Comments: Ntawm no yog lwm qhov kev tshawb nrhiav qhia tau tias cov tshuaj Naltrexone pab cov neeg quav yeeb quav tshuaj tswj lawv kev siv porn (ua rau muaj kev cuam tshuam dhau los). Rau cov txhij txhua, thiab ci ntsa iab, kev sib tham ntawm Naltrexone thiab cov neeg quav yeeb quav tshuaj pom qhov no kev tshawb nrhiav yav dhau los.
Txuas mus rau Kev Tshawb Fawb Txoj Cai PDF ntawm daim ntawv puv ntoob
Shane W. Kraus, PhD a, b * Sarah Meshberg-Cohen, PhD a, b Steve Martino, PhD a, b Lantie J. Quinones, MD c Marc N. Potenza, MD, PhD b
VISN 1 Mental Illness Research Research thiab Cov Chaw Kuaj Mob, VA Connecticut Kev Kho Mob Nkeeg, West Haven, CT Tebchaws USA
b Yale University School of Medicine, New Haven, CT Tebchaws USA
c McLean Tsev Kho Mob, Tsev Kawm Ntawv Kho Mob Harvard, Department of Psychiatry, Belmont, MA teb chaws USA
* Tus neeg sau ntawv hu ua: Shane W. Kraus, Ph.D., VISN 1 MIRECC, VA Connecticut Healthcare System, 950 Campbell Avenue 151D, West Haven, Connecticut 06515, Tebchaws Asmeskas. Xov tooj: 203-932-5711, Ext: 7907; Email: [email tiv thaiv]
MUS RAU EDITOR:
Nyob nruab nrab ntawm 30-50% ntawm US cov txiv neej saib cov duab liab qab tsis tu ncua, thiab tsuas yog ib qho me me ntawm cov neeg saib pom kev siv compulsive. Kev siv cov duab liab qab sib txuas lus yog kev ntxub ntxaug, kev coj tus cwj pwm tsis zoo, kev tsis sib thooj / kev ua haujlwm tsis zoo, thiab ntau dua ntawm kev puas siab puas ntsws comorbidity (1). Hauv lub teeb ntawm ob zaug nyuam qhuav luam tawm (2, 3) tawm tswv yim naltrexone, tus kws kho mob opioid antagonist, yuav txo qhov kev siv ntawm kev sib daj sib deev thiab tus cwj pwm txuam nrog cov cwj pwm kev sib deev tsi ntsees, peb tshaj tawm rau ib rooj plaub ntawm naltrexone ua tus kws kho mob ib tus txij nkawm, ua haujlwm ua haujlwm, ib tus poj niam tub rog nyob rau hauv nws 30s uas tau nrhiav kev kho rau cov teeb meem hauv Internet saib duab liab qab. Naltrexone qhov hauj lwm zoo ntawm kev txo kom muaj kev sib daj sib deev kom mob siab txog kev saib duab liab qab yeej tsis muaj kev cuam tshuam.
Mr. D. pib siv cov duab liab qab tsis tu ncua thaum hnub nyoog 13. Thaum lub sijhawm xam phaj, nws tau tshaj tawm txog kev saib tsis tau cov duab liab qab rau lub 10 lub xyoos tas los txawm tsis tshua muaj kev sim siab zias; nws saib cov duab liab qab hauv Internet txhua hnub rau li ntawm 30 feeb. Nws tau qhia txog kev mob nyuab siab heev, thiab tsis muaj keeb kwm ntawm kev quav tshuaj yeeb dej caw, cov cwj pwm muaj teeb meem txog kev sib daj sib deev, teeb meem kev mob loj, lossis nws tsis noj tshuaj dabtsi.
Mr. D pib tuaj koom txhua tus neeg kev paub txog tus cwj pwm kev coj tus cwj pwm coj los ntawm ib tus kws kho mob hlwb kws kho mob qib siab. Rau 18 lub lis piam, nws ua tiav cov ntawv ua haujlwm txhua hnub uas soj ntsuam saib cov duab liab qab hauv Internet (1.0 = Tsis txhob ua siab phem, 7.0 = Mob siab heev) thiab seb nws puas tau saib thiab ntxub cov duab liab qab. Txawm tias nws txo nws txoj kev siv cov duab liab qab los ntawm kwv yees li 70%, Mr. D tseem pheej tshaj tawm txog kev sib deev kom muaj kev ywj pheej rau hauv Internet pornography. Yog li ntawd, nyob rau lub lim tiam ntawm kev kho mob, nws tau sau cov tshuaj naltrexone (50 mg / d).
Tsis pub dhau ob lub lim tiam ntawm kev pib noj tshuaj, nws qhia txog kev txo hwj chim hauv nws txoj kev xav kom mob siab txog kev saib duab liab qab. Raws li pom nyob hauv daim duab 1, tshaj li ntawm 9 lub lis piam uas nws tau siv cov naltrexone, qhov kev siv ntawm nws kev sib daj sib deev hnyav tsawg (M1-9 lub lis piam = 3.71, SD= 1.28 vs. M10-18 lub lis piam = 2.37, SD=. 80), t(124) = 6.93, p<.0001, Cohen tus d = 1.25). Nws kuj tau saib cov duab liab qab tsawg dua (5 hnub hauv lub lis piam 10-18; 17 hnub hauv lub lis piam 1-9), χ2 (1, N= 125) = 7.04, p<.01 (LOSSIS = .25, 95% CI = 0.09-0.73). Nyob rau hauv tas li ntawd, nws resumed tsis tu ncua, txaus siab nrog kev sib deev nrog nws tus poj niam.
Peb cov kev tshawb pom tias naltrexone yuav yog ib txoj kev pabcuam rau cov neeg mob uas qhia txog kev tswj kev coj tus cwj pwm xws li kev saib cov duab pornography ntau dua. Ib qho kev ceeb toom ntawm qhov xwm txheej tam sim no yog tias peb tsis ntiav ib qho kev hloov (ABA) nrog Mr. D. Tsis tas li ntawd, kev twv ntxiv rau hauv ob lub qhov muag dig muag, randomized, placebo-controlled mus ntsuam xyuas cov kev ua tau zoo thiab muaj peev xwm ua rau muaj tus kab mob naltrexone nrog ( los yog tsis muaj) tus kws kho mob rau kev kho cov teeb meem saib duab liab qab thiab lwm yam kev coj tus cwj pwm sib deev yuav tsum tau muaj.
ua tim khawv
1. Kraus SW, Potenza MN, Martino S, Grant JE. Kev ntsuam xyuas cov kev puas siab puas ntsws ntawm Yale-Brown Obsessive-Compulsive Scale hauv ib qho piv txwv ntawm cov neeg siv cov duab liab qab. Compr Psychiatry. 2015.
2. Bostwick JM, Bucci JA: Kev sib daj sib deev hauv Internet kho nrog naltrexone. nyob rau hauv Mayo Clinic Proceedings, Elsevier; 2008. pp. 226-230.
3. Raymond NC, Grant JE, Coleman E. Augmentation nrog naltrexone los kho tus cwj pwm kev sib deev compulsive: ib cov ntaub ntawv series. Ann Clin Psychiatry. 2010; 22: 55-62. 5
Tus naj npawb ntawm Lub Lis Piam Daim Duab 1. Lub ntsiab lus ntawm kev xav ntawm kev saib duab liab qab thiab Tus naj npawb Hnub Saib Duab Pornography Txhua Lub Lis Piam Ua Ntej / Tshaj Tawm Naltrexone (50mg / d) Kev Ruaj Ntseg Qib (1.0 - Tsis Tau Tsoo, 7.0 - Ua Rau Siab) Muaj pes tsawg hnub siv duab liab qab toj ib asthiv
Naltrexone 50mg / d
Nyiaj
Cov ntaub ntawv no tau qhia los ntawm Veterans Affairs Administration, VISN 1 Mental Illness Research Research and Clinical Centers, CASAColumbia thiab National Center for Responsible Gaming. Cov ntsiab lus ntawm phau ntawv sau qhia txog cov kev xav ntawm cov sau phau ntawv thiab tsis tas cov koom haum pab nyiaj. Cov chaw pabcuam tsis muaj cov tswv yim rau cov ntsiab lus ntawm phau ntawv sau.
Tshaj tawm
Cov sau phau ntawv ceeb toom hais tias lawv tsis muaj nyiaj txiag tsis sib haum ntawm kev txaus siab nrog rau cov ntsiab lus ntawm daim ntawv no. Dr. Potenza tau txais nyiaj txiag los yog nyiaj them rau cov nram no: Dr. Potenza tau sab laj thiab qhia Lundbeck, Ironwood, Shire, INSYS thiab RiverMend Health; tau txais kev tshawb nrhiav (Yale) los ntawm National Institutes of Health, Mohegan Sun Casino, National Center for Responsible Gaming, thiab Pfizer pharmaceuticals; tau koom nrog cov ntawv tshawb fawb, cov ntawv xa los yog kev sib tham hauv xov tooj uas ntsig txog kev quav yeeb quav tshuaj, kev tswj hwm kev mob hlwb lossis lwm yam kev mob nkeeg; tau sab laj rau kev twvtxiaj thiab kev cai lij choj ntawm cov teeb meem ntsig txog kev tswj kav; muab kev kho mob hauv chaw kho mob hauv Connecticut Department of Mental Health thiab Kev Pab Cuam Txog Kev Pab Cuam Tiv Thaiv Kev Teeb Meem Kev Pab; tau ua tiav kev ntsuam xyuas rau National Institutes of Health thiab lwm lub koom haum; muaj edited lossis qhua-edited txhua hnub lossis cov ntawv sau se; tau muab kev qhia txog kev kawm hauv cov voj voog loj, CME cov rooj sib tham thiab lwm qhov chaw kho mob lossis chaw tshawb fawb; thiab tau tsim cov phau ntawv los yog phau ntawv tshooj rau cov luam tawm ntawm cov ntawv kho mob hlwb.