Kulimbitsa mgwirizano, kugwiritsidwa ntchito komanso kuwonetsetsa za thanzi la anthu pazovuta chifukwa cha makhalidwe oipa

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

Kulimbitsa mgwirizano, kugwiritsidwa ntchito komanso kuwonetsetsa za thanzi la anthu pazovuta chifukwa cha makhalidwe oipa.

World Psychiatry, 17: 363-364. do:10.1002 / wps.20570

Lingaliro la "chizoloŵezi cha khalidwe" (chosagwirizana ndi mankhwala) "linayambika pafupi zaka makumi atatu zapitazo, ndipo mabuku ambiri akuwonjezeka posachedwa pazomwezi1, 2. Panthaŵi imodzimodziyo, olemba ena aona kuti chikhalidwe cha zizoloŵezi za khalidwe labwino chimafuna khama kwambiri3, 4. Pano timapereka ndondomeko pamadera awa, ndikugogomezera ntchito yaposachedwapa yomwe ikuchitika pa chitukuko cha ICD-11, ndikuyankhira funso ngati kuli kofunikira kukhala ndi gawo losiyana pa zovuta chifukwa cha makhalidwe oipa m'gulu lino.

Zida zonse za DSM ndi ICD zakhala zikulepheretsa kuti mawu akuti "chizoloŵezi" adziwonekere pokhazikitsa "kukhudzana ndi mankhwala". Komabe, DSM-5 imaphatikizapo vuto lakutchova njuga m'mutu wake wokhudzana ndi vutoli, komanso limapereka chithandizo cha vuto la kusewera kwa intaneti, powalingalira kuti ndilo chinthu chomwe chimafuna kupitiliza kuphunzira, ndi kuwonetsa zofanana zake ndi vuto la kugwiritsira ntchito mankhwala5-7. M'ndandanda wa ICD-11, World Health Organization yatulutsa lingaliro la "mavuto chifukwa cha khalidwe lachiwerewere" kuphatikizapo njuga ndi mavuto a masewera2, 8. Matendawa amadziwika ndi kuchepa kwa mayendedwe okhudzana ndi zizolowezi zosokoneza bongo, zomwe zimapangitsa kuti munthu azichita zambiri pamoyo wake, ndikupitilizabe kuchita zomwe amachita ngakhale atakumana ndi zovuta zina, chifukwa chovutika kapena kuwonongeka kwakukulu pamunthu, banja, mayanjano, ndi zina madera ofunikira2, 8.

Cholinga chofunika kwambiri pa chitukuko cha DSM-5 chinali pazidziwitso zoyenera. Ndithudi, pali umboni wina wokhudzana ndi vuto la kugwiritsira ntchito mankhwala ndi mavuto chifukwa cha makhalidwe oipa, monga vuto lakutchova njuga, pa zowonjezera zowonjezereka kuphatikizapo zovuta, njira zowonongeka, ndi njira yothetsera mankhwala5-7. Kwa vuto la masewera, pali zambiri zomwe zikuwonjezeka pazinthu zamagetsi ndi zamaganizo. Kwazinthu zina zoledzeretsa zamakhalidwe, zochepa zowonjezera zimakhalapo. Komanso, zingapo zingathe kusonyeza kuti pali vuto linalake loletsa kupanikizika (mu DSM-IV ndi ICD-10), kuphatikizapo kuwonongeka, njira zowonongeka, ndi njira yothetsera mankhwala9.

Magulu omwe akugwira ntchito pa ICD-11 amazindikira kufunikira kwa ovomerezeka pamavuto amisala ndi machitidwe, popeza kuti dongosolo lokhala ndi chidziwitso chodziwika bwino lingatithandizire kukhala ndi zotsatira zabwino. Panthaŵi imodzimodziyo, magulu ogwira ntchito a ICD-11 adayang'ana makamaka pazithandizo zakuchipatala komanso kulingalira zaumoyo wa anthu pazokambirana zawo, ndikuwunika kwambiri zakukweza chisamaliro choyambirira m'malo omwe si akatswiri, mogwirizana ndi kutsindika kwa ICD-11 paumoyo wamaganizidwe apadziko lonse lapansi. Kusiyanitsa kwabwino kwamavuto ndi zovuta zazing'ono, ngakhale zitathandizidwa ndi ntchito yolimbikitsa pakuzindikira, sizingakhale zofunikira poti akatswiri omwe si akatswiri amapereka chisamaliro. Komabe, kulemala ndi kuwonongeka komwe kumayenderana ndizofunikira kwambiri pamalingaliro awa, kuthandizira kuphatikiza kutchova juga ndi zovuta zamasewera mu ICD-112, 8.

Pali zifukwa zingapo zomwe zimachititsa kuti zizindikilo zowonongeka chifukwa cha makhalidwe oipa ndi kuphatikizidwa muzithukuko pamodzi ndi vuto la kugwiritsira ntchito mankhwala zingathandize kuthetsa thanzi la anthu. Chofunika kwambiri, ndondomeko zaumoyo zapadera zothandiza kupewa ndi kusamalira zovuta zogwiritsira ntchito mankhwala zingakhale zogwiritsidwa ntchito ku vuto lakutchova njuga, vuto la masewera, komanso mwina mavuto ena chifukwa cha makhalidwe oipa (ngakhale bungwe la ICD-11 likusonyeza kuti lisanakhalepo msanga mndandanda wa matenda ena onse chifukwa chokhala ndi njuga kunja kwa njuga ndi mavuto a masewera).

Cholinga cha thanzi labwino choganizira zovuta chifukwa cha khalidwe lachiwerewere chiri ndi ubwino wambiri. Makamaka, zimapereka chidwi choyenera pa: a) chiwonetsero chokhala ndi zochitika zolimbitsa thupi popanda zovulaza ku thanzi kudzera mu khalidwe lokhudzana ndi vuto lalikulu; b) kufunika kwa kafukufuku wapamwamba ndi zofunikira za makhalidwe ndi zovuta izi, ndi c) kugwiritsa ntchito mfundo zopangira umboni kuti zisawonongeke.

Ngakhale ena angakhale okhudzidwa ndi mankhwala okhudzidwa ndi moyo wamoyo, zowonongeka zimadziwika kuti zizoloŵezi zina zomwe zimakhala ndi zovuta sizingatheke ndipo sizikhoza kukhala matenda a chipatala, ndipo zimatsindika kuti kuchepetsa ndi kuchepetsa kulemedwa kwa thanzi ndi chikhalidwe ndi mavuto chifukwa cha khalidwe lachiwerewere akhoza kupindula m'njira zogwira mtima kudzera mwazinthu zopanda ntchito zachipatala.

Maganizo ena angapo a zovuta za khalidwe kapena zovuta chifukwa cha khalidwe lachiwerewere akhoza kukambidwa kuti akambirane. Tanena kale m'magazini ino kuti ntchito yowonjezera ikufunika kuti pakhale zifukwa zamphamvu zokhudzana ndi matenda9, komanso ndondomeko ya ICD-11 imatchulidwanso kutchova njuga ndi masewera a masewera mu gawo la "matenda oletsa kuthamanga". Zowonjezereka, pali chifukwa chodetsa nkhaŵa kuti malire a gululi akhoza kuperekedwa mosayenera kupatula njuga ndi vuto la masewera kuti aphatikize mitundu yambiri ya ntchito zaumunthu. Zina mwa zotsutsanazi zikugwirizana ndi zomwe zikugogomezera kuopsa kwa njira yachipatala yothetsera mavuto omwe amagwiritsa ntchito.

Ngakhale tikudziwa kufunika kwa nkhaniyi, maganizo athu ndi akuti vuto lalikulu la matenda chifukwa cha chizoloŵezi cha chizoloŵezi cholakwitsa chimafuna kuyankha moyenera, ndipo kuti njira yabwino kwambiri ndiyomwe amagwiritsira ntchito thanzi labwino.

Pano ife tafotokoza zifukwa zomwe chitukuko cha thanzi cha anthu chomwe chili chothandiza pa vuto la kugwiritsira ntchito mankhwala chingagwiritsidwe ntchito moyenera ku vuto lakutchova njuga, vuto la masewera, komanso, mwinamwake, matenda ena chifukwa cha makhalidwe oledzera. Mtsutso uwu umapereka chithandizo cha kuphatikizapo vuto la kugwiritsira ntchito mankhwala, vuto lakutchova njuga ndi vuto la masewera m'magulu amodzi pamutu wokhudzana ndi maganizo, khalidwe kapena neurodeveloppmental matenda a ICD-11.

Olemba okha ndiwo amene amachititsa maganizo omwe ali mu kalatayi ndipo sakuimira ziganizo, ndondomeko kapena maganizo a bungwe la World Health Organization. Kalatayi imachokera pa ntchito kuchokera ku Action CA16207 "Europe Network for Problematic Usage Internet", yomwe ikuthandizidwa ndi European Cooperation in Science and Technology (COST).