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),
World Psychiatry, 17: 363-364. doi: 10.1002/wps.20570
Lingaliro la "kuledzera kwa khalidwe (kosakhala mankhwala)" linayambitsidwa pafupifupi zaka makumi atatu zapitazo, ndipo mabuku ambiri atuluka posachedwa pa izi ndi zina zokhudzana nazo 1 , 2. Nthawi yomweyo, olemba ena awona kuti kugawa magulu a zizolowezi zamakhalidwe kumafuna khama lowonjezera 3 , 4. Apa tikupereka zosintha pankhaniyi, kutsindika ntchito yaposachedwa yomwe yachitika panthawi yomanga ICD-11, ndikuyankha funso loti ngati kuli kothandiza kukhala ndi gawo losiyana pazovuta zomwe zimachitika chifukwa cha zizolowezi zamakhalidwe m'gululi.
Machitidwe onse a DSM ndi ICD akhala akupewa mawu oti "kuledzera" m'malo mogwiritsa ntchito mawu oti "kudalira mankhwala osokoneza bongo". Komabe, DSM-5 ikuphatikiza vuto la kutchova juga m'mutu wake wokhudza matenda okhudzana ndi mankhwala osokoneza bongo komanso osokoneza bongo, ndipo imapereka njira zoyenera zochizira matenda amasewera pa intaneti, poganizira kuti ndi chinthu chomwe chikufunika kuphunziridwa kwina, ndikuwonetsa kufanana kwake ndi matenda ogwiritsa ntchito mankhwala osokoneza bongo 5-7 . Mu chikalata cha ICD- 11 , World Health Organisation yayambitsa lingaliro la "matenda omwe amabwera chifukwa cha machitidwe osokoneza bongo" kuphatikiza kutchova juga ndi matenda amasewera 2 , 8. Matendawa amadziwika ndi kusalamulira bwino kuchita zinthu zosokoneza bongo, khalidweli limakhala ndi gawo lofunika kwambiri pa moyo wa munthu, komanso kupitiriza kuchita zinthu mosasamala kanthu za zotsatirapo zoyipa, zomwe zimakhala ndi mavuto okhudzana ndi kutchova juga kapena kuwonongeka kwakukulu m'magawo aumwini, m'banja, pagulu, ndi zina zofunika kwambiri pakugwira ntchito 2 , 8.
Cholinga chachikulu pakukula kwa DSM-5 chinali pa zotsimikizira matenda. Ndithudi, pali umboni wina wosonyeza kugwirizana pakati pa matenda ogwiritsira ntchito mankhwala osokoneza bongo ndi matenda omwe amabwera chifukwa cha zizolowezi zoledzera, monga vuto la kutchova juga, pa zotsimikizira zofunika kuphatikizapo matenda obwera chifukwa cha mankhwala, njira zamoyo, ndi yankho la mankhwala 5-7 . Pa vuto la masewera, pali chidziwitso chowonjezeka pa zizindikiro zachipatala ndi za ubongo. Pa mitundu yosiyanasiyana ya zizolowezi zina zoganiza kuti munthu ali ndi zizolowezi zoipa, pali umboni wochepa. Kuphatikiza apo, zingapo mwa izi zitha kuwonetsanso kuyanjana ndi matenda oletsa kusokonezeka (mu DSM-IV ndi ICD-10), kuphatikiza matenda obwera chifukwa cha mankhwala, njira zamoyo, ndi yankho la mankhwala 9.
Magulu omwe akugwira ntchito pa ICD-11 amazindikira kufunika kwa otsimikizira matenda amisala ndi machitidwe, chifukwa njira yogawa magulu yokhala ndi chidziwitso chokwanira ingathandize kuti pakhale zotsatira zabwino za chithandizo. Nthawi yomweyo, magulu ogwira ntchito a ICD-11 ayang'ana kwambiri pa zofunikira zachipatala ndi zaumoyo wa anthu pazokambirana zawo, ndikuyang'ana kwambiri pakukweza chisamaliro choyambirira m'malo omwe si akatswiri, mogwirizana ndi momwe ICD-11 ikugogomezera thanzi la maganizo padziko lonse lapansi. Kusiyanitsa kwa matenda ndi mitundu yosiyanasiyana ya matenda, ngakhale kuthandizidwa ndi ntchito yofufuza pa kutsimikizika kwa matenda, mwina sikuthandiza kwambiri m'malo omwe si akatswiri amapereka chisamaliro. Komabe, kulemala ndi kuwonongeka komwe kumayenderana ndi izi ndi nkhani zazikulu pankhaniyi, zomwe zimathandiza kuphatikizidwa kwa matenda a juga ndi masewera 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.
Kutsutsa kwina kochuluka kwa malingaliro a matenda kapena matenda chifukwa cha makhalidwe osokoneza bongo kungafotokozedwe kuti tikambirane. Tanena kale m'magazini ino kuti ntchito yowonjezera ikufunika kuti tipeze mfundo zolimba zokhudza kuzindikira matenda 9 , ndipo chikalata cha ICD-11 pakadali pano chikulembanso matenda a kutchova juga ndi masewera mu gawo la "matenda oletsa kugwedezeka". Kuphatikiza apo, pali nkhawa yomveka kuti malire a gululi angapitirire mosayenera kupitirira kutchova juga ndi masewera kuti aphatikizepo mitundu ina yambiri ya zochita za anthu. Zina mwa mfundozi zimagwirizana ndi zomwe zimagogomezera zoopsa za njira yochepetsera matenda ogwiritsira ntchito mankhwala osokoneza bongo.
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).
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