Hanaʻia o nā mea hōʻailona o kaʻikepili o ka Internet: Disorders Treatment and Preliminary Before-After Results Involving Pharmacotherapy and Modified Cognitive Behavioral Therapy (2016)

LINK I NĀ KULA KULA

1Laboratory of Panic and Respiration, Institute of Psychiatry of The Federal University of Rio de Janeiro (IPUB / UFRJ), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil

2Institute of Mathematics and Statistics, Keʻena ʻikepili, Fluminense Federal University (UFF), Rio de Janeiro, Brazil

* like pū kēia poʻe kākau ʻana

Mea kākau hoʻopili:

Veruska Andrea Santos, MSc

Laboratory o Panic a me ka mahalo, Institute of Psychiatry (IPUB)

Ke Kulanui ʻAmelika Hui Pū ʻIa ʻO Rio de Janeiro (UFRJ)

Av Venceslau Bras, 71 - Botafogo

Rio de Janeiro, 22290-140

Palakila

Helu kelepona: 55 2122952549

Palepa: 55 2125433101

Email: veruskaasantos [at] gmail.com

 

 

KANAWAI

ʻO ka ʻāina: ua ulu ka ulu o ka Pūnaewele i ka loli nui a lilo i mea hoʻohui i ka nohona o kēia manawa. Ua hana maʻalahi i ke ola a maʻalahi i nā pono helu; akā, ua hoʻohana ʻia ka nui o ka hoʻohana ʻana i ka hiki no ka pili, ke alakaʻi nei i nā hana ʻino i loko o ka nohona, haʻawina, kālā, naʻauao, a me nā hana hana. Hoʻohui ʻia nā mea pilikino i ka Pūnaewele i nā pilikia psychiatric comorbid. ʻO ka maʻi panic (PD) a me ka maʻi maʻamau hopohopoʻokoʻa (GAD) he maʻi maʻamau o ka noʻonoʻo, e pili ana i ka nui o ka hōʻino i ke ola o ka mea maʻi.

Nānā: ʻO kēia noiʻi hoʻokolokolo i wehe ʻia e wehewehe i kahi protocol mālama i waena o nā mea maʻi 39 me ka hopohopo i ke kaumaha a me ka hoʻoweliweli pūnaewele (IA) e pili ana i ka lāʻau lapaʻau a me ka hoʻololi ʻana e pili ana i ka hana kolohe (CBT).

Nā Palapala: No nā maʻi 39, ua loaʻa ka 25 i ka PD a me 14 me GAD, ma ka hoʻohui ʻana i ka Pūnaewele Noho. I ka screening, pane nā mea maʻi i ka MINI 5.0, ʻO Hamilton An depression Rating Scale, Hamilton Depression Rating Scale, Scical Global Impressions Scale, a me ka ʻōpio Pūnaewele Hoʻomau ʻōpio. I kēlā manawa, ua nānā ʻo IA i ka nānā ʻana i ka IAT scale (hōʻoki i ka helu ma luna o 50), aʻo nā maʻi hopohopo ua hōʻike ʻia e kahi maʻi maʻi. Ua hoʻokuʻu ʻia nā mea maʻi no ka lāʻau lapaʻau a me ka protocol CBT hoʻololi ʻia. Ua alakaʻi ʻia kēlā me kēia maʻi i hoʻokahi manawa, ma hoʻokahi hebedoma, ma kahi o 10 mau pule, a hōʻike nā hopena he maikaʻi loa ka mālama ʻana no ke hopohopo a me ka hoʻohui honua.

Nā hopena: Ma mua o ka hoʻōla ʻana, manaʻo ʻia nā pae hopohopo i ka hopohopo koʻikoʻi, me ka helu pākahi o 34.26 (SD 6.13); akā, ma hope o ka hoʻomaʻamaʻa ʻana i ka helu mean 15.03 (SD 3.88) (P<.001). Ua ʻike ʻia kahi hoʻomaikaʻi nui i ka helu ʻana i nā helu ʻai ma ka Pūnaewele, mai 67.67 (SD 7.69) ma mua o ka mālama ʻana, e hōʻike ana i ka hoʻohana pūnaewele pilikia, i ka 37.56 (SD 9.32) ma hope o ka lapaʻau (P<.001), e hōʻike ana i ka hoʻohana pūnaewele waena. Me ka pili i ka pilina ma waena o IA a me ka hopohopo, ka pilina ma waena o nā helu he .724.

Nā hopenaʻōlelo: ʻO kēia noiʻi ka mea noiʻi mua loa i ka lapaʻau ʻana o IA ka nui o kahi heluna ʻo Brazil. Kahi ʻia ka hoʻomaikaʻi ʻana ma muli o ka hoʻopukapuka piha ʻana o nā mea maʻi i ka maʻi maʻi, ka mea i hāʻawi i ke kūleʻa o ka mālama ʻana mai kahi ʻano hana, a hāʻawi i nā mea maʻi i hoʻomau e hoʻomau i ka hoʻohana ʻana i ka hoʻohana o ka Pūnaewele i ko lākou ola.

JMIR Res Protoc 2016; 5 (1): e46

doi: 10.2196 / resprot.5278

Introduction

 

 

kāʻei kua

ʻO ka wikiwiki wikiwiki o ka Pūnaewele a me kona hoʻopili ʻana i ke ola o kēia mau mea i alakaʻi ai i ka loli o ka nui o ko mākou ola i kēlā me kēia lā. Hiki i ka Pūnaewele ke hāʻawi i nā pōmaikaʻi nui; akā, ua lawe ʻia ka hoʻohana nui ʻana i ka hiki no ka pili a me ka hana ʻana i nā mea i hoʻopilikia ʻia i loko o ka piliona, haʻawina, kālā, naʻauao, a me nā hana hana. Ua ho'ākāka ʻia ka addiction pūnaewele (IA) me ka nele o ka hiki ke kāohi i ka hoʻohana ʻana i ka Pūnaewele, kahi e hōʻeha ai i ka pōpilikia, ua hoʻopau ka manawa, a hopena paha i nā pilikia pili lima, nā pilikia hana, a i ʻole ka loaʻa kālā.1]. Nā hana hoʻonāukiuki e like me ka minamina, ke hoʻohaʻahaʻa ʻana iā ʻoe iho, maikaʻi ka hakina ʻana, hopohopo, ʻehaʻeha, a me ke kaumaha.2-4]. Hiki ke pili i ke ʻano hoʻonāukiuki i ka nui o ka hoʻohana pūnaewele.5].

ʻAʻole ia he popona kahi maʻiʻino i ka Diagnostic a me ka Manual Manual of Mental Disorders (DSM-5) [6], a ʻaʻohe ʻae i ka ʻaeʻana i nā ʻōlelo maʻi; Eia nō naʻe, ʻōlelo kekahi poʻe noiʻi i nā hiʻohiʻona e like me ke salience, ʻano hoʻololi, ʻoluʻolu, hoʻihoʻi, hakakā, a me ka hoʻi hou ʻana, me ka hoʻopaʻapaʻa ʻana e kaʻana o nā hui i nā kumumanaʻo o nā kaʻina biopsychosocial [7]. Nā kulekele maʻi maʻamau e hoʻohana pinepine ʻia e pili ana i ka hoʻololi ʻana no ka papa huluhulu i ka ʻokoʻa: ka hoʻolauna nui ʻana me ka Pūnaewele; ka pono e hoʻohana i ka Pūnaewele no ka hoʻonui ʻana i nā manawa; ʻo nā hana kū ʻole ʻole e kāohi i ka hoʻohana pūnaewele; mai ka noho hoʻomaha, ʻole, ʻoluʻolu, a i ʻole huhū ke hoʻāʻo e hōʻoki i ka hoʻohana ʻana i ka pūnaewele; ke noho lōʻihi aku ma mua o ka pūnaewele ma mua o ka manaʻo mua; ka nalowale o ka pili nui, hana, a i ʻole ka hoʻonaʻauao hoʻonaʻauao ʻana; e hoʻopunipuni ana i nā poʻe ʻē aʻe e hūnā i ka nui o ka pilina me ka Pūnaewele; a me ka hoʻohana ʻana i ka Pūnaewele e pakele ai i nā pilikia a e hōʻoluʻolu paha i kahi ʻano dysphoric. Ua manaʻo ʻia he mea pili i ka wā e hele ai ka 5 a i ʻole nā ​​pae hou i loaʻa i kahi manawa ma 6-malama [8,9].

ʻOiai, ʻaʻohe ʻano loiloi maʻamau, ua hōʻoia nā noiʻi i kekahi mau mea hana e loiloi ai i ka IA, a he nui nā ʻano lahilahi o ka honua. ʻO nā nīnau nīnauʻi ʻoi loa: ʻo ka ʻōpio Pūnaewele Hoʻohālikelike ʻAi Pūnaewele (IAT) [10], ka Pūnaewele Hoʻohui Kūʻē (CIUS) [11], ʻo ka hana hoʻohana pūnaewele nui (EIU).12], ka Pūnaewele Pūnaewele Waiau pilikia (PIUQ) [13], ʻo Chen Pūnaewele Hoʻohui ʻokoʻa (CIAS) [14], Ka Mana Kahikina Pūnaewele Pūnaewele Pū ʻIa Hōʻike Pūnaewele (BAPINT-SV) [15], ka Pūnaewele Pūnaewele Hoʻohālikelike (Scale KS)16], a me ka nīnau ma ka Diagnostic Questionnaire (YDQ) [8]. Wahi a ia, ʻokoʻa nui ka nui o ka honua o ka IA a me ka nui, e like me, mai 1.0% a i 18.7% [17].

ʻO kaʻeha hopohopo e hāʻawi i nā hiʻohiʻona o ka makaʻu nui a me ke hopohopo a me nā pilikia e pili ana. Hoʻomaopopo kēia mau ʻōuli i ka pilikia nui i ka nohona, limahana, a i nā wahi ʻē aʻe o ka hana. Panic disorder (PD) pili i ka hoʻomaka ʻana o ka hōʻeha a me ka hopohopo i ʻike ʻia e ka neʻe nui ʻana o ka makaʻu nui e hōʻea ana i ka hopena i loko o nā minuke, e hele pū ana me nā hōʻailona kino a me ka hoʻowalewale e like me ka palpitations, ka palau, ka ʻeha ʻeha, hopohopo i ka nalowale ʻana i ka hopohopo, makaʻu ka make. haʻalulu, a me ka nausea. ʻO ka hopohopo nui o ka hopohopo maʻamau (GAD) pili i ka hopohopo nui a hopohopo i nā hana i kēlā me kēia lā e ʻike nui ana ka mea maʻi e hoʻomāʻeha a pili me ka maʻalahi o kaʻeha, ka huhū, ka pīhoihoi, ka pilikia o ka hiamoe, paʻakikī paʻakikī, a me ka hoʻomaha ʻole [6].

ʻOi aku ka nui o ka poʻe i hilinaʻi ʻia e like me ka waiʻona, ka uwahi, nā lāʻau lapaʻau, nā meaʻai, a me ka wahine a ʻoi ke kiʻekiʻe o ka hoʻouka ʻana i ka IA, no ka mea, ua aʻo lākou i ka hana ʻana i nā hopohopo a me nā pilikia ma o ka hoʻokaumaha ʻia.18]. Loaʻa i nā poʻeʻelima me IA i ka mau maʻi psychiatric comorbid a ʻo kēia hui e hoʻonāukiuki i ka hoʻohana ʻana o ka Pūnaewele; he pilina nui ka pilina ma waena o IA a me kekahi mau maʻi psychiatric a ua ala aʻe i ka makemake naʻauao. Ua hoʻopili nā kānaka noiʻi mai i ka IA me ke kaumaha [19,20-22], ka nānā 'ana i ka nānā'23-25], hoʻomohala ʻia i ka pilikia maʻamau a me nā hopohopo pilikia.23,26-28], makeaham [26], lilo ma ka wai alia [i ka maʻi '29], nā mea mālama 'ana [30], ka nānā 'ana i ka hana pilikino manuahi, ka palena palena huna a me ka haʻalele ʻana i nā pilikia pilikino [26], ai kuʻiia [31]. Ua hōʻike kekahi mau noiʻi hiki i IA ke lilo i hōʻailona o kekahi maʻi ʻē aʻe e like me ka hopohopo a i ʻole ke kaumaha a ʻaʻole i ka hauna maoli.4,32], a ua hoʻohālike ʻo IA i ke kīnā ʻana i ke kuhi.2,33-35]; akā, ua hoʻokūkū kekahi me ka maʻi ʻĀkau loa IA e lilo i ka maʻi nui.10,36].

Ke kuleana nui nei kēia mau comorbidities i ka mālamaʻana i ka IA, pono i hōʻike i ke kūlana psychiatric a mālama pono i ka hoʻohana ʻana i ka pūnaewele hōʻino [19]. Hōʻike nā haʻawina ʻo IA i nā mea i poino i nā ʻenehana, olakino, a me ka noʻonoʻo o ke ola, e hana ana i ka nalowale o ka hana, male hoʻohemo, ka pili ʻana o ka ʻohana, neʻeneʻe ʻana i ka lehulehu, hana ʻole i ka hana, haʻalele a haʻalele paha i ke kula.37,38], ka ʻōpala, nā ʻeha musculoskeletal, nā hōʻeha o ke kanulau, ke kīnā o ka pōkole, ka momona, a me ka pōkole blurred [31] a me nā mea lewa like ʻole e like me ka mālama ʻana, paʻakikī ka hoʻohiolo ʻana, hoʻopalapiha, a me ka hana ʻole.39,40].

Nā hōʻailona

Keia lāʻau [41,42] a me ke olonā4,18,43-46] ua hāpai ʻia nā hana e hoʻokaʻawale ʻia ai no ka ʻĀina a me ka ʻokoʻa.47]. Ka mea hiki ke hoʻoweliweli a hiki hoʻi ʻo IA ke kaʻana like me ka mekanobiological like ʻana, no laila, i kēia ke noʻonoʻo, hiki i nā lāʻau lapaʻau hoʻohui hoʻohui ke kōkua i nā mea ʻē aʻe.3]. Nā lāʻau lapaʻau e like me escitalopram [48], kaipeopram [49], ka pelapuna [41,50], olanzapine [51], quetiapine [52], ʻo nā naltrexone [53], makexia [54], memantine [55] Ua hoʻohana ʻia ʻoi e mālama i IA.

Ua hōʻike ʻia ka Cognitive-behavioral therapy (CBT) e kūleʻa i ka mālama ʻana i ka IA a ua ʻōlelo ʻia i nā haʻawina he nui [18,43,56-58]. Hoʻomaopopo ʻo CBT i ka pilina ma waena o nā manaʻo, nā manaʻo, a me nā ʻano, a e aʻo i nā mea maʻi e mālama pono i kēia a me ka mākaukau e ʻike i nā ʻano hana hoʻohālikelike i ko lākou mau manaʻo a me ko lākou mau manaʻo. Ua aʻo aku ʻo CBT psychotherapist i ke ʻano o ka hana ʻana, a paipai i ka mālama ʻana i ka mālama ʻana, hoʻololi i nā ʻano, a me ka pale ʻana i ka hana hou [58]. Ma ke ʻano he lapaʻau no IA, ua hōʻike kekahi mau noiʻi CBT maʻamau [43,44,59-62], ʻO CBT a me ka ʻōlelo aʻo [63], CBT me ka electroacupuncture (EA) [64,65], CBT a me ka paipai ninaninau (MI) [66], ʻO CBT a me nā lāʻau lapaʻau [59,61,67], ka mālama ʻana i luna a i ʻole ke ʻano i ka hana kūpono [68], a me kahi polokalamu CBT i hoʻololi ʻia e uluhia ana i ka manawa pōkole o ka hōʻaha o ka Pūnaewele a me ka hoʻohui kamepiula (STICA) me nā hui pilikino a me nā hui [44].

ʻO ka psychotherapy hui a me ka hale hoʻomaha no ka detoxification kekahi mau hiʻohiʻona o ka lapaʻau no IA [5]; pū kekahi, hoʻokūkū multimodal e hoʻohana ana i ka CBT, psychotherapy me nā ʻohana, mālama i nā comorbidities, nā lāʻau lapaʻau, a me ka hoʻokipa hoʻokolohua pū ʻia kekahi.69].

No laila, ʻo ka pahuhopu nui o kēia noiʻi ʻo ia ka hoʻāʻo ʻana i ka hopena o kahi mālama no PD a i ʻole GAD a me IA e pili ana i ka lāʻau lapaʻau a me CBT loli. ʻO ka pahuhopu tuarua he hana i ka ʻikepili noiʻi lapaʻau e hoʻoponopono i ka hoʻomaopopo ʻana i ka IA me kahi ʻano hana ʻokoʻa a hōʻoia i ke ʻano o ka pilina ma waena o nā maʻi hopohopo a me IA.

Nā Papahana

ʻO nā helu e kau ʻia ana i mau inoa nei: (1) nā mea maʻi ma waena o 18 a me 65 mau makahiki me IA; (2) kahi maʻi o PD a GAD paha ma o ka Mini International Psychiatric Interview (MINI), a hōʻoia ʻia e kekahi ʻikepikema; (3) ke hele a hoʻopau i ka hālāwai ninaninau mua; a (4) lawa ka maopopo o ke akamai i maopopo i nā ʻōlelo aʻoaʻo. ʻO nā mea maʻi i ʻike ʻole ʻole e heluhelu a kākau, a i ʻole ka Axis II pathology [6], pani ʻia.

Ua aʻo ʻia kēia haʻawina e ka Komite Holika o ke Federal University of Rio de Janeiro, CAAE 2704531460000526. Ua hoʻopaʻa inoa ka poʻe maʻi āpau i kahi palapala ʻae a hele i ke Laboratory of Panic and Respiration ma ke Institute of Psychiatry o ka Federal University of Rio de Janeiro (IPUB / UFRJ).

Ua ʻimi ka poʻe maʻi āpau i ka mālama ʻana no nā hōʻailona hopohopo. I ka screening, pane lākou i nā unahi eia penei: MINI 5.0 [70], ʻO ka Hamilton Anruptcy Rating Scale (HAM-A) [71], ke Kiki Palapala Hōʻailona o ka Hamilton (HDRS) [72], Ke Kahu Pūnaewele Kūʻai Kūʻē Kūʻē (CGI) [73], a me ka hoʻāʻo ʻana i ka Pūnaewele Hoʻomau ʻApiopio (IAT) [10]. ʻIaʻi ʻia ʻo IA ma o ka IAT (loaʻa ma mua o 50), ʻoiai, ua hōʻike ʻia nā maʻi kaumaha e kekahi psychiatrist. Ua kono ʻia nā mea maʻi e komo i kēia noiʻi ʻana a ua hōʻike ʻia no ka lāʻau lapaʻau a me ka protocol CBT hoʻololi ʻia.

Ua hoʻomaʻamaʻa ʻia nā mea maʻi e kahi mea lapaʻau ma ka hoʻomaka ʻana o ka mālama ʻana, ua ʻae ʻia e lawe i ka lāʻau lapaʻau i kuhikuhi ʻia e ka psychiatrist i ka wā mālama ʻana, a ua mālama pū ʻia e ka psychiatrist ma loko o ka mālama ʻana.

ʻO nā maʻi āpau 39 a pau loa psychotherapy (ua hoʻololi ʻia ʻo CBT), i mālama ʻia hoʻokahi me hoʻokahi pule no nā wiki 10. ʻO ke kumu ʻo ia e aʻo i ka poʻe maʻi pehea e hoʻokele ai i nā hōʻailona hopohopo me ka ʻole o ka hoʻohana ʻana i ka Pūnaewele, a me ka hoʻolaha ʻana i ka hoʻohana mua ʻana i ka Pūnaewele. Ua hahai mai ʻo Psychotherapy ma hope o 4: psychoeducation e pili ana i ke hopohopo a me ka hoʻohana ʻana i ka Pūnaewele, hoʻololi hou ʻana a me ke ʻano, hoʻololi i ke ʻano, a me ka pale ʻana i ka hoʻi hou ʻana (1 Pūnaewele).

 

  

‎
ʻ Xlelo 1. ʻO ka wehewehe o ka psychotherapy.
E nānā i kēia papa

 

ʻO ka papa mua o ka psychotherapy e mau loa i nā hālāwai 3 a ua hoʻopaʻa ʻia hoʻi ma ka psychoeducation e pili ana i ka hana ʻana i ka hopohopo, hōʻike i nā wahi weliweli, a me nā hoʻoiho e hoʻonui nei i ka hopohopo a me ka pilikia o ka hoʻohana ʻana i ka pūnaewele. ʻO ke kauā ʻana ma luna o ke aʻo ʻana i ka hanu ʻana ma o nā hana hanu a me nā hoʻolālā, me ka ʻole o ka hoʻohana ʻana i ka Pūnaewele e hana i nā manaʻo hopohopo a me nā kūlana. I loko o kēia manawa, aʻo nā mea maʻi e hoʻomaopopo a hoʻokipa i nā manaʻo a pau i ka hakakā ʻana i ko lākou hopohopo. Hoʻomaopopo ka poʻe maʻi i ko lākou hopohopo a me kāna pilina i ka hoʻohana pūnaewele ma o ka nānā ʻana i kā lākou hoʻohana ʻana i kā lākou Pūnaewele i ka wā e pili ana i ka hopohopo. ʻO nā mea mālama ʻē aʻe e pili ana i ka hōʻino pūnaewele a me ka hopohopo ua ʻimi ʻia nō hoʻi. Hiki i kēia mau mea ke hoʻopili pono i ke kūlana pilikino, kahi, ka piliona, ʻona pōpilikia, a i ʻole he kūlana hana. 

ʻO ka lua kahi e pili ana i ka reappraisal cognitive o ka hopohopo a me ka hoʻohana ʻana ma ka pūnaewele. I ka manawa o kēia manawa, noʻonoʻo nā mea maʻi e pili ana i kā lākou hoʻohana pūnaewele o ka lā, cognitions i pili i kēia hoʻohana, a me ka hopohopo. Ua ʻike ʻia nā kuhi hewa ʻana a ʻike ka mea maʻi i nā kuhi e like me ka aʻe e pili ana i ka hoʻohana nui ʻana o ka Pūnaewele: "He mau minuke wale nō ma ka Pūnaewele ʻaʻole e hana ʻino mai iaʻu"; "Pono wau e pane koke i kaʻu mau hoaaloha, inā ʻaʻole lākou e kala mai iaʻu"; "Inā ʻaʻole hāʻawi koʻu mau hoaaloha i ka" makemake "ma kaʻu mau puke a i ʻole kaʻu mau kiʻi, he hōʻailona ia no ka ʻaʻole makemake lākou iaʻu a i ʻole wau i hana hewa"; a "Inā haʻalele wau i ka Pūnaewele, e poina wau i nā mea koʻikoʻi no ka mea ʻo nā mea maikaʻi loa ma ka Pūnaewele." ʻO nā manaʻo āpau e pili ana i ka hopohopo a me ka hoʻohana ʻana i ka pūnaewele ua hoʻoponopono hou ʻia a manaʻo ʻia nā manaʻo hou; Hoʻohui ʻia nā manaʻo ʻē aʻe ma waena o nā hālāwai 2.

ʻO ke kolu kahi (3 mau manawa) pili i ka hoʻololi ʻana i ke ʻano o ka hanana me ka hōʻike ʻana i nā kūlana makaʻu ʻia / ansiogenic, aʻo ka mālama ʻana i ka manawa, a me ka noi o kahi diary o ka hoʻohana pūnaewele. Hoʻokomo ʻia ka hoʻololi ʻana wahi. Hoʻopili ʻia nā māhele āpau o nā kūlana, a hoʻololi a hoʻoili ʻia paha e pono ai e hana i nā mea ʻokoʻa a me ka maikaʻi e hoʻololi i nā ala kahiko o ka hana. ʻO kekahi mea nui o kēia pae ka hoʻokomo ʻana i nā manaʻo kūpono i loko o nā hana i kēlā me kēia lā e hoʻomohala ai i ka ʻike pilikino, no laila e hoʻolaha ai i ka hoʻohana liʻiliʻi ʻana i ka Pūnaewele a me nā ʻoihana hou aku i loko. Wahi a ka psychology maikaʻi, ʻo ka hoʻonui ʻana i ka manaʻo maikaʻi e hoʻonui i ka hoʻoikaika, e kōkua ana e hōʻemi i nā hōʻailona a me nā hōʻailona o ka hopohopo a me ke kaumaha a pale i ka hoʻihoʻi ʻana.74].

Hoʻopau ka ʻehā i nā hui 2 me ka neʻe ʻana i ka hoʻomau hou ʻana a me ka hoʻohemo hou ʻana i ka pale ʻana ma o ka hoʻoikaika ʻana i nā manaʻo hou a me nā ʻano, a me nā akamai e like me ka assertiveness, hoʻonā i ka pilikia, ka kamaʻilio waha, a me ka empathy. Loaʻa nā hoʻokō / hoʻomaikaʻi ʻana i luna o kahi kāleka (kāleka hoʻokō) a me nā poʻe maʻi e hoʻomau i ka hoʻokau ʻana i nā mea a lākou i aʻo ai i ka psychotherapy. I ka hui hope loa, ua pane nā mea hana ma nā ʻāpana like ʻole i hoʻohana ʻia ma ka hoʻomaka ʻana o ka mālama ʻana (IAT, HAM-A, HAM-D, a me CGI), i ka nānā ʻana a hōʻoia i ka hoʻomaikaʻi ʻana i nā helu helu. Ma kahi o ka hoʻomaikaʻi ʻana i nā helu helu, ua hōʻemi ʻia nā mea nui e pono ai ka manawa i loko o ka Pūnaewele, ka nui o ka launa pū ʻana o ke kanaka, a me ka mea, ʻoi aku ka pono e hoʻohana i ka Pūnaewele e pakele ai i nā pilikia a hoʻokele paha i ka hopohopo.

Results

Ua hōʻike ʻia kēia noiʻi hoʻāʻo e hōʻike i ka hana a me ka hoʻoweliweli psychotherapeutic e mālama i nā mea maʻi i hōʻike ʻia me PD a i ʻole GAD a me IA. I ka mua, ua hoʻokō nā maʻi 41 i nā koi a ua koho ʻia e loaʻa ka mālama psychotherapy no PD a i ʻole GAD a me IA; akā nō naʻe, ʻaʻole i hele ka ʻelua me ka hoʻōki ((33-mau keiki ʻekena kaʻa ʻōpiopio me PD a me IA i neʻe aku i kekahi mokuʻina ma hope o ke kolu o ke kau ʻana; a he wahine pū kekahi 36 me PD a me MA me kekahi mau maʻi ʻē aʻe. me kahi mea e ʻai ai kāu a me ka manawa kaumaha, a laila i hele wale i nā hālāwai me 2 o ka psychotherapy. ʻO nā mea maʻi 39 ʻē aʻe i hele i nā papa āpau; Hōʻike ʻia nā hiʻohiʻona demographic i loko 2 Pūnaewele.

Ua kuhikuhi ʻia e nā psychiatrists i nā lāʻau lapaʻau e mālama ai i ka PD a i ʻole GAD a IA. ʻO kekahi o nā lāʻau lapaʻau i hoʻohana ʻia nā antidepressants e like me fluoxetine, sertraline, venlafaxine, desvenlafaxine, paroxetine, escitalopram, zolpidem, a me endxetine; anxiolytics e like me clonazepam a me alprazolam; nā psychostimulants e like me methylphenidate; a me nā antipsychotics e like me quetiapine.

No nā maʻi 39, ua ʻike ʻia ka 25 me PD a me 14 me GAD, he ʻokoʻa kekahi me IA. Ma mua o ka mālama ʻana, nā pae pilikia e pili ana i ka HAM-A i ʻōlelo ʻia me ka ʻeha kaumaha, me ka helu pākahi o 34.26 (SD 6.13); ma hope o ka hoʻōla, ʻo ka ʻikepili helu he 15.03 (SD 3.88). ʻO ka helu awelika IAT ma ka hoʻomaka ʻana o ka mālama ʻana, ʻo 67.67 (SD 7.69), e hōʻike ana i ka hoʻohana ʻana o ka pūnaewele pilikia; ma hope o nā haʻina, ʻo ka ʻāhaʻI IAT i ka helu 37.56 (SD 9.32), e hōʻike ana i ka hoʻohana ʻana i ke ʻano o ka Pūnaewele a me ka hoʻomaikaʻi ʻana i ka mea i pili no ka hoʻohui. ʻO ka manaʻo HDRS mākahi ma ke kahua ʻo 16.72 (SD 5.56), e hōʻike ana i ke kaumaha haʻalulu, aʻo ia hoʻi ma hope o ka mālama ʻana i ka helu minima ʻo 7.28 (SD 2.52), e hōʻike ana ʻaʻohe kaumaha. Nā hopena o nā t hōʻike ʻia nā hōʻike hoʻohālikelike i mua o nā helu ma mua a ma hope o ka mālama ʻana 3 Pūnaewele.

 

  

‎
ʻ Xlelo 2. Nā hiʻohiʻona hiʻona.
E nānā i kēia papa

 

  

‎
ʻ Xlelo 3. Nā hopena o t -ʻi ka hoʻohālikelike ʻana i nā helu ʻana ma mua a ma hope o ka mālama ʻana.
E nānā i kēia papa

 

  

Ua helu pū ʻia ma waena o nā helu kauahi. ʻO ka hoʻoponopono ʻana ma waena o nā helu i ka IAT a me HAM-A ka .724, ma waena o nā helu ma ka HAM-A a me HDRS ʻo .815, a ma waena o nā helu i ka IAT a me HDRS ʻo .535.

I ka hopena o ke psychotherapy, uaʻike maikaʻi nā mea maʻi a pau i kā lākou hana a uaʻike nui loa, ma hope o ka loaʻa hou ʻana o ko lākou ola. Ua hōʻike i nā mea maʻi i ka holomua o nā hōʻailona hopohopo a mālama ʻia i ka hopohopo me ka hoʻohana ʻole ʻana i ka Pūnaewele. Hoʻohana ka hoʻohana ʻana i ka pūnaewele ma hope o ka mālama ʻana a ua hoʻokaʻawale ʻia nā maʻi āpau e like me nā mea hoʻohana. Ke hōʻike nei kēia mau loaʻa ua hiki i nā maʻi ke ola i ke ola pono.

kūkākūkā

I ka noiʻi ʻana i kēia manawa, ua kākau ka mea kākau i kahi protocol no ka hoʻololei CBT hoʻoponopono ʻia, nānā i ka hopena o kēia mālama a me ka lāʻau lapaʻau ma nā maʻi maʻi 39 me PD / GAD a IA, a me ka nānā i ka pilina ma waena o ka hopohopo a me IA. ʻOiai ka hoʻopaʻapaʻa e pili ana i ka ʻike ʻana o IA e like me ka maʻi kūhelu lima, ua hōʻike ʻia nā hopena maikaʻi loa o kēia hoʻohui i kēia ʻano hana.75-80]. Ua hōʻike ʻia ka protocol psychotherapy ka mea kūpono i ka mālama ʻana o ka hopohopo a me IA, ʻoiai ua aʻo nā mea maʻi a pau e mālama i ka hopohopo me ka ʻole o ka Pūnaewele a hōʻike i ka hoʻohana ʻana ma ka hopena o nā hālāwai.

Ua hoʻopaʻa ʻia kekahi mau noiʻi i ka hui ʻana ma waena o ke kaumaha a me IA [19-23,27]; akā, ua ʻimi nā mea noiʻi i ka hui ma waena o ka hopohopo a me IA [26,81,82]. Hōʻike nā hōʻike i ka hana ʻana i nā hana like ʻole o IA i mea e hoʻonāukiuki i ka pilikia o ka mana; ua hōʻike ʻia ka hoʻonaninani resonance magnetic ka mea i hoʻāla ʻia nā wahi i ka manaʻo o kekahi kanaka me IA i ka manaʻo e hoʻohana i ka Pūnaewele aia nā wahi like i hoʻoiho ʻia e nā mea hoʻohui pū ʻia. [5]. I ka manawa like, loaʻa i ke hopohopo he kuleana nui i ka hoʻonui ʻana i ka hoʻohana pūnaewele a me ka hoʻoikaika i ka hoʻohui. Ua hoʻolaha aku nā mea kākau e pili ana i ka pilina ma waena o nā pilikia hoʻoluhi a me IA ma o ka correlation i hōʻike ʻia. (.724), e hōʻike ana i ka ʻoiaʻiʻo o nā kuhi a me nā ʻano e pili ana i ka hopohopo he hopena koʻikoʻi o ka hoʻohana pūnaewele a me ka launa pū me ka honua.

ʻO nā hana ma mua no ka IA i wehewehe ʻia i loko o ka palapala i like me CBT [45,56,60,83], ʻO CBT a me nā lāʻau lapaʻau [59,67,68], a me nā polokalamu multimodal e pili ana i ka hui 'ana a me ka hui' ōlelo, a me ka aʻo 'ana, a me ka loea ʻohana.44,61,84].

ʻO ke kaupalena ʻana o ke aʻo ʻana ʻo ia ka nui o ka nui huaʻōlelo (ua komo ʻo 39); Eia naʻe, hōʻike nā hopena i ke kūpono o ka mālama ʻana i hāpai ʻia, ma ke hōʻemi ʻana i nā hōʻailona o ke hopohopo a paipai ʻana i ka hoʻohana pūnaewele maikaʻi, e hoʻomaikaʻi ai i ka maʻi maʻi IA. Eia kekahi, ʻo kēia noiʻi ka mea noiʻi mua loa e pili ana i ka mālama ʻana IA i loko o ka lehulehu o Brazil.

Pono ka noiʻi o ka wā e hiki ai ke mālama ʻia nā hana kūpono no ka IA e hoʻohana ana i nā hoʻolālā hou a me nā hoʻokele, e like me ke gestalt, ke aʻoʻana, ka ʻohana, nā manaʻo noʻonoʻo, nā psychodynamic therapy, ka noʻonoʻo noʻonoʻo o ka maʻi, a me ka hana transdiagnostic. Pono e mālama ʻia nā hoʻokolohua a me ka nānā ʻana i ke kūkulu ʻana i nā loina hou no ka hoʻopulapula maoli i loaʻa iā ia nā pōʻino maikaʻi, e like me nā poʻe male me nā pilikia mare, ka poʻe i loaʻa i ka ʻeha, nā poʻe me nā maʻi kūlohelohe, a me nā mea e like me nā ʻano hoʻohālike ʻē aʻe, e like me ulaula, lawe ole i ka laau, ai, ai ole, a kuai ole.

Ke hōʻike nei kā mākou mau ʻike i kahi lāʻau lapaʻau a me ka protocol hoʻomohala o ka psychotherapy i ka mālamaʻana i nā mea maʻi me ka hopohopo a ʻo IA nā hana kūpono. He mea kupanaha ka hoʻomaikaʻi ma muli o ka hoʻopiha piha o nā poʻe maʻi i ka maʻi maʻi, ka mea i kōkua i ka kūleʻa o ka mālama ʻana mai kahi ʻano hana, a hāʻawi i nā mea maʻi i hoʻomau e hoʻomau a mālama i ka hoʻohana o ka Pūnaewele i ko lākou ola.

Ke ulu nui nei ʻo IA a puni ka honua a i kekahi mau ʻāina, e like me South Korea a me Kina, ua manaʻo ʻia ʻo ia no ke ola olakino. Ma kēia ʻano, pono e noi ʻia nā hana kūpono e hōʻike ʻia ana e hoʻolaha i ka hoʻohana pono ʻana i ka Pūnaewele, a pili pū i ka hoʻomaikaʻi ʻana i ka ʻohana, nā hoaaloha, a me ke ola kino. Pēlā e hoʻomaopopo ai i ka hoʻohana ʻana i ka pūnaewele i mea ʻole e lilo i ka hōʻino, a me ka hoʻopili ʻana ma luna o ka Pūnaewele e hoʻoikaika a hoʻonui i nā pilina o loko.

 

Nā ʻōlelo a nā manaʻo kūlike. 

E hoʻomaopopo '

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‎ 

ailona

AUKA Hoʻohālikelike Kuhi Pūnaewele Pūnaewele Hoʻohālikelike
CBT: cognitive-behavior therapy
CGI: Scale Global Impressions Scale
CIAS: Ke Kahi Hana Pūnaewele Pūnaewele Pūnaewele
CIUS: Palapala Hoʻoikaika Pūnaewele Hoʻohana
DSM: Ka Papa Hana Hoʻonaʻauao a me Heluhelu o nā Mino Lō
EA: ke kohopili
EIU: Ka Hoʻolālā Kūwaho Kūʻē Pūnaewele
GAD: ʻOliau hopohopo maʻamau
HAM-A: He Palapala Hoʻoikaika Hamilton Scale
Nā HDRS: He Koho Palapala Kūʻai Helu Hamilton
IA: 'ōlelo pūnaewele pūnaewele
IAT: Ka ho'āʻo 'ana i ka' Intaneti
IPUB / UFRJ: Institute of Psychiatry o ke Federal University o Rio de Janeiro
MI: nā nīnau ninaninau
MINI: Nīnauele kahua ʻikepili Psych International
PD: hoʻomohola ʻino
PIUQ: Hoʻopau i ka nīnau nīnau pūnaewele pūnaewele
STICA: ka hoʻolālā pōkole o ka Pūnaewele a me ka hoʻohui ʻana i nā kamepiula
YDQ: Nīnau Makai Diagnostic ʻōpio

I hoʻoponopono ʻia e G Eysenbach; waiho ʻia 25.10.15; peer-loiloi e AC Maia, V Alves; nā manaʻo i ka mea kākau 18.11.15; hōʻano hou ʻia loaʻa ma 28.11.15; taliaina 29.11.15; paʻi ʻia 22.03.16