mai amfani da asibiti da kuma amfani da kayan aikin duniya na DSM-5. Manufar ita ce ta rage girman bambanci ko rarrabewa tsakanin ICD-11 da DSM-5, kodayake bambancin ra'ayi da aka ƙayyade.
BABI NA BUGA A CIKIN ICD-11 CDDG
Wani muhimmin mahimmanci na ICD-11 CDDG shi ne hanyar da zasu iya kwatanta abubuwan da ke tattare da kowace cuta, wanda ke wakiltar waɗannan bayyanar cututtuka ko halaye wanda likita zai iya tsammanin zai iya samuwa a duk lokuta na rashin lafiya. Duk da yake jerin abubuwan da suka dace a cikin sharuɗɗa sunyi kama da ka'idojin bincike, yanke cututtuka da ƙayyadaddun bukatun da aka danganta da alamar alamun kuma yawancin lokaci ana kauce masa, sai dai idan an kafa waɗannan a cikin ƙasashe da al'adu ko kuma akwai wata dalili mai mahimmanci da ya haɗa su.
An tsara wannan tsarin ne don biyan hanyoyin da likitoci suka yi don magance su, tare da saurin aikin gwaji, da kuma kara yawan masu amfani da asibiti ta hanyar barin bambancin al'adu a cikin gabatarwa da kuma abubuwan da ke cikin al'amuran da suka shafi tsarin kiwon lafiya wanda zai iya shafar aikin bincike. Wannan hanyar da ta dace ta dace da sakamakon bincike na likitoci da masu ilimin psychologist da aka gudanar a farkon tsarin aiwatar da ICD-11 game da kyawawan halaye na tsarin tsarin tsabtace hankali3, 10. Nazarin filin a cikin saitunan asibiti a cikin kasashe na 13 sun tabbatar da cewa likitoci sunyi la'akari da mai amfani da asibiti na wannan hanya don yin hakan11. Abin mahimmanci, tabbatar da gaskiyar abubuwan ICD-11 na tabbatarwa ya zama akalla kamar yadda aka samo ta ta amfani da matakan ka'idoji masu tsabta.12.
An gabatar da wasu sababbin sababbin abubuwa a cikin ICD-11 CDDG ta hanyar samfurin da aka ba wa Ƙungiyoyi Masu Aikatawa don yin shawarwari (wato, "nau'in abun ciki"). A matsayin wani ɓangare na daidaitaccen bayanin da aka bayar a cikin jagororin, an kula da hankali ga kowace cuta zuwa fasalin tsarin da ke cikin iyaka tare da daidaituwa na al'ada da kuma fadada bayanin da aka bayar a kan iyakoki tare da wasu cututtuka (ganewar bambancin).
Hanyar da aka samu don ICD-11 na nufin cewa rarrabuwa na halayyar halayya da halayya tare da farawa yana faruwa a lokacin yaro kuma yaro ya ƙare, kuma waɗannan nakasa sun rarraba zuwa wasu rukuni wanda suke raba alamun bayyanar. Alal misali, rarraba rarrabuwar rikice-rikice ya motsa damuwa da raunin rikici da tsoro. Bugu da ƙari, ICD-11 CDDG tana bada bayani ga kowace cuta da / ko rukuni inda aka samo bayanan da ke kwatanta bambancin a cikin gabatarwar cutar a tsakanin yara da matasa har ma daga cikin tsofaffi.
An tsara bayanai game da al'adu bisa ga nazari na wallafe-wallafe game da tasiri na al'adu a fannin ilimin kwakwalwa da kuma maganganunsa ga kowane jinsin bincike na ICD-11 da kuma cikakken bayani kan abubuwan da suka shafi al'ada a cikin ICD-10 CDDG da DSM- 5. Ana ba da jagorancin al'adu don rashin tsoro a Table 1 a matsayin misali.
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Wani muhimmin bidi'a a cikin rarrabuwa na ICD-11 shine ƙaddamar da hanyoyin aiwatar da tsarin girma a cikin tsarin mahallin tsari da takamaiman takaddama. Wannan gwagwarmaya ya motsa shi ta hanyar shaida cewa yawancin hankali na tunanin mutum zai iya zama mafi kyau da aka kwatanta tare da yawan alaƙa da alamar bayyanarwa maimakon a matsayin ɗakunan rarrabe.13-15, kuma an shirya shi ta hanyar sababbin abubuwa a tsarin tsarin coding na ICD-11. Halin da ake ciki na ICD-11 ya fi fahimta sosai a rarraba yanayin halin mutum16, 17.
Don saitunan ba na ƙwararru ba, ƙimar girman yanayin cuta na yanayin ICD-11 yana ba da sauƙi da amfani na asibiti fiye da rarraba ICD-10 na takamaiman halin mutum, haɓaka ƙwararrun marasa lafiya waɗanda ke buƙatar hadaddun idan aka kwatanta da mafi sauƙi jiyya, kuma mafi kyau inji don sauyin canje-canje akan lokaci. A cikin ƙarin saitunan musamman, ƙungiyar tauraruwar halayen mutum na iya sanar da takamaiman dabarun shiga tsakani. Tsarin girma yana kawar da cututtukan wucin gadi da ke tattare da rikicewar halin mutum da kuma rashin bincikar rikice-rikicen halin mutum, tare da samar da tushe don bincike a cikin manyan sifofi da tsoma baki a cikin bayyanar cututtukan mutum daban-daban.
An kuma gabatar da jerin masu cancantar girma don bayyana alamun bayyanar cututtukan schizophrenia da sauran cututtukan psychotic na farko.18. Maimakon mayar da hankali kan ƙananan ƙwararru, ƙaddarar girman kai na mayar da hankali ga bangarori masu dacewa na gabatarwa a halin yanzu a hanyoyi da suka fi dacewa da hanyoyin sake farfadowa da ilimin kiwon lafiya.
Hanyoyin da ake fuskanta game da lalacewar mutum da kuma bayyanar cututtuka na ɓangarorin ƙananan psychotic an kwatanta dalla-dalla a cikin sassan da ke baya a wannan takarda.
ICD-11 FIELD STUDENTS
Shirin nazarin filin na ICD-11 yana wakiltar wani ɓangare na manyan bidi'a. Wannan aikin aikin ya haɗa da amfani da mahimman hanyoyi don nazarin mai amfani na asibiti na rubutun ganewa, ciki har da daidaito da daidaitattun aikace-aikacen da likitoci suka dauka idan aka kwatanta da ICD-10 da kuma wasu abubuwan da ke da alhakin kowane rikici19. Babban karfi na shirin bincike shi ne cewa mafi yawancin nazarin da aka gudanar a wani lokaci suna ba da sakamakon su don samar da dalili don nazarin jagorancin don magance duk wani rauni da aka gani20.
Haɗin duniya ya kasance maƙasudin ma'anar shirin shirin ICD-11 CDDG. An kafa Cibiyar Harkokin Gudanar da Harkokin Gudanarwar Duniya (GCPN) don ba da damar kiwon lafiya ta tunanin mutum da kuma masu sana'a na asali daga ko'ina cikin duniya don shiga kai tsaye a cikin ci gaban ICD-11 CDDG ta hanyar binciken yanar-gizo.
A tsawon lokaci, GCPN ya ƙaddamar ya haɗa da kusan likitocin 15,000 daga kasashen 155. Dukkanin yankunan duniya na WHO suna wakilci a cikin yanayin da ya fi dacewa da kasancewar masu ilimin kiwon lafiya ta yanki, tare da yawancin samowa daga Asiya, Turai da Amurka (kamar yadda aka raba tsakanin Amurka da Kanada a gefe guda da Latin Amurka akan wasu). Fiye da rabi na mambobin GCPN sune likitoci, masu ilimin likita, kuma 30% su ne masu ilimin kimiyya.
An kiyasta kimanin GCPN daruruwan darussa a yau, mafi yawan suna mayar da hankali kan ka'idojin binciken ICD-11 da aka tsara tare da ka'idodin ICD-10 dangane da daidaituwa da daidaituwa na samfurin likitoci, ta hanyar yin amfani da matsala don magance bambance-bambance.19, 21. Sauran nazarin sun bincika samfurori don masu bincike22 da kuma yadda kamfanonin likita suke amfani dasu5. An gudanar da nazarin GCPN a cikin Sinanci, Faransanci, Jafananci, Rasha da Mutanen Espanya, ban da Ingilishi, kuma sun haɗa da binciken sakamakon ta yankin da harshe don gano matsaloli na duniya ko al'adu da kuma matsalolin fassara.
An gudanar da nazarin asibiti ta hanyar hanyar sadarwa na cibiyoyin nazarin filin wasa na kasa da kasa don kimanta amfani da asibiti da kuma amfani da ka'idodin bincike na ICD-11 da aka tsara a cikin yanayin yanayi, a cikin saitunan da ake nufi da za a yi amfani dashi11. Wadannan nazarin sun kuma gwada tabbatar da tabbacin bincikar bincikar bincikar bincikar bincikar maganin da aka samu a cikin asusun ajiyar kuzari12. An gudanar da nazarin filin sararin samaniya a cikin kasashe na 14 a dukan yankunan duniya na WHO, kuma ana gudanar da tambayoyi na haƙuri don nazarin a cikin harshe na kowace ƙasa.
BABI NA GASKIYA NA ICD-11 BABI NA BABI NA HAUSA, HAUSA DA NASIHIN NASUWA.
A cikin ICD-10, yawancin rukuni na rikitarwa an hana su ta hanyar ƙaddamar da tsarin ƙaddamarwa na decimal wanda aka yi amfani da shi a cikin ƙaddamarwa, don haka ba zai iya yiwuwa a yi iyakacin manyan ƙungiyoyi goma na rikitarwa ba a cikin sura a kan cututtukan tunani da halayyar mutum. A sakamakon haka, an halicci rukunin bincike wanda ba a dogara ne akan mai amfani da asibiti ko hujjojin kimiyya (misali, rikitarwa masu rikitarwa an haɗa su a matsayin ɓangare na rarrabuwa da ke tattare da neurotic, damuwa, da kuma rikitarwa). ICD-11 yayi amfani da tsarin haɓakaccen alphanumeric wanda aka ba da izinin yawan kungiyoyi, ya sa ya yiwu a ci gaba da ƙungiyoyi masu bincike waɗanda suka fi dacewa akan shaidar kimiyya da kuma bukatun aikin aikin asibiti.
Don samar da bayanai don taimakawa wajen bunkasa tsarin ƙungiya wanda zai zama mafi amfani da asibiti, an gudanar da nazarin filin karatu guda biyu23, 24 don bincika ra'ayoyin da masana harkokin kiwon lafiyar duniya suke yi a duniya game da dangantaka tsakanin rikici na tunanin mutum. Wadannan bayanan bayanan bayanai game da tsarin mafi kyau na ƙayyadewa. Ƙungiyar ƙungiyar ICD-11 ta kuma shawo kan ƙwaƙwalwar da WHO da Ƙwararrun Ƙwararrun Ƙwararrun Amurka suka yi don daidaita tsarin tsarin ICD-11 a kan hadaddun hankali da halayyar mutum tare da tsarin DSM-5.
Ofungiyar ICD-10 babi game da rikice-rikice na hankali da halayyar mutum ya fi dacewa ya nuna ƙungiyar babin da aka fara amfani da ita a cikin Littafin Rubutun Lafiya na Kraepelin, wanda ya fara da rikice-rikicen ƙwayoyin cuta, sannan psychoses, cututtukan jijiyoyin jiki, da rikicewar halin mutum.25. Ka'idojin da ke jagorantar kungiyar ICD-11 sun hada da ƙoƙarin yin umurni da rukunin bincike tare da bayanan ci gaba (sabili da haka, nakasar neurodevelopmental ya fara fitowa da nakasar neurocognitive karshe a cikin ƙayyade) da kuma haɗuwar rikitarwa tare bisa tushen abubuwan da ke tattare da ilimin halitta da kuma pathophysiological (misali, cuta musamman hade da danniya) da kuma haɓakar kamala (misali, dissociative disorders). Tebur 2 yana ba da jerin sunayen ƙungiyoyin bincike a cikin sashin ICD-11 a kan halayen tunanin mutum, halayyar jiki da kuma ciwon kwakwalwa.
| Ciwon daji na neurodevelopmental |
| Schizophrenia da sauran magungunan psychotic |
| Catatonia |
| Ciwon yanayi |
| Rashin tsoro da rikici |
| Abun tsoro-rikitarwa da rikici |
| Abubuwa da ke hade da damuwa |
| Rashin rarrabawar dissociative |
| Ciyar da ci abinci |
| Cutar kawarwa |
| Rashin ciwo na wucin jiki da kuma kwarewar jiki |
| Rashin lafiya saboda abubuwa masu amfani da ƙwayoyi |
| Matsalar kulawa da cuta |
| Cutar lalacewa da rashin lafiya |
| Rashin halin mutum |
| Cutar ɓarna |
| Rashin lafiya |
| Ciwon daji na neurocognitive |
| Halin ƙwaƙwalwar tunani da halayyar halayen da ke haɗe da ciki, haihuwa da puerperium |
| Hanyoyin ilimin kimiyya da halayyar da ke cutar da cututtuka ko cututtuka da aka ƙayyade sauran wurare |
| Ƙunƙwarar ƙwararru ta biyu ko halayyar halayyar halayen da ke tattare da cuta ko cututtuka da aka ƙayyade a wasu wurare |
Hada rarrabawar rashin barci a cikin ICD-10 ya dogara ne akan raguwa tsakanin raunin kwayoyin da marasa lafiya, wanda ya haifar da lalacewar barcin "marasa kwayoyin" a cikin babi na kan lahani da kuma halin mutum na ICD-10, da kuma maganin barci "kwayoyin" sun hada da su a cikin wasu surori (watau cututtuka na tsarin mai juyayi, cututtuka na numfashi, da kuma endocrin, da abinci mai gina jiki da kuma cututtuka na rayuwa). A cikin ICD-11, an rarraba wani nau'i na dabam domin rashin lafiyar barci wanda ke tattare da duk abin da aka gano game da barci.
ICD-10 kuma ya haɗa da kwayar halitta tsakanin kwayoyin halitta da wadanda ba kwayoyin halitta a cikin tsarin zubar da jima'i ba, tare da "lalata kwayoyin halitta" da aka hada a cikin babi akan cututtukan tunani da halayyar mutum, da kuma "zane-zane" jima'i don yawancin da aka jera a cikin babi na kan cututtuka na tsarin dabbobi. Wani sabon bangare mai mahimmanci don yanayin da suka danganci lafiyar jima'i an ƙara shi zuwa ICD-11 don gina ɗakantarwa na jima'i da zubar da ciki da jima'i.26 kazalika da canje-canje a jikin namiji da mace. Bugu da ƙari, an sake renon nau'in cutar ta ICD-10 a tsakanin maza da mata a cikin ICD-11 kuma ya koma daga matsala na lalata tunanin mutum zuwa sabon sashin lafiyar jima'i.26, ma'anar cewa ba za a sake la'akari da ainihin ainihin ainihi ba. Ba a samar da matsala ba tsakanin maza da mata a cikin ICD-11 saboda a kasashe da dama suna samun damar kiwon lafiyar lafiya yana da alaƙa akan ganewar ganewa. Ka'idodin ICD-11 ya bayyana a bayyane cewa yanayin haɓaka tsakanin jinsi da kuma abubuwan da aka zaɓa ba su isa ba don yin ganewar asali.
BABI NA HAUSA, HAUSA DA NASIHIN NASUWA A CIKIN ICD-11
Bisa la'akari da bayanan da aka samu game da ingantacciyar kimiyya, da kuma yin la'akari da amfani da asibiti da kuma amfani da duniya, an kara yawan sababbin cututtuka a cikin layin ICD-11 a kan cututtukan tunani, halayyar mutum da kuma ciwon kwakwalwa. Bayanin irin wannan cuta kamar yadda aka bayyana a cikin jagorancin binciken ICD-11 da kuma dalilai don hada su an samo a kasa.
Catatonia
A cikin ICD-10, an haɗa catatonia a matsayin daya daga cikin subtypes na schizophrenia (watau, schizophrenia catatonic) kuma a matsayin daya daga cikin maganin kwayoyin cuta (watau kwayar cuta na catatonic). Idan kun san gaskiyar cewa cutar ta Catatonia zai iya faruwa a cikin haɗuwa da ciwo da dama27, wani sabon rukunin bincike na catatonia (a daidai wannan mataki na rikici, tashin hankali da damuwa da tsoro, da dai sauransu) an kara shi a cikin ICD-11.
Catatonia yana faruwa ne da abin da ya faru da dama da alamun bayyanar cututtuka irin su stupor, catalepsy, waxy flexibility, mutism, negativism, posturing, stylesisms, stereotypies, psychomotor agitation, grimacing, echolalia da echopraxia. Sharuɗɗa uku sun haɗa su a cikin sabon rukunin bincike: a) catatonia da ke haɗuwa da wani ƙwayar cuta (kamar lalacewar yanayi, schizophrenia ko wasu na farko na psychotic cuta, ko rashin lafiya ta hanyar autism); b) ƙwayar cutar ta hanyar abubuwa masu kwakwalwa, ciki har da magunguna (misali, magungunan antipsychotic, amphetamines, phencyclidine); da kuma c) sakandaren sakandare (watau, yanayin likita, kamar ketoacidosis na ciwon sukari, hypercalcemia, kwakwalwa na rashin lafiya, homocystinuria, neoplasm, ciwon zuciya, cuta na cerebrovascular, ko encephalitis).
Nau'in nau'in halitta na II
DSM ‐ IV sun gabatar da nau'ikan cuta bipolar. Rikicin na Bipolar type I ya shafi gabatarwar da ke tattare da aƙalla aukuwa guda daya na maniyyi, alhali kuwa cuta mai kama-karya ta II na buƙatar aƙalla ɓarnar ɓarna da ƙarancin wani babban mawuyacin halin ɓacin rai, in babu tarihin abubuwan da suka faru. Shaidun da ke tallafawa ingancin rarrabe tsakanin waɗannan nau'ikan nau'ikan sun hada da bambance-bambance a cikin maganin antothepressant monotherapy amsa28, matakan neurocognitive28, 29, sakamakon kwayoyin halitta28, 30, da kuma binciken neuroimaging28, 31, 32.
Bayar da wannan shaidar, kuma mai amfani na asibiti na bambanta tsakanin waɗannan iri biyu33, raunin cuta a cikin ICD-11 an raba shi zuwa nau'in I da kuma gurfanar da cututtuka na II.
Dysmorphic cuta
Mutanen da ke fama da ƙwayar dysmorphic jiki suna cike da damuwa da lahani ɗaya ko fiye ko ɓarna a cikin bayyanar jiki wanda ba shi da ganewa ko dan kadan ga wasu34. Halin da ake ciki yana tare da haɓakawa da kuma halayen kisa, ciki har da yin nazarin bayyanar ko bayyanar da rashin kuskure ko ɓarna, ƙoƙari mai zurfi don sake sakewa ko canza abin da aka sani, ko alamar yanayin zamantakewa ko kuma abubuwan da ke haifar da ƙyama game da kuskure ko lalata.
Da farko an kira "dysmorphophobia", wannan yanayin da aka haɗa a cikin DSM-III-R. Ya bayyana a cikin ICD-10 a matsayin wani abu mai haɗakarwa kuma mai haɗari a ƙarƙashin hypochondriasis, amma an umurci likitoci su gano shi a matsayin ɓarna a cikin al'amuran da aka yi imani da abin da suka shafi bangaskiya. Wannan ya haifar da mawuyacin irin wannan cuta da za a sanya nau'o'in ƙwayar cuta daban-daban ba tare da gane cikakken nau'i na rashin lafiya ba, wanda zai iya haɗa da bangaskiyar da ta ɓoye saboda girman ƙwaƙwalwar da aka yi da shi.
Idan aka fahimci bayyanar cututtuka, yawancin jama'a da kuma kamantattun maganganu masu rikitarwa da rikici (OCRD), ƙwayar dysmorphic jiki an haɗa shi a wannan rukunin ƙarshe a cikin ICD-1135.
Abubuwan da suka shafi maganganu masu kyau
Wannan yanayin yana nuna damuwa da tsinkaya tare da imani cewa mutum yana fitar da tsinkaye ko tsinkaye na jiki ko numfashin jiki, wanda ba shi da ganewa ko dan kadan ga wasu34.
Dangane da damuwarsu, mutane sukan shiga cikin halin da ake ciki da kuma halayya irin su bincika jiki akai-akai ko bincikar ma'anar ƙanshi; sau da yawa na neman tabbacin; yunkurin wuce gona da iri don sake sakewa, canzawa ko hana tsinkar tsinkaye; ko alamar kauce wa yanayin zamantakewa ko abubuwan da ke haifar da damuwa game da tsinkayewa ko wariyar ƙanshi. Mutanen da suka shafi wadanda suka shafi mutane suna jin tsoro ko kuma sun tabbata cewa wasu da ke lura da ƙanshi za su ƙi ko wulakanta su36.
Rashin haɗin tunani na Olfactory an haɗa shi a cikin ƙungiyar ICD-11 OCRD, saboda yana da alaƙa da kamanceceniya da sauran rikice-rikice a cikin wannan rukunin game da kasancewar damuwar rikicewar rikicewa da halayen haɗuwa da maimaitawa35.
Rashin ciwo
Rashin haɓaka yana haɗuwa da haɗuwa da dukiya, saboda haɗuwa da kima ko wahala ya sa su, ko da kuwa ainihin ainihin su35, 37. Samun daɗaɗɗa yana samuwa da matsalolin maimaitawa ko al'amuran da ke tattare da tarawa ko sayen abubuwa. Diffar wuya a watsar da shi shine halin da ake tsammani yana buƙatar ajiye abubuwa da kuma damuwa da ke haɗuwa da su. Haɗuwa da dukiyarsu yana haifar da wuraren zama a cikin ɓarna har zuwa ma'anar cewa an yi amfani da amfani da su ko aminci.
Kodayake ana iya nuna halayen ɗabi'a a matsayin wani ɓangare na ɗimbin rikice-rikicen tunani da halayyar mutum da sauran yanayi - gami da rikice-rikice na rikice-rikice, cututtukan ciki, schizophrenia, rashin hankali, cututtukan bambance-bambance na Autism da Prader-Willi syndrome - akwai wadatattun shaidun da ke tallafawa tattara cuta a matsayin cuta ta daban kuma ta musamman38.
Mutanen da ke fama da rikicewar ajiyar kuɗi ba a fahimta da kulawa da su, wanda ke jayayya daga hangen nesa na lafiyar jama'a don haɗa ta cikin ICD-1139.
Tashin hankali na Excoriation
Wani sabon bincike da ke tattare da ƙwayar cuta, mayar da hankali ga rikitarwa na jiki, an ƙara shi zuwa ƙungiyar OCRD. Ya haɗa da trichotillomania (wanda aka haɗa a cikin haɗakar al'ada da damuwa a cikin ICD-10) da kuma sabon yanayin, rikicewar tashin hankali (wanda aka fi sani da cutar fata).
Rashin halayyar Excoriation yana tattare da ɗaukar fatar mutum ta maimaitaccen lokaci, wanda ke haifar da raunin fata, tare da ƙoƙarin rashin nasara ko dakatar da halayyar. Ingaukar fata dole ne ya zama mai tsananin isa don haifar da mawuyacin wahala ko rauni a cikin aiki. Rashin haushi (da trichotillomania) sun bambanta da sauran OCRDs saboda ba a cika samun halayyar ta hanyar abubuwan da suka shafi hankali kamar tunani na rikice-rikice, damuwa ko damuwa, amma a maimakon haka ƙila abubuwan ƙwarewa ne za su iya gabatasu.
Haɗarsu cikin rukunin OCRD na dogara ne akan haɗin gwiwar juna, alamu na haɗin iyali, da kuma tsarin ilimin halayyar ilimin halitta tare da wasu cututtuka a wannan rukuni35, 40.
Matsalar ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta
Matsalar ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta (ƙaddarar PTSD)41 Mafi yawanci suna bin matsaloli masu tsanani na yanayi mai tsawo, ko abubuwa masu yawa ko maimaitawa daga abin da gudun hijira ke da wuya ko ba zai yiwu ba, kamar azabtarwa, bauta, kisan gillar, tashin hankali na gida, ko kuma maimaita cin zarafin yara ko cin zarafin jiki.
Bayanin alamun yana alama ta manyan abubuwa guda uku na PTSD (watau, sake fuskantar abin da ya faru da bala'i ko abubuwan da suka faru a halin yanzu ta hanyar tunanin tunani mai rikitarwa, tunowa ko mafarki mai ban tsoro; guje wa tunani da tunanin abin da ya faru ko ayyukan, yanayi. ko mutane masu tuna abin da ya faru; tsinkaye na ci gaba da fuskantar barazanar yanzu), wanda ke tare da ƙarin ci gaba, rikice-rikice masu ɗorewa a cikin ƙa'idodi masu tasiri, tunanin kai da aiki tare.
Bugu da ƙari na PTSD mai rikitarwa ga ICD-11 an sami tabbacin a kan shaidar cewa mutane da ke fama da rashin lafiya sunyi asarar rayuka kuma sun amfana daga jiyya daban-daban kamar yadda aka kwatanta da mutane tare da PTSD42. PTSD ƙungiya ta maye gurbin tsari na ICD-10 wanda ya kayar da shi ta hanyar jimrewa ta mutuntaka bayan masifar catastrophic41.
Zama baƙin cikin baƙin ciki
Raunin baƙin ciki na tsawon lokaci yana nuna matukar mawuyacin ci gaba da magance matsalolin haɗari41. Bayan mutuwar abokin tarayya, mahaifa, yaro ko wani mutum na kusa da waɗanda aka yi musu rasuwa, akwai martani mai dorewa da yaɗuwa game da kewar mamacin ko damuwa da mamacin na ci gaba, tare da tsananin zafin rai. Kwayar cututtukan na iya haɗawa da baƙin ciki, laifi, fushi, ƙi, zargi, wahalar karɓar mutuwa, jin cewa mutum ya rasa wani ɓangare na kansa, rashin iyawa don samun kyakkyawan yanayi, ƙarancin motsin rai, da wahalar shiga cikin zamantakewa ko wasu ayyukan. Dole ne amsar bakin ciki ta ci gaba na tsawon lokaci ba attajiri ba bayan sama da asara (sama da watanni shida) kuma a fili ya wuce ƙa'idodin zamantakewar mutum, al'adu ko addini don al'adun mutum da mahallinsa.
Kodayake mafi yawan mutane suna bayar da rahoto a kalla jinkirin raguwa daga jin zafi mai tsanani kamar kimanin watanni shida bayan raunuka, wadanda ke ci gaba da fuskantar halayen haushi mai tsanani suna iya samun matsala sosai a cikin aiki. Yin hada da baƙin ciki mai tsanani a cikin ICD-11 shine amsawa ga ƙarin shaida na yanayin da ke ciki da bala'in da ba a bayyana shi ba a halin yanzu game da bincikar binciken ICD-10 na yanzu43. Harkokinsa da kuma bambanta daga al'amuran al'ada da kuma cutarwa suna da mahimmanci, sabili da abubuwan da ke tattare da magungunan magani da kuma alamun maganganu na ƙarshe44.
Ciwon cin nama na Binge
Ciwon cin nama na Binge yana faruwa ne a lokuta masu yawa, lokutta na cin abinci binge (misali, sau ɗaya a mako ko fiye fiye da tsawon watanni). A binge cin abinci labari ne wani lokaci daban-daban a lokacin da mutum na samun wani asarar asali na kula da cin abinci, ci musamman fiye ko daban-daban fiye da saba, da kuma jin iya dakatar da cin abinci ko ƙayyade irin ko adadin abinci ci.
Abincin Binge yana jin dadi kamar yadda yake da matukar damuwa kuma yana tare da halayyar motsa jiki irin su laifi ko mummunan hali. Duk da haka, ba kamar bulimia nervosa ba, binge eating episodes ba a kai a kai bi da rashin dacewa halaye da nufin hana ƙananan riba (misali, gurbataccen mutum magudi, amfani da laxatives ko enemas, aiki mai tsanani). Kodayake rashin cin nama yana ci gaba da haɗar kaya da kiba, waɗannan siffofin ba wajibi ne ba kuma matsalar zata iya zama a cikin mutane masu nauyi.
Thearin rashin cin abinci mai yawa a cikin ICD-11 ya dogara ne akan bincike mai zurfi wanda ya samo asali a cikin shekaru 20 da suka gabata yana tallafawa ingancinta da fa'idar asibiti.45, 46. Mutanen da suka bayar da rahoto game da cin abinci tare da rashin halaye marasa dacewa suna wakiltar mafi yawan jama'a a tsakanin waɗanda suka karbi binciken ICD-10 na wasu cututtuka da aka ƙayyade ko kuma ba a bayyana su ba, don haka ana sa ran cewa hada ciwon binge cin abinci zai rage waɗannan ƙwayoyin.47.
Cire rashin cin abinci abinci mai guba
Abun kaucewa / gurgunta abinci mai cin nama (ARFID) yana nuna rashin cin nama ko cinye hali wanda zai haifar da cin abinci mai yawa ko iri iri don cin abincin da ya dace ko makamashi. Wannan yana haifar da asarar nauyi, rashin cin nasara kamar yadda ake tsammani a lokacin yaro ko ciki, ƙananan ƙwayoyin abinci mai gina jiki, dogara ga maganin abinci mai gina jiki ko magunguna abincin, ko kuma mummuna yana rinjayar lafiyar mutum ko sakamakon sakamako marar nauyi.
ARFID ta banbanta da rashin damuwa game da rashin damuwa game da nauyin jiki ko sifa. Hada shi a cikin ICD-11 ana iya ɗauka a matsayin fadada rukunin ICD-10 "matsalar rashin abinci na ƙuruciya da ƙuruciya", kuma mai yiwuwa ya inganta ƙimar asibiti a duk tsawon rayuwar (watau, ba kamar takwaran ta ICD-10 ba, ARFID ya shafi yara, matasa da manya) gami da kiyaye daidaito tare da DSM-545, 47.
Tsarin kamfani dysphoria
Tsarin dysphoria na jiki shine wani mummunar cuta da ake nufi da sha'awar ci gaba da rashin lafiyar jiki (misali, yankewa, ɓarna, makanta, kurari) yana fara ne a lokacin yaro ko kuma samari48. Ana iya bayyana sha'awar ta hanyoyi da dama, ciki har da yin mamakin samun ciwon jiki na jiki, wanda yake yin "dabi'a" (misali, ciyar da lokuta a cikin keken hannu ko yin amfani da takalmin gyaran kafa don yin simintin ciwon gurɓata kafa), da kuma ciyar da lokaci neman hanyoyi don cimma rashin lafiya.
Magancewa tare da sha'awar samun nakasar jiki (ciki har da lokacin da aka yi amfani da shi) yana da matukar damuwa da yawan aiki, ayyukan cin abinci, ko aiki na zamantakewa (misali, mutumin bai yarda ya yi dangantaka ta kusa ba saboda zai sa ya yi wuyar ɗauka). Bugu da ƙari, ga mutane masu rinjaye da yawa da wannan sha'awar, farfadarsu ta wuce kwarewa, kuma suna biye da sha'awar ta hanyar dabara (watau, ta hanyar yankewa zaɓaɓɓe na wata ƙungiya mai lafiya) ko ta hanyar cin zarafin wata ƙungiya. wani digiri wanda aka yanke shi ne kawai zaɓin warkewa (misali, daskarewa wani ɓangare a cikin busassun kankara).
Cutar wasan
Kamar yadda wasan kwaikwayon intanit ya karu sosai cikin shahararrun 'yan shekarun nan, an lura da matsalolin da suka shafi shiga cikin wasan kwaikwayo. An haɗu da ƙwayar cuta a cikin ƙungiyar bincike da aka ƙaddara da aka ƙaddara da ake kira "damuwa saboda halin kwaikwayo" (wanda ya ƙunshi yanayin caca) don amsa damuwa ta duniya game da tasirin matsalar cinikayya, musamman ma layi ta yanar gizo49.
Kwayar wasan kwaikwayo tana da alaƙa da ci gaba da cin zarafin yanar-gizon ko ci gaba da wasan kwaikwayo ("wasan kwaikwayo na dijital" ko "wasan kwaikwayo na bidiyon") wanda aka nuna ta hanyar kulawa da lalacewa (misali, rashin iya iyakance adadin lokacin da aka kashe wasan kwaikwayon), ba da fifiko mafi yawa ga wasanni har ya kasance yana da fifiko akan sauran abubuwan rayuwa da ayyukan yau da kullum; da kuma ci gaba ko tasowa wasanni duk da sakamakon da ba shi da kyau (misali, ana janye shi daga aikinsa saboda rashin wucewa ba saboda wasan kwaikwayo). An bambanta da labarun wasan kwaikwayon ba tare da bala'i mai mahimmanci ba a cikin aiki yana samar da ita.
Harkokin halayen jima'i mai tsanani
Halin halayen halayen jima'i yana da alaƙa da rashin cin nasara akan halayen jima'i ko jarabawa, wanda ya haifar da halayen jima'i na tsawon lokacin (misali, watanni shida ko fiye) wanda ke haifar da wahala ko rashin lafiyar mutum, iyali, zamantakewa , ilimi, sana'a ko wasu muhimman wuraren da suke aiki.
Abubuwan da ke iya faruwa a bayyane na tsarin ci gaba sun hada da: maimaita ayyukan jima'i ya zama babban abin da ya shafi rayuwar mutum har zuwa rashin kulawa da lafiya da kulawar mutum ko wasu bukatu, ayyuka da nauyi; mutumin da ke yin ƙoƙari da yawa ba tare da nasara ba don sarrafawa ko rage halayen maimaita jima'i; mutumin da ke ci gaba da maimaita halayen jima'i duk da mummunan sakamako kamar lalata maimaita dangantaka; kuma mutum yana ci gaba da maimaita halayen jima'i koda kuwa lokacin da ya daina samun gamsuwa daga gare ta.
Kodayake wannan nau'in halitta yayi kama da mahimmancin abu, an haɗa shi a cikin ɓangaren ƙwayoyin cuta na ICD-11 don gane rashin rashin bayani game da ko matakan da ke tattare da ci gaba da kulawa da cutar sun kasance daidai da wadanda aka lura a cikin cuta masu amfani da kuma cin zarafin hali. Harkokinsa a cikin ICD-11 zai taimaka wajen magance matsalolin kula da marasa lafiya da kuma yiwuwar rage rashin kunya da laifin da ke tare da taimakon taimako tsakanin masu wahala50.
Cutar rikice-rikice
Harkokin rikice-rikice masu rikitarwa na faruwa ne akan lokuttan da aka yi maimaitawar maganganu ko lalata jiki ko halakar dukiyar da ke wakiltar rashin nasarar magance matsalolin zalunci, tare da tsananin mummunan hali ko matsananciyar mummunan halin da ake ciki ba tare da raguwa da tsokanar ba ko haɓakar halayen kwakwalwa.
Saboda irin wannan yanayi zai iya faruwa a wasu yanayi dabam-dabam (misali, rashin amincewa da adawa, rikici, rashin kwakwalwa), ba a ba da ganewar asali idan wani tunanin tunanin mutum, halayyar mutum ko ciwon zuciya ya fi kyau.
Kodayake rikice-rikice masu rikitarwa a cikin DSM-III-R, ya bayyana a cikin ICD-10 kawai a matsayin kalmar hadawa a ƙarƙashin "sauran al'amuran da nakasa". An haɗa shi a cikin ɓangaren ƙwayoyin cuta na ICD-11 don ganewa shaidar shaida ta inganci da mai amfani a cikin saitunan asibiti51.
Tsarin dysphoord na premenstrual
Maganin dysphoord na farko (PMDD) yana da nau'in yanayi mai tsanani, ƙari ko ƙwararrun bayyanar cututtuka da suka fara kwanaki da yawa kafin a fara samfurin, fara farawa a cikin 'yan kwanaki, kuma ya zama kadan ko ba a nan ba cikin kimanin mako guda bayan faɗakarwar menses.
Mafi mahimmanci, ganewar asali yana buƙatar alamun bayyanar cututtukan jiki (tawayar rai, rashin tausayi), alamun bayyanar cututtuka (ƙwaƙwalwa, haɗaɗɗen haɗin gwiwa, ƙwaƙwalwa), ko bayyanar cututtuka (matsalolin ƙaddamarwa, manta) wanda ya faru a lokacin yawancin haɗuwar hauka a cikin baya shekara. Wadannan cututtuka suna da matukar damuwa don haifar da matsala mai mahimmanci ko bala'i mai mahimmanci a cikin sirri, iyali, zamantakewa, ilimi, sana'a ko wasu muhimman wurare na aiki, kuma ba su wakiltar ƙaddamar da wani ƙwayar cuta ba.
A cikin ICD-11, PMDD ya banbanta daga mafi yawan rikice-rikice na rikice-rikice na premenstrual ta hanyar tsananin alamun bayyanar da buƙatar cewa suna haifar da babbar damuwa ko lahani52. Hanya PMDD a cikin nazarin bincike na DSM-III-R da DSM-IV ya karfafa yawan bincike da ya tabbatar da inganci da amincinsa.52, 53, wanda ya jagoranci ya shiga cikin ICD-11 da DSM-5. Kodayake matsayinsa na farko a cikin ICD-11 yana a cikin babi na kan cututtuka na tsarin dabbobi, PMDD an tsara shi a cikin rukuni na cututtuka na nakasa saboda sanannun yanayin bayyanar cututtuka.
SANTAWA DA KARANTA DA CIKIN CIKIN CIKIN ICD-11
Wadannan sassan suna taƙaita canje-canje da aka gabatar a cikin kowace ƙungiya masu ɓarna na ƙananan cuta na ICD-11 a kan halayen tunanin mutum, halayyar jiki da kuma ƙananan ƙwayoyin cuta ba tare da sababbin sassa ba a cikin sashe na baya.
Wadannan canje-canje an yi ne bisa ga nazarin bayanan kimiyya na ICD-11 da masu bada shawara, masu nazarin mai amfani da asibiti da kuma amfani da duniya, kuma, idan ya yiwu, sakamakon gwajin gwaji.
Ciwon daji na neurodevelopmental
Abubuwan da ke cikin ƙananan ƙwayoyin cuta sune abubuwan da ke tattare da matsaloli masu yawa a cikin saye da aiwatar da takamaiman fasaha, motsa, harshe ko ayyukan zamantakewa da farko a yayin lokacin ci gaban. Cutar ta ICD-11 neurodevelopmental ta ƙunshi ƙungiyar ICD-10 ta raguwa da lalacewa na ci gaba da kwakwalwa, tare da kara da rashin kulawa da cututtuka na rashin hankali (ADHD).
Babban canje-canje a cikin ICD-11 sun hada da sake suna na ɓarna na ci gaban hankali daga ICD-10 jinkirta tunanin mutum, wanda shine wani lokacin da ba shi da tsada da kuma lalacewa wanda bai dace ya kama nau'in siffofin da etiologies da aka haɗu da wannan yanayin ba54. Har ila yau, ci gaba da lalacewa na ci gaba da fasaha a kan ƙananan ƙuntatawa a cikin aiki na fasaha da daidaitaccen hali, wanda aka ƙaddara ta ƙaddara ta hanyar daidaitawa, ƙayyadaddun tsari da kuma ƙayyadaddun kayan aiki. Idan aka fahimci rashin samun dama ga matakan da aka dace na gida ko ma'aikatan da aka horar da su don gudanar da su a wurare da dama na duniya, kuma saboda muhimmancin ƙayyade tsanani ga tsarin kulawa, ICD-11 CDDG kuma sun samar da cikakken tsari na nuna alama. Tables55.
Za a rarrabe zane-zane don yin amfani da hankali da kuma daidaitaccen aiki da ke aiki da yankuna (fahimta, zamantakewa, masu amfani) bisa ga ƙungiyoyi uku (ƙuruciya, yara / tsufa da kuma girma) da kuma matakan huɗu (m, matsakaici, mai tsanani, mai zurfi). Abubuwan da suke nunawa suna nuna irin basira da kwarewa da za a iya lura da su a cikin kowane ɗayan waɗannan kuma za'a sa ran inganta ingantacciyar halayyar kirkiro da kuma inganta bayanin lafiyar jama'a dangane da nauyin ɓarna na ci gaban hankali.
Autism bambance-bambance a cikin ICD-11 ya ƙunshi duka autism na yara da Asperger's ciwo daga ICD-10 a ƙarƙashin rukuni guda wanda ke da alaƙa da raunin sadarwar zamantakewar jama'a da ƙuntataccen, maimaitawa da sauyayyun halaye na halaye, abubuwan sha'awa ko ayyuka. An sabunta sharuɗɗa don rikice-rikice na bambance-bambance don yin tunatar da wallafe-wallafen yanzu, gami da gabatarwa a tsawon rayuwarsu. Ana ba da ƙwararru don ƙarancin rashin ƙarfi a cikin aikin tunani da ƙwarewar harshe mai aiki don ɗaukar cikakken gabatarwar gabatarwar rikicewar rikice-rikice a cikin yanayin girma.
ADHD ta maye gurbin cutar ICD-10 hyperkinetic kuma an tura shi zuwa haɗuwa da cututtuka na ƙananan cuta saboda yanayin ci gabanta, halayyar halayyar hankali, motsa jiki da ayyukan zamantakewa, da kuma haɗin kai na kowa tare da wasu cututtuka da ke tattare da neurodevelopmental. Wannan matsayi yana magance rashin ƙarfi na ra'ayi game da adadin ADHD yayin da yake da alaka da lalata rikici da rikice-rikicen dissociation, wanda aka ba mutanen da ke ADHD ba su da haɓakawa da gangan.
ADHD za a iya bayyana shi a cikin ICD-11 ta yin amfani da ƙwararru don yawancin rashin kulawa, yawanci mai mahimmanci-haɓaka, ko haɗin haɗuwa, kuma ana bayyana a fadin rayuwa.
A ƙarshe, cututtuka na yau da kullum, ciki har da ciwo na Tourette, an rarraba su a cikin sashin ICD-11 akan cututtuka na tsarin jinƙai, amma an tsara su a cikin haɗuwa da cututtukan neurodevelopmental saboda haɗin haɗin haɗar (misali, tare da ADHD) da farawa na farko a lokacin lokacin ci gaba.
Schizophrenia da sauran magungunan psychotic
Ƙungiyar ICD-11 ta haɗin ƙwarewa da sauran ƙwayoyin psychotic na maye gurbin ICD-10 haɗuwa da ƙwayar cuta, schizotypal da cuta masu ruɗi. Kalmar "firamare" tana nuna cewa tsarin aiki na psychotic abu ne mai mahimmanci, wanda ya bambanta da cututtuka na psychotic wanda zai iya faruwa a matsayin wani ɓangare na wasu nau'o'in ƙwarewar jiki (misali, yanayin yanayin)18.
A cikin ICD-11, bayyanar cututtuka na schizophrenia sun kasance ba su canzawa daga ICD-10, duk da cewa muhimmancin bayyanar Schneiderian na farko sun kasance an karfafa su. Babban canji mafi muhimmanci shi ne kawar da dukkanin subtypes na schizophrenia (misali, paranoid, hebephrenic, catatonic), saboda rashin cancanta ko kuma mai amfani a zaɓin magani. Dangane da subtypes, an gabatar da sassan zane-zanen siffofi18. Wadannan sun hada da: alamun bayyanar cututtuka (ruɗi, hallucinations, rarraba tunanin da hali, kwarewa na karuwa da iko); ƙananan bayyanar cututtuka (ƙuntatawa, ƙusai ko launi, alogia ko lalacewar magana, haɓaka, anhedonia); m yanayin bayyanar cututtuka; manic yanayi bayyanar cututtuka; magungunan psychomotor (cututtukan motsa jiki, halayyar kwakwalwa, ƙwararrun cututtuka); da kuma alamun bayyanar cututtuka (musamman gazawa cikin sauri na aiki, kulawa / maida hankali, daidaitawa, hukunci, abstraction, rubutu ko na gani, da kuma ƙwaƙwalwar ajiyar aiki). Ana iya amfani da waɗannan samfurori na sauran alamomi a cikin rukunin (cututtuka masu cuta, cututtuka na zuciya da rashin tausayi, rikice-rikice).
Cikiwar ICD-11 har yanzu yana buƙatar kusanci guda biyu na ciwo na schizophrenia da kuma ɓangaren yanayi. Sakamakon ganewar asali shine nufin tunawa da halin da ake ciki na rashin lafiya kuma ba a fahimta ba ne a matsayin barci mai tsawo.
ICD-11 mummunan zuciya da rashin tausin zuciya a halin yanzu yana nuna saurin kwatsam na kwakwalwa na kwakwalwa wanda ke ci gaba da hanzari a cikin yanayi da ƙarfinsa a cikin gajeren lokaci kuma ya ci gaba ba fiye da watanni uku ba. Wannan ya dace ne kawai da nauyin "polymorphic" a cikin ICD-10, wanda shine mafi yawan gabatarwa da kuma wanda bai nuna alama ba game da schizophrenia56, 57. An cire rukunin ƙananan cututtuka na marasa lafiya a cikin ICD-10 kuma za a sanya su a cikin ICD-11 a matsayin "sauran ƙananan psychotic cuta".
Kamar yadda a cikin ICD-10, an rarraba cuta na schizotypal a cikin wannan rukuni kuma ba a dauke shi da yanayin hali ba.
Ciwon yanayi
Ba kamar a cikin ICD-10 ba, yanayin ICD-11 ba alamar yanayi ne kawai ba, amma an yi amfani da su akan lokaci don zama tushen don sanin wane yanayin rashin lafiya ya fi dacewa da gabatarwar asibiti.
Cutar da ke cikin jiki ta zama raguwa cikin cututtuka (wanda ya haɗa da rashin lafiyar zuciya guda daya, ciwon zuciya mai rikitarwa, rikitarwa mai rikitarwa, cuta mai rikitarwa da damuwa) da kuma cututtuka na jini (wanda ya haɗa da nau'i na irin nau'i mai nau'i, numfashi na biyu, da cyclothymia). ICD-11 ya raba raunin cutar ta ICD-10 zuwa gurbin jini kamar irin na I da kuma nau'in II. An rarraba rarrabuwa na ICD-10 na rikitarwa na yanayin ci gaba, wanda ya ƙunshi dysthymia da cyclothymia, an shafe ta58.
Ka'idojin bincike na ɓangaren matsala suna daya daga cikin wurare kaɗan a cikin ICD-11 inda ake buƙatar ƙididdiga ƙima. Wannan shi ne saboda bincike mai zurfi da kuma al'adar asibiti game da halin ciki cikin wannan hanya. Ana buƙatar aƙalla biyar na alamun cututtuka goma maimakon nau'in alamun tara na tara wanda aka tsara a cikin ICD-10, saboda haka haɓaka daidaituwa tare da DSM-5. Cikin ICD-11 CDDG ya tsara alamar cututtuka a cikin ɓangarori guda uku - masu tasiri, haɓaka da kuma neurovegetative - don taimaka wa likitoci a conceptualizing da kuma tunawa da dukan nauyin cututtuka. Rashin haɗari yana cikin ɓangaren samfurori ne amma ba a dauke shi cikakke matsayin bayyanar da ake ciki ba; a maimakon haka, ko dai kusan kowace rana ta damuwar yanayi ko rage yawan sha'awar ayyukan da ake bukata akalla makonni biyu ana bukata. An ƙaddamar da rashin fatawa a matsayin ƙarin alama ta alamomi saboda shaidar da ke da tabbaci game da ƙimar da aka gano don maganin cututtuka59. ICD-11 CDDG tana ba da cikakken jagoranci game da bambancin tsakanin yanayin halayen tausayi na al'adu da kuma bayyanar cututtuka waɗanda ke ba da tabbaci a matsayin abin takaici a cikin matsala.60.
Don abubuwan da ke cikin kwalliya, ICD-11 na buƙatar kasancewar matakan shigarwa na karuwar yawancin aiki ko kwarewa na mutum na ƙaruwa, baya ga euphoria, irritability ko expansiveness. Wannan yana nufin kiyaye kariya ga ƙananan lokuta masu kyau wanda zai iya kasancewa mafi kyau kamar yadda yanayin haɓaka yake cikin yanayi. An yi la'akari da abubuwan da ake kira ICD-11 na yau da kullum kamar yadda aka samo asali na yanayin farfadowa ba tare da rashin raunin aiki ba.
An bayyana fasalin da aka haɗa a cikin ICD-11 a hanyar da ta dace daidai da ICD-10, bisa ga shaida don amincin wannan tsarin.61. An bayar da shiryarwa game da bayyanar cututtukan da ke tattare da hankulan da ake gani a yayin da magunguna ko cututtuka sun fi ƙarfin. Gabatarwar wani ɓangaren matsala yana nuna nau'in nau'i mai linzami na I ganewar asali.
ICD-11 tana ba da wasu ƙwararru don bayyana yanayin aiki na yanzu ko matsayin remission (watau, a takaici ko a cikakke fansa). Hakanan za'a iya kwatanta matsayi mai mahimmanci, haɗari da haɗin gwiwar tare da ko ba tare da rashin lafiya ba. Matakan da ke faruwa a halin yanzu a cikin mahallin rashin tausananci ko kuma na lalatawa zai iya kara kasancewa mai tsanani (m, matsakaicin ko mai tsanani); ta hanyar fasalin halayen ma'ana wanda ke ɗauke da dangantaka ta kai tsaye tare da manufar ciwo mai ciwo a ICD-10; kuma ta hanyar cancanta don gano abubuwan ci gaba na tsawon shekaru biyu. Duk wani yanayi na yanayi a cikin mahallin rashin tausayi ko matsalar rashin lafiya zai iya kara bayyanawa ta hanyar amfani da shahararren rashin daidaito bayyanar cututtuka; wata matsala da ke nuna alamun tashin hankali; da kuma cancanta don gano yanayin yanayi. Ana iya samun damar samun karfin motsa jiki don samun kwakwalwa.
ICD-11 ya hada da nau'i na ɓacin rai da damuwa saboda muhimmancin saitunan kulawa na farko62, 63. An cire wannan rukuni daga rikitarwa a cikin ICD-10 zuwa cututtuka masu tayar da hankali a ICD-11 saboda shaidar da ta fyauce tare da yanayin bayyanar cututtuka64.
Rashin tsoro da rikici
Cikin ICD-11 yana kawo rikici tare da damuwa ko jin tsoro kamar yadda ya kasance a cikin sabon rukuni65. Dangane da tsarin ICD-11, wannan rukuni ya hada da raguwa da rikice-rikice da mutuntaka, wadanda aka sanya su a cikin ƙananan yara a cikin ICD-10. An rarraba rarrabuwa ICD-10 tsakanin rashin lafiya da jigilar kwayoyin cuta da sauran nau'in tashin hankali a cikin ICD-11 don neman hanyar da za a iya amfani da shi na asibiti ta hanyar gano kowane damuwa da damuwa dangane da tsoro kamar yadda ya ke da damuwa66; Wato, ƙwararrakin da mutum ya ruwaito ya haifar da damuwa, damuwa da farfadowa na jiki da kuma maganganun halayen kirki. Ƙungiyar jin kunya ta jiki (GAD) tana nuna damuwa da damuwa ko kuma damuwa wanda ba'a hana shi ga wani abu mai mahimmanci ba.
A cikin ICD-11, GAD yana da cikakkiyar sassaukakken samfurori masu fasali, yana nuna cigaba da fahimtar abubuwan da ke tattare da shi; musamman, damuwar ta kara da cewa yawancin damuwa ne a matsayin wani ɓangare na ɓangaren cuta. Sabanin ICD-10, ICD-11 CDDG ya bayyana cewa GAD zai iya haɗawa tare da cuta mai rikitarwa muddin alamun bayyanar suna kasancewa ba tare da daidaito ba. Hakazalika, wasu dokokin ICC-10 ba tare da izini ba (misali, GAD ba za a iya bincikar su ba tare da maganin rikici na kwayoyin cuta ko cuta mai rikitarwa) kuma an kawar da su, saboda mafi kyawun maganin cuta a cikin ICD-11 da kuma shaidar cewa waɗannan dokoki tsoma baki tare da ganowa da kuma kula da yanayin da ake buƙatar taƙaitaccen kulawa na asibiti.
A cikin ICD ‐ 11, agoraphobia an tsara shi azaman alama da tsoro mai yawa ko damuwa da ke faruwa a, ko cikin tsammanin, yanayi da yawa inda tsere zai iya zama da wahala ko taimako ba samu ba. Abinda ake nufi da fargaba shine tsoron takamaiman sakamako mara kyau wanda zai zama rashin aiki ko abin kunya a waɗancan yanayi, wanda ya bambanta da mafi ƙanƙantar ra'ayi a cikin ICD-10 na tsoron wuraren buɗewa da alaƙa da alaƙa, kamar taron jama'a, inda mafaka zuwa amintaccen wuri na iya zama da wahala.
An kwantar da rashin tsoro a cikin ICD-11 ta hanyar ci gaba da kai hare-haren ba da tsoro ba wanda ba'a ƙuntatawa ga matsaloli ko yanayi ba. Cutar ICD-11 CDDG ta nuna cewa hare-haren tsoro wanda ya faru ne gaba daya don amsawa ko tsammanin abin da ake ji damuwa a cikin wani cuta da aka ba (misali, magana ta jama'a a yanayin rashin jin dadin jama'a) ba sa bada tabbacin ƙarin ƙari na rashin tsoro. Maimakon haka, za a iya amfani da "ƙwaƙwalwar haɗari" ga sauran yanayin rashin jin tsoro. Za a iya amfani da "ƙwaƙwalwar haɗari" a matsayin mahallin da ake ciki inda tashin hankali yana da muhimmanci yayin da ba a bayyana alama ba (misali, a wasu mutane a lokacin wani ɓangare na ciki).
Cikin yanayin tashin hankali na ICD-11, wanda aka tsara a kan tsoron tsoron gwagwarmaya ta wasu, ya maye gurbin ICD-10 zamantakewar zamantakewa.
Cikin ICD-11 CDDG ya kwatanta rarrabuwa da rashin tausayi a cikin manya, inda aka fi mayar da hankali kan abokin tarayya ko ɗan yaro.
Abun tsoro-rikitarwa da rikici
Gabatarwar ƙungiyar OCRD a cikin ICD-11 tana wakiltar wani muhimmin tashi daga ICD-10. Dalilin da zai samar da raunin OCRD ya bambanta daga rikice-rikice da rikici, duk da rikice-rikice na halittu, ya dogara ne akan mai amfani da asibiti na warware matsalolin tare da raba alamun bayyanar maimaita tunanin da ba'a so ba da kuma halayen da suka shafi abin da ya shafi asibiti. Ƙungiyar bincike ta wannan rukuni ta fito ne daga shaidar da ke tattare da masu haɓaka a tsakanin ƙwayoyin da ke tattare da ilimin lissafi, kwayoyin halitta da kuma bincike na neurochemical35.
ICD-11 OCRD ya haɗa da cuta mai rikitarwa, ƙwayar cuta na jiki, maganin maganganu mai mahimmanci, hypochondriasis (rashin lafiyar rashin lafiyar jiki) da damuwa. Kalmomin da ke cikin ICD-10 sun kasance a cikin ƙungiyoyi masu rarraba. Har ila yau, sun haɗa da OCRD wani raguwa ne na rikitarwa na rikitarwa na jiki wanda ya haɗa da trichotillomania (cututtukan gashi) da tashin hankali (cututtukan fata), dukansu suna rarraba ainihin ma'anar hali na sakewa ba tare da halayen na sauran OCRDs ba. Ciwo na Tourette, wata cuta na tsarin jinƙai a cikin ICD-11, an tsara shi a cikin ƙungiyar OCRD saboda yawancin abubuwan da ya faru tare da rikice-rikice.
ICD-11 tana riƙe da ainihin siffofin cutar ICD-10 da ke damuwa, wato, abubuwan da ake damu da kuma / ko matsaloli, amma tare da wasu mahimman bayanai. ICD-11 yana fadada tunanin da ya shafi abubuwan da ba su da sha'awa ba tare da buƙatawa ba. Bugu da ƙari, batun ƙaddamarwa yana fadada don haɗawa da ɓoye (misali, maimaita yawan ƙidayawa) da kuma sauke nauyin haɓaka.
Kodayake damuwa shine kwarewar aikin da yafi dacewa da abubuwan da ke faruwa, ICD-11 ya ba da labari game da sauran abubuwan da marasa lafiya suka ruwaito, kamar su wulakanci, kunya, ma'anar "bai cika ba", ko rashin jin daɗin cewa abubuwa ba sa ganin "dama". An cire shafukan ICD-10 na OCD, saboda yawancin marasa lafiya suna nuna abubuwan da ake gani da ƙaddamarwa, da kuma saboda basu da tabbas don tabbatar da maganin. Haramtacciyar ICD-10 akan gwagwarmaya da nakasassuwar cuta tare da cututtuka masu ciwo ciki an cire shi a cikin ICD-11, yana nuna yawan haɗin ɓarwar waɗannan rikitarwa da kuma buƙatar tsaftacewa.
Magungunan hypochondriasis (rashin lafiyar lafiyar jiki) an sanya shi a cikin OCRD maimakon a cikin rikice-rikice da rikici, kodayake yanayin kiwon lafiyar yana da alaka da damuwa da tsoro, saboda rarraba ilimin halitta da alamu na tarayya tare da OCRD67. Duk da haka, hypochondriasis (rashin lafiyar lafiyar jiki) an tsara shi a cikin rikici da rikice-rikice masu rikitarwa, a cikin ƙwarewar wasu samfurori da suka fara farfado.
Dysmorphic cuta, maganin maganganu mai mahimmanci, da rikici ƙaddamarwa sune sababbin nau'o'i a cikin ICD-11 waɗanda aka haɗa a cikin ƙungiyar OCRD.
A cikin OCRDs waɗanda ke da ƙananan ra'ayi, ana iya yin imani tare da irin wannan ƙarfin hali ko tsayayyar cewa suna da ɓarna. Lokacin da waɗannan alkawurran da suka dace suka kasance daidai da abubuwan da suka faru na OCRD, in ba tare da wasu cututtuka na psychotic ba, dole ne a yi amfani da gwadawa "tare da matalauta ba tare da fahimta ba", kuma ba za'a sanya wani ganewar asali na ɓarna ba. Ana nufin wannan ne don taimakawa wajen kiyaye rashin kulawa da rashin dacewa a tsakanin mutane tare da OCRDs35.
Abubuwa da ke hade da damuwa
Hakanan ICD-11 na haɗuwa da cututtukan da ke haɗaka da danniya ya maye gurbin halayen ICD-10 zuwa damuwa mai tsanani da kuma daidaitawa, don jaddada cewa waɗannan nakasassun suna raba abin da ake buƙata (amma bai ishe) ba don ƙaddamarwa ga wani matsala mai mahimmanci, da kuma bambanta ya haɗa da cuta daga wasu cututtukan ƙwayar ƙwayoyin cuta waɗanda suka taso a matsayin mai maganin matsalolin (misali, rashin tausanan zuciya)41. ICD-10 halayen haɗin gwiwar ƙananan yara da kuma hana haɗin haɗin ƙananan yara yana ƙira ga wannan rukuni saboda tsarin kula da ICD-11 da kuma fahimtar takamaiman abubuwan da suka shafi abin da aka haɗaka a cikin wannan cuta. ICD-11 ya hada da sababbin abubuwan da suka dace da ra'ayi na ICD-10 da gabatar da PTSD mai wuya da damuwa da baƙin ciki, wanda basu da daidai a cikin ICD-10.
An rarraba PTSD ta siffofi guda uku da ya kamata ya kasance a kowane hali kuma dole ne ya haifar da rashin kuskure. Su ne: sake fuskanci halin motsa jiki a yanzu; Hanyar kauce wa tunatarwa na iya haifar da sake fuskanta; da kuma hangen nesa na haɗari na barazana. Yin hada da abin da ake buƙata don sake fuskanci abubuwan da suka shafi halayen zuciya, na ciki ko na ilimin lissafi a cikin nan da yanzu maimakon maimakon tunawa da abin da ake bukata zai iya magance ƙananan ƙofar binciken ga PTSD a cikin ICD-1042.
An rarraba cuta a cikin ICD-11 a kan ainihin siffar damuwa tare da damuwa ta rayuwa ko sakamakonsa, yayin da a cikin ICD-10 an gano wannan cuta idan bayyanar cututtuka da ke faruwa a mayar da martani ga danniya mai rai bai cika ka'idodi na wani cuta.
A ƙarshe, ba'a ƙara ɗaukar mawuyacin halin ƙarfin hali ba a cikin ICD-11, amma a maimakon haka an fahimci matsayin zama na al'ada ga matsanancin damuwa. Saboda haka, an rarraba shi a cikin layin ICD-11 akan "dalilan da ke tasiri halin kiwon lafiya ko kuma sadarwa tare da ayyukan kiwon lafiya", amma an tsara su a cikin haɗuwa da cututtukan da suka haɗa da damuwa don taimakawa wajen ganewar asali.
Rashin rarrabawar dissociative
Hakanan ƙungiyar CDS-11 dissociative disorders ya dace da cutar ICD-10 dissociative (tuba), amma an sake tsara shi sosai kuma ya sauƙaƙe, don yin la'akari da binciken da ya faru na baya-bayan nan da kuma inganta ingantaccen asibiti. Ma'anar kalmar "tuba" an kawar da shi daga rukunin rukuni68. ICD-11 dissociative neurological symptom disorder ya kasance daidai da yadda ICD-10 dissociative cuta motsi da kuma jin dadi, amma aka gabatar a matsayin cuta guda tare da goma sha biyu subtypes bayyana a kan mafi yawan bayyanar neurological alama (misali, rikice-rikice, ba-epileptic seizures , maganganun magana, rashin lafiya ko rashin ƙarfi). ICD-11 dissociative amnesia ya haɗa da cancanta don nuna ko fugue dissociative ya kasance, wani abu da aka ƙayyade a matsayin cuta ta raba a cikin ICD-10.
ICD-11 ta raba cuta ta rashin hankali ta ICD-10 a cikin ɗakunan binciken cuta na rashin hankali da rashin hankalin mallaka. Rabuwar tana nuna fasalin rarrabewa a cikin rikicewar rikicewar tunani wanda a ciki aka maye gurbin ma'anar mutumtaka ta asali ta wani “mallaki” na waje wanda aka danganta da tasirin ruhu, iko, allahntaka ko wani abin ruhaniya. Bugu da kari, mafi yawan nau'ikan hadaddun halaye za a iya nuna su a cikin rikicewar rikicewar hankali, yayin da rikicewar rikice-rikice yawanci ya haɗa da maimaita ƙaramin ƙaramin juzu'i na halaye mafi sauƙi.
ICD-11 rikicewar rikicewar rikicewa ya dace da ma'anar ICD-10 rikicewar halin mutum da yawa kuma an sake masa suna don dacewa da tsarin nomenclature na yanzu da ake amfani da shi a cikin yanayin asibiti da bincike. ICD-11 kuma ya gabatar da rikice-rikicen rarrabuwa na ainihi, yana nuna gaskiyar cewa fifikon rikicewar rikice-rikicen ICD-10 da aka ƙididdige ta ana gabatar da su ne ta hanyar gabatarwa inda ƙasashe marasa rinjaye ba sa karɓar ikon zartarwa na hankalin mutum da aiki.
Ƙunƙasawa da ƙaddamarwa, wanda ke cikin wasu cututtukan da ke tattare da su a cikin ICD-10, an matsa shi zuwa ƙungiyar rikici ta dissociative a cikin ICD-11.
Ciyar da ci abinci
Hakanan ICD-11 na cin abinci da cin abinci yana hada halayen cin abinci na ICD-10 da kuma cin abinci na yara, saboda ganewa da haɗar waɗannan cututtuka a fadin rayuwa, da kuma nuna gaskiyar cewa waɗannan cututtuka zasu iya amfani da su a cikin kowane yanki yawancin shekaru45, 47.
ICD-11 tana samar da labarun kwaikwayo na nau'ikan nauyin nauyin nau'i da kuma bulimia nervosa don kunshe da shaida na kwanan nan, wanda ya kawar da buƙatar abubuwan ICD-10 "inypical". Har ila yau, ya haɗa da sababbin mahaukaci na cin nama, wanda aka gabatar bisa la'akari da goyon baya ga tabbatar da inganci da kuma asibiti, da kuma ARFID, wanda ke fadada cutar rashin ciwon yara ta ICD-10 na jariri da yaro.
Anorexia nervosa a cikin ICD-11 ya kawar da buƙatar ICD-10 don kasancewar cuta mai yaɗuwa ta cikin jiki, saboda shaidu suna nuna cewa wannan ba ya faruwa a kowane yanayi kuma, koda lokacin da yake, sakamakon rashin nauyin jiki ne maimakon bambanci. bayyana fasalin cutar. Bugu da ƙari kuma, shari'o'in da ba su da cututtukan endocrine sune ke da alhakin bincikar cutar rashin abinci. Thofar don ƙananan nauyin jiki a cikin ICD-11 an tashe shi daga 17.5 kg / m2 zuwa 18 kg / m2, amma sharuɗɗa sunyi amfani da yanayin da ƙididdiga ta jiki bazai iya kwatanta yanayin hoto na ƙwaƙwalwa ba (misali, asarar hasara mai haɗari a cikin mahallin sauran cututtuka). Anorexia nervosa baya buƙatar "fat phobia" kamar yadda yake a cikin ICD-10, don ba da izini ga cikakken nau'i na nau'ikan bambancin al'adu don maganin abinci da maganganun jiki.
Ana bayar da halayen kirki don nuna bambancin matsayi na matsakaicin matsayi, wanda aka ba da wannan mummunar yanayin jikin mutum yana da haɗari da mummunar haɗari da mace-mace. Matsayin da zai iya kwatanta nau'in halayen halayen ya haɗa (watau ƙuntata tsarin, alamar binge-purge).
Zuwa iya bincikar cutar Bulimia a cikin ICD-11 ba tare da la'akari da nauyin da ake yi yanzu na mutum ba, muddin rubutun jiki ba shi da ƙananan hali don cika ka'idodin da ake bukata don anorexia nervosa. Bisa ga ƙayyadadden ƙananan ƙwararrun binge waɗanda suke, a gaskiya, ba da tallafi ba, ICD-11 yana bada jagora mafi sauki. Wani bulimia nastosis ganewar asali ba ya buƙatar binges "haƙiƙa" kuma za'a iya bincikarsa akan "banda", wanda mutum ya ci ko fiye da yadda ya saba kuma yana jin dashi akan cin abinci tare da wahala, koda kuwa yawan adadin na abinci da gaske ci. Ana sa ran wannan canji ya rage yawan adadin wanda ba a bayyana shi ba da kuma maganin cutar cin abinci.
Cutar kawarwa
An cire kalmar nan "marasa kwayoyin" daga cutar ta ICD-11, wanda ya hada da enuresis da encopresis. Wadannan rikitarwa suna bambanta daga wadanda za'a iya bayanin su ta hanyar wani lafiyar lafiyar jiki ko sakamakon ilimin lissafi na abu.
Rashin ciwo na wucin jiki da kuma kwarewar jiki
Rikicin ICD-11 na wahalar jiki da ƙwarewar jiki sun ƙunshi rikice-rikice guda biyu: rikicewar damuwa na jiki da mutuncin dysphoria na jiki. Rashin lafiyar jiki na ICD-11 ya maye gurbin rikice-rikicen ICD-10 na somatoform kuma ya haɗa da batun ICD-10 neurasthenia. ICD-10 hypochondriasis ba a haɗa shi ba kuma a maimakon haka an sake tura shi zuwa ƙungiyar OCRD.
Cutar baƙin ciki tana nuna halin bayyanar cututtuka na jiki wanda ke damuwa ga mutum kuma da hankali da yawa da aka nuna ga alamun bayyanar, wanda zai iya bayyana ta hanyar sadarwa tare da masu kiwon lafiya.69. An lalata yanayin rashin lafiya kamar yadda yake kasancewa a kan ci gaba mai tsanani kuma zai iya zama mai dacewa (m, matsakaici ko mai tsanani) dangane da tasiri akan aiki. Abu mai mahimmanci, matsalar rashin lafiyar jiki ta bayyana bisa ga abubuwan da ke da muhimmanci, irin su ciwo da damuwa da tunani da ƙyama, maimakon a kan tushen bayanin likita don rashin lafiyar cututtuka, kamar yadda a cikin ICD-10 somatoform disorders.
Tsarin mallaka na ICD-11 na dysphoria ne sabon ƙaddarwar da aka ƙaddamar da shi a wannan rukuni48.
Rashin lafiya saboda abubuwa masu amfani da ƙwayoyi
Hakanan ICD-11 na haɗuwa da cuta saboda amfani da kayan daɗaɗɗa da haɓakawa ya ƙunshi rashin lafiya wanda ya haifar da sakamakon amfani da abubuwa masu kwakwalwa, ciki har da magunguna, da nakasa saboda dabi'un haɓakawa da suka samo asali daga sakamakon ƙwarewa da ƙarfafawa.
Ƙungiyar ICD-11 cuta ta hanyar amfani da kayan aiki daidai ne da tsarin kulawa da ICD-10, inda aka ƙaddamar da ƙwayoyin ƙwayoyin asibiti bisa ga nau'ikan kayan aiki.70. Duk da haka, ana ƙaddamar jerin abubuwa a cikin ICD-11 don nuna halin da ake ciki yanzu da amfani da kayan aiki na zamani. Kowane abu ko jinsin kayan aiki na iya haɗawa da ƙananan ƙwayoyin cuta na asibiti: guda ɗaya na ɓangare na amfani da abubuwa masu illa ko lahani mai amfani da kayan abu, wanda ke wakiltar gyaran aikin ICD-10 mai amfani; da kuma abin dogara. Ana iya bincikar maye gurbi da kuma janyewar abu ko dai tare da ƙananan ƙwayoyin magungunan asibiti ko kuma da kansa a matsayin dalilin dashi na sabis na kiwon lafiya lokacin da ba a sani ba irin yadda ake amfani da shi ko yiwuwar dogara.
Bisa ga yawancin duniya da ke fama da cuta ta hanyar amfani da kayan abu, an rutsa rukunin don ingantawa da karɓar bayanin kiwon lafiyar da za su kasance da amfani a cikin mahallin mahallin, goyan bayan saka idanu da kuma bada rahoto, da kuma sanar da rigakafi da magani70. Bugu da ƙari na ICD-11 guda ɗaya na ɓangaren abubuwa masu amfani da abubuwa masu cutarwa yana ba da zarafin yin amfani da shi da rigakafi na ƙara yawan amfani da cutar, yayin da bincikar cututtuka na amfani da kayan abu da mahimmancin abu sun bada shawara game da buƙatar ƙaddamarwa mai tsanani.
ICD-11 tana fadada manufar cutar don lafiyar jiki saboda amfani da kayan aiki don cutar da lafiyar wasu mutane, wanda zai iya haɗawa da cutar ta jiki (misali, saboda tuki yayin da ake shan giya) ko cututtukan zuciya (misali, ci gaban PTSD da ke gaba mota na mota).
ICD-11 ya haɗa da cuta ta jiki wanda ya haifar da ƙwayar cuta kamar yadda ciwon cututtuka ke nunawa da ƙwayar cututtukan zuciya ko halayyar kamala waɗanda suke kama da waɗanda ke cikin sauran ƙwayar tunanin mutum amma suna bunkasa saboda amfani da kayan aiki na psychoactive. Rashin ciwo da ƙananan abu zai iya haɗuwa da abu mai maye ko janye abu, amma ƙarfin ko tsawon lokaci na bayyanar cututtuka sun kasance mafi mahimmanci daga waɗannan halayyar maye ko janyewa saboda abubuwan da aka ƙayyade.
ICD-11 ya haɗa da nau'o'in kayan abu mai hatsari, wanda ba a lasafta shi a matsayin rashin lafiyar mutum ba amma dai an yi shi a cikin babi na "dalilan da ke tasiri halin kiwon lafiya ko tuntuɓar ayyukan kiwon lafiya". Ana iya amfani da waɗannan kullun idan nau'i na abu yayi amfani da haɗarin cututtukan lafiyar jiki ko tunanin tunanin mutum ga mai amfani ko wasu zuwa har ya samar da hankali da shawara daga kwararru na kiwon lafiya, amma babu wata mummunar cutar da ta faru. Ana nufin su nuna alamar damar yin amfani da su na farko da takaice, musamman a cikin saitunan kulawa na farko.
Cutar ta ICD-11 saboda dabi'un fassarar sun hada da nau'i biyu na bincike: matsalar caca (caca-caca a cikin ICD-10) da kuma matsalar wasan kwaikwayo, wadda aka gabatar da shi49. A cikin ICD-10, an ladafta caca-caca a matsayin al'ada da damuwa. Duk da haka, shaidu na baya suna nuna muhimmancin halayen halitta tsakanin rikitarwa saboda yanayin haɗari da maganin rashin amfani da kayan abu, ciki har da haɗuwa da haɗuwa da halayen juna da kuma al'amuran al'ada na kasancewa da jin dadi na gaba da biyo baya ga asarar darajar lamuni da kuma buƙata don ƙara amfani. Bugu da ƙari, rikitarwa saboda amfani da abubuwa da magunguna saboda yanayin haɓakawa suna bayyana irin wannan kwayar halitta, musamman kunnawa da kuma neuroadaptation a cikin lada da kuma motsa jiki na hanyoyi.71.
Matsalar kulawa da cuta
ICD-11 rikitarwa ta rikici yana nuna halin rashin nasarar da ya ci gaba da yin tsayayya da karfi, motsawa ko roƙo don yin wani aiki da yake ba wa mutum rai, a kalla a cikin gajeren lokaci, duk da ciwo mai tsawo har ma ga mutum ko ga wasu.
Wannan rukuni ya hada da pyromania da kleptomania, waɗanda aka ƙayyade a cikin ICD-10 a ƙarƙashin al'ada da rikici.
ICD-11 ya gabatar da mummunan cuta na rikice-rikice da kuma ƙaddara ICD-10 matsananciyar jima'i zuwa wannan rukuni kamar yadda ICD-11 ke haifar da rikici50, 72, 73.
Cutar lalacewa da rashin lafiya
Ƙungiyar ICD-11 ta haɓaka da lalacewa da kuma rashin lafiya ta hanyar maye gurbin ICD-10 lalacewar hali. Sabuwar kalma mafi kyau ya nuna cikakken nauyin halayyar dabi'un da samfurori da aka lura a cikin ka'idodi guda biyu da aka haɗa a cikin wannan rukuni: rashin adawa da adawa da rikici da rikici. Wani muhimmin canji da aka gabatar a cikin ICD-11 shi ne cewa za'a iya bincikar cuta guda biyu a kowane fanni, yayin da ICD-10 ya gina su a matsayin ƙananan yara. Bugu da ƙari, ICD-11 ya gabatar da ƙwararrun da ke nuna halayen maganganu na rushewa da kuma rashin lafiyar jiki da ake nufi don inganta mai amfani na asibiti (misali, ƙirar).
Cutar ta ICD-11 ta nuna rashin amincewar ita ce kama da tsarin ICD-10 daidai. Duk da haka, ana iya samar da matakan "rashin tausayi da fushi" don faɗakar da wadanda ke nuna irin wannan cuta tare da rinjaye, yanayi marar fushi ko fushi. An gane wannan gabatarwa don ƙara yawan haɗari ga rashin ciki da damuwa. Cikakken ICD-11 na wannan gabatarwa a matsayin nau'i na rikici na adawa daidai yake da shaida na yanzu kuma ya karkata daga tsarin DSM-5 na gabatar da sabuwar cuta, rikicewar rikice-rikicen yanayi na dysregulation74-76.
Cutar ICD-11 tana ƙarfafa maganganun marasa lafiya guda uku da aka ƙayyade a cikin ICD-10 (watau, wanda aka tsare a cikin mahallin iyali, wanda ba a haɗa shi ba, da zamantakewa). ICD-11 ya yarda cewa rikicewar rikicewa da rikice-rikice masu rikitarwa suna danganta da matsalolin halayen kwakwalwa da halayen halayen halayen halayen kwakwalwa, kamar su ƙin ƙwararru, ɓangaren ɓangaren ƙwaƙwalwa, da matsalar ƙwaƙwalwar mahaifa. Hakanan za'a iya nuna bambancin mahimmancin asibiti a tsakanin yara da yarinya na farko daga cikin cuta ta hanyar cancanta, bisa ga shaidar cewa a baya an danganta shi da cututtuka masu tsanani da rashin lalacewar yanayin.
Cancanta don nuna ƙarancin motsin rai na yau da kullun ana iya sanya shi zuwa halaye masu rikicewa da rikicewar rikice-rikice. A cikin yanayin ganewar asali game da rikicewar rikicewar adawa, wannan gabatarwa yana da alaƙa da daidaitaccen yanayin ƙaƙƙarfan halayyar adawa. A cikin yanayin rikice-rikicen rikice-rikice na rashin daidaituwa, yana da alaƙa da hali zuwa mawuyacin hali, mai saurin tashin hankali da daidaitaccen halin rashin haɗin kai.
Rashin halin mutum
Matsaloli da lalata ICD-10 da ke tattare da halayen mutum guda goma sun haɗa da mahimmancin ƙwarewar mutum dangane da haɗarsu tsakanin mutane tare da wasu ƙwayar cuta, kamar yadda kawai daga cikin nau'ikan halin mutum (halin rashin tausayi na zuciya, da yanayin lalata, da rashin daidaituwa ta mutum) an rubuta su tare da kowane lokaci a cikin bayanan da aka samo asali, kuma yawancin haɗin gwanin ya kasance mai girma, tare da yawancin mutane da ke fama da mummunan haɗuwar haɗuwa da bukatun don yawancin halin mutum16, 17.
ICD-11 CDDG ta nemi likitan ya fara tantancewa ko gabatarwar asibiti na mutum ya cika cikakkun bukatun bincike na rashin lafiyar mutum. Kwararren likitan sai ya tantance ko ganewar asali, matsakaiciya ko tsananin halin ɗabi'a ya dace, bisa laákari da: a) mataki da kuma yawan rikice-rikice a cikin ayyukan ɓangarorin kai (misali, kwanciyar hankali da haɗin kai na ainihi, darajar kai, daidaito na kai self ra'ayi, damar iko kai tsaye); b) digiri da kuma yaduwar lalacewar mu'amala tsakanin mutane (misali, fahimtar hangen nesan wasu, bunkasawa da kiyaye alaka ta kud da kud, kula da rikici) a duk fannoni da alakar; c) yaduwar yanayi, tsanani da kuma ci gaba na motsin rai, fahimta da halayyar halayyar mutum; da kuma) gwargwadon yadda waɗannan alamomin suke haɗuwa da wahala ko raunin halayyar kwakwalwa.
Bayan haka an sake bayyana rikice-rikicen mutum ta hanyar nuna halaye na halaye marasa kyau na halaye. Includedungiyoyi biyar na halaye sun haɗa da: mummunan tasiri (halin fuskantar ƙarancin motsin zuciyar kirki); yankewa (halin da ake ciki na kiyaye zamantakewar jama'a da nisantar juna da wasu); rashin daidaituwa (rashin kulawa da haƙƙoƙi da jin daɗin wasu, ya ƙunshi duka son kai da rashin tausayawa); hanawa (halin yin komai cikin hanzari sakamakon matsalolin cikin gida ko na muhalli kai tsaye ba tare da yin la’akari da sakamakon da ya daɗe ba); da anankastia (takaitaccen hankali kan daidaitaccen mutum na kamala da na daidai da kuskure da kan sarrafa nasa da halayen wasu don tabbatar da dacewa da waɗancan ƙa'idodin). Da yawa daga cikin waɗannan yankuna masu ƙima za a iya sanya su a matsayin ɓangare na ganewar asali kamar yadda aka yanke hukunci su zama fitattu kuma masu ba da gudummawa ga rikicewar ɗabi'a da tsananin ta.
Bugu da ƙari, an ba da cancanta na zaɓi don "alamar iyaka". Ana nufin wannan ƙirar don tabbatar da ci gaba da kulawa a yayin sauyawa daga ICD-10 zuwa ICD-11 kuma zai iya inganta mai amfani na asibiti ta hanyar yin bayanin mutane waɗanda zasu iya amsawa ga wasu magunguna. Za a buƙaci ƙarin bincike don sanin ko yana bayar da bayanan da ya bambanta daga abin da aka ba da yankuna.
ICD-11 ya ƙunshi nau'i na wahala na mutum, wanda ba a la'akari da rashin hankali ba, amma an tsara shi a cikin haɗin matsalolin da suka shafi hulɗar interpersonal a cikin babi a kan "dalilan da ke tasiri halin kiwon lafiya ko tuntuɓar ayyukan kiwon lafiya". Halin danniya yana nufin halayyar halayyar mutum wanda zai iya shafar magani ko samar da ayyukan kiwon lafiya amma ba ya kai ga matsayi na tsanani don tabbatar da ƙin ganewar halin mutum.
Cutar ɓarna
Ƙungiyar ICD-11 ta ƙunshi marasa lafiya na parabibi ya maye gurbin ICD-10 haɗuwa da ɓarna na jima'i na son jima'i, daidai da sababbin kalmomin zamani da aka yi amfani da su a cikin bincike da kuma jigilar mahalli. Babban abin da ke tattare da rikici mai launi shine cewa sun haɗu da alamomi na jima'i da ke mayar da hankali kan waɗanda ba su yarda ba77.
ICD-11 rikitarwa masu ɓarna suna haɗa da ciwo na nuna rashin lafiyar jiki, rashin lafiyar jiki, da nakasar pedophilic. Sauran gabatarwa sune rikice-rikicen rikice-rikice na jima'i, cututtuka na wariyar launin fata, da kuma sauran cututtuka wadanda suka shafi wadanda basu yarda ba. Wani sabon nau'i na wasu cututtuka na ɓangaren da ke tattare da halayen mutum ko masu haɗakarwa an haɗa su, wanda za'a iya sanyawa lokacin da tunanin jima'i, kwarewa, roƙo ko halayen suna haɗuwa da ƙananan matsalolin (amma ba saboda sakamakon kin amincewa ba ko jin tsoron kin amincewa da abin da ya dace by wasu) ko gabatar da hadarin rauni ko mutuwa (misali, asphyxophilia).
ICD-11 ya bambanta tsakanin yanayin da ke da alaka da lafiyar jama'a da kuma ilimin halin kwakwalwa da kuma wadanda ke nuna halin mutuntaka kawai, kuma saboda haka ne aka kawar da nau'o'in ICD-10 na sadomasochism, tarin fuka, da kuma fasistism transvestism26.
Rashin lafiya
ICD-11 ya gabatar da wani sabon rukuni na rikitarwa masu rikitarwa wanda ya haɗa da rashin lafiya da aka sanya a kan kai da rashin daidaituwa. Wannan rukuni yana da kwaskwarima daidai da binciken ICD-10 na samarwa da gangan ko nuna alamun bayyanar cututtuka ko nakasa, ko dai ta jiki ko tunanin (rashin lafiya), amma yaɗa ya haɗa da yanayin yanayin asibiti inda mutum yayi fice, falsifies, ko kuma ganganci ya jawo ko kuma ya kara matsa lamba , alamomi ko halayyar halayya da alamomi a wani mutum (yawanci yaro).
Ba a tilasta halayen kawai ta hanyar sakamako na zahiri ko ihisani, kuma an bambanta su bisa wannan tushen daga ɓarna, wanda ba a lasafta shi azaman tunani, halayya ko ci gaban ci gaban jiki ba, amma dai ya bayyana a cikin babin kan “abubuwan da ke tasiri ga lafiyar ko saduwa da ayyukan kiwon lafiya ”.
Ciwon daji na neurocognitive
ICD-11 nakasar neurocognitive an samo yanayin da ke cikin ƙananan asibiti a cikin aiki mai hankali, kuma sun haɗa da mafi yawan yanayi da aka ƙayyade a cikin tsarin ICD-10, ciki har da alamun cututtuka, ƙwayoyin tunani. Ta haka ne, ƙungiyar ta haɗa da jinƙan zuciya, rashin lafiya na nakasassu (wanda ake kira rashin tausin zuciya a cikin ICD-10), rashin ciwo, da damuwa. Za'a iya rarraba ƙwayar cuta da damuwa ta hanyar likita a sauran wurare, saboda wani abu ko magani, ko kuma saboda dalilai masu yawa. Za'a iya ƙaddamar ladabi kamar m, matsakaici ko mai tsanani.
Abun halaye na nakasar da ke tattare da nau'o'i daban-daban (misali, lalacewa saboda cututtukan Alzheimer, lalacewa saboda cutar rashin daidaituwa ta mutum) an bayyana su a cikin sura ta hanyar tunanin mutum, halayyar mutum da kuma ciwon kwakwalwa, yayin da aka ƙididdige ƙa'idodin da ake amfani da su ta amfani da kundin daga babi a kan cututtuka na tsarin jinƙai ko sauran sassan ICD, kamar yadda ya dace78. Zamu iya gano cutar rashin lafiya ta jiki tare da tantancewar ilimin ilimin halitta, yana nuna ingantattun hanyoyin ganowa don karfin zuciya, wanda ya wakiltar wata dama don bada magani don jinkirta cigaba da cutar. Hakanan ICD-11 ya fahimci sassan zuciya, halayyar mutum da kuma tunanin abin da ke tattare da nakasar da ke cikin kwakwalwa da maƙasudinsu.
karshe
Ci gaban ICD-11 CDDG don rikicewar hankali, ɗabi'a da ci gaban haɓaka da ƙididdigar ƙididdigar ƙididdigar su na wakiltar babban bita na farko game da mafi girman ƙididdigar ƙwaƙwalwar duniya a cikin kusan shekaru 30. Ya ƙunshi matakin da ba a taɓa yin irinsa ba da kuma kewayon duniya, masu yare da yare da dama. Anyi canje-canje masu mahimmanci don haɓaka ingancin kimiyya bisa la'akari da shaidar yanzu da haɓaka kayan aiki na asibiti da amfani na duniya bisa ga tsarin tsari na gwajin filin.
Yanzu, duka nau'ikan babi na ICD-11 don amfani da ƙasashen membobin WHO don ƙididdigar kiwon lafiya da CDDG don amfani dasu a cikin saitunan asibiti ta ƙwararrun masu ƙwaƙwalwar ƙwaƙwalwa sun cika cikakke. Domin ICD ‐ 11 ya cimma nasarorin sa a duniya, hankalin WHO zai karkata zuwa aiki tare da ƙasashe membobin da kuma tare da ƙwararrun kiwon lafiya kan aiwatarwa da horo.
Aiwatar da sabon tsarin rabe-raben tsari ya kunshi cudanya da rabe-raben da kowace kasa dokoki, manufofi, tsarin kiwon lafiya da kayayyakin more rayuwa. Dole ne a haɓaka hanyoyi da yawa don horar da ƙwararrun masanan kiwon lafiya na duniya. Muna fatan ci gaba da haɗin gwiwarmu tare da WPA da kuma aiki tare da ƙasashe membobin, cibiyoyin ilimi, ƙwararrun masana da ƙungiyoyin kimiyya a cikin wannan aikin na gaba.
GODIYA
Masu marubuta ne kawai ke da alhakin ra'ayoyin da aka bayyana a cikin wannan takarda kuma ba dole ba ne su wakilci yanke shawara, manufofin ko ra'ayi na WHO. Masu marubuta suna nuna godiya ga mutanen da suka ba da gudummawa ga ci gaba da ƙaddamar da ƙaddamar da cututtuka ta jiki, ta hanyar halayyar jiki da kuma ciwon kwakwalwa: G. Baird, J. Lochman, LA Clark, S. Evans, BJ Hall, R. Lewis -Kannández, E. Nijenhuis, RB Krueger, MD Feldman, JL Levenson, D. Susa, MJ Tassé, P. Caramelli, HG Shah, DP Goldberg, G. Andrews, N. Sartorius, K. Ritchie, M. Rutter, R Thara, Y. Xin, G. Mellsop, J. Mezzich, D. Kupfer, D. Regier, K. Saeed, M. van Ommeren da B. Saraceno. Har ila yau, suna gode wa sauran mambobin kungiyar ICD-11 da masu ba da shawara, da yawa da za su ambaci a nan (don Allah a duba http://www.who.it/mental_health/evidence/ICD_11_contributors don cikakkun jerin).
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