Pa 18 June 2018, olemba a International Classification of Diseases, 11th Revision , adatulutsa chikalata cholengeza kuti mtundu wotsatira wa ICD-11 tsopano ukupezeka pa intaneti. Unaphatikizapo Compulsive Sexual Behaviour Disorder koyamba ( ulalo wa nkhani yoyambirira ).
- Nkhani yofalitsa imapezeka pa tsamba la WHO Pano. Kuti tipeze mosavuta, tachilembapo mwatsatanetsatane.
- Nkhani ya ICD-11 imatchula kuwonjezereka kwa maseŵera ngati matenda a matenda a m'maganizo, ndi momwe chikhalidwe cha chiwerewere chimagwiritsidwa ntchito panopa.
- Zimatero musatchule matenda ena atsopano: "Kusokonezeka kwa khalidwe la kugonana"Zomwe zikuwonekera mu" Impulse control troubles ".
- The "Kutulutsidwa Mfundo”Pachidziwitso chilichonse muli mawu awa: "Ma code a ICD-11 MMS ndi okhazikika."
- Nazi pano ndime yomalizira ya "matenda opatsirana pogonana":
Matendawa
Matenda okhudza khalidwe logonana [6C72], pamapeto pake amapatsa akatswiri azaumoyo chidziwitso chovomerezeka komanso chodziwikiratu cha kulephera kulamulira khalidwe logonana ngakhale zotsatira zake zoipa. Kukhazikitsa malamulo atsopanowa kumasiyana kulikonse, koma chofunika kwambiri ndichakuti akatswiri azaumoyo padziko lonse lapansi avomereza kuti khalidwe logonana lokakamiza liyenera kudziwika. Ndi mawu ambiri omwe angagwiritsidwe ntchito kwa aliyense amene akwaniritsa zofunikira zake. "Khalidwe logonana lokakamiza" limatchedwanso "chizolowezi chogonana kapena hypersexuality" malinga ndi katswiri wofufuza matenda Jon E. Grant, JD, MD, MPH mu Current Psychiatry ( February 2018: p.3). Kuzindikira kwatsopano kwa CSBD kungagwiritsidwenso ntchito kuzindikira omwe ali ndi zizindikiro zokhudzana ndi kugwiritsa ntchito zolaula pa intaneti.
Oposa 80% a anthu omwe ali ndi khalidwe lochita zachiwerewere amanena kuti zolaula zimagwiritsidwa ntchito kwambiri kapena zovuta.
"Kugwiritsa ntchito zolaula zovuta kungayimire kuwonetseredwa kwakukulu kwa kugonana mopitirira muyeso (komwe kumatchedwanso kukakamiza kugonana, chizolowezi chogonana kapena khalidwe logonana mopitirira muyeso m'mabuku - Kafka, 2010; Karila et al., 2014; Wéry & Billieux, 2017) chifukwa m'maphunziro angapo anthu oposa 80% omwe ali ndi kugonana mopitirira muyeso adanena kuti amagwiritsa ntchito zolaula mopitirira muyeso/zovuta (Kafka, 2010; Reid et al., 2012)". ( Bőthe et al. 2018 :2)
Mabuku ofotokoza matenda monga a WHO’s International Classification of Diseases (ICD-11) ndi a American Psychiatry Association’s Diagnostic and Statistical Manual of Mental Health (DSM-5) satchula matenda amisala ngati “Kuledzera” kwenikweni. Amakonda “Kusokonezeka.”
"Kuchita zachiwerewere" kumayambitsa matendawa kumachokera ku chitsanzo cholephera kuthetsa chilakolako chogonana, chilakolako cha kugonana, kapena chilakolako chogonana, chomwe chimayambitsa khalidwe la kugonana nthawi yambiri (mwachitsanzo, miyezi 6 kapena kuposa).
Kupanga chithandizo cha CSBD
Otsutsa oyambirira anali ndi nkhawa kuti matenda aliwonse ovomerezeka angagwiritsidwe ntchito pochiza anthu ochepa omwe ali ndi vuto la kugonana komanso njira zina zogonana. Komabe, kuti akwaniritse zofunikira zodziwira matenda a CSBD, khalidwe lovutali liyenera kuyambitsa kuvutika maganizo kosalekeza kapena kusokonezeka kwakukulu m'magawo aumwini, m'banja, pagulu, pamaphunziro, pantchito, kapena m'malo ena ofunikira pakugwira ntchito. Mwanjira ina, matenda atsopanowa sazindikira odwala kutengera khalidwe lawo la kugonana lomwe amachita momasuka. Amazindikira odwala kutengera vuto losalekeza komanso kuvutika maganizo. Ngati khalidwe la kugonana, kaya limakhala lotani, silibweretsa vuto lililonse, matenda atsopanowa sadzagwira ntchito.
Otsutsa ena anachenjeza kuti matenda a CSBD angayambitse matenda olakwika odwala omwe odwala omwe analibe khalidwe lawolo, omwe anali okhumudwa, komanso omwe anali ndi vuto labwino chifukwa cha odwala kapena akatswiri. Pofuna kupewa zoterezo, kachilombo ka HIV kamatulutsa kuti, "Mavuto omwe ali okhudzana ndi chikhalidwe cha makhalidwe abwino komanso osatsutsa zokhudzana ndi kugonana, zolimbikitsana, kapena makhalidwe omwe sali okwanira." Mwachidziwitso, wodwalayo sayenera kuthetsa zofuna zake ndikukhala kuchita mobwerezabwereza khalidwe la kugonana lomwe lakhala lovuta.
Zogwiritsira Ntchito Zotsutsana
Pakhala mkangano waukulu pa nthawi yofalitsa gulu latsopano la ICD-11. Matenda a khalidwe lokakamiza kugonana (omwe amadziwika kuti hypersexual disorder) adaganiziridwa kuti alowe mu DSM-5 koma pamapeto pake adachotsedwa. Malinga ndi akatswiri odziwika bwino a sayansi ya ubongo, "Kuchotsedwa kumeneku kwalepheretsa kupewa, kufufuza, ndi chithandizo, ndipo kwasiya asing'anga opanda chidziwitso chovomerezeka cha matenda a khalidwe lokakamiza kugonana." ( Potenza et al. 2017 )
Pakadali pano, gulu lalikulu la matenda atsopano a CSBD ndi Impulse Control Disorders, lomwe limaphatikizapo matenda monga Pyromania [6C70], Kleptomania [6C71] ndi Intermittent Explosive Disorder [6C73]. Komabe kukayikira kulipobe pa gulu loyenera. Monga momwe katswiri wa sayansi ya mitsempha ya Yale Marc Potenza MD PhD ndi Mateusz Gola PhD, wofufuza ku Polish Academy of Sciences ndi University of California San Diego akunenera, "Lingaliro lamakono logawa matenda a CSB ngati matenda oletsa kusinthasintha ndi lotsutsana chifukwa mitundu ina yaperekedwa ... Pali deta yomwe ikusonyeza kuti CSB imagawana zinthu zambiri ndi zizolowezi." ( Kraus et al 2018 )
Ndikoyenera kudziwa kuti ICD-11 imaphatikizapo matenda a Gambling Disorder pansi pa Matenda Omwe Amachitika Chifukwa cha Addictive Behaviors komanso pansi pa Impulse Control Disorders. Chifukwa chake, kugawa matenda sikuyenera kukhala kosiyana nthawi zonse ( Bőthe et al. 2018 :2). Kugawa kungasinthenso pakapita nthawi. Gambling Disorder poyamba idayikidwa m'gulu la matenda osokoneza bongo mu DSM-IV ndi ICD-10, koma kutengera kupita patsogolo kwa kumvetsetsa kwamphamvu, Gambling Disorder yasinthidwa kukhala "Substance-Related and Addictive Disorder" (DSM-5) ndi "Disorder Due to Addictive Behaviour" (ICD-11). N'zotheka kuti matenda atsopano a CSBD awa angatsatire njira yofanana ndi Gambling Disorder.
Ziribe kanthu momwe zokambiranazi zimasinthira m'kupita kwa nthawi, kuikidwa kwa CSBD mu ICD-11 kumapereka chidziwitso choyenera kuti pali anthu omwe akufunikira thandizo lachipatala kuti athe kuwongolera bwino khalidwe lawo la kugonana ndi zotsatira zake. Idzathandizanso kuti pakhale kafukufuku wamtsogolo wokhudzana ndi mavuto okhudza kugonana.
"Zingakhale zofunikira kuganizira momwe DSM ndi International Classification of Diseases (ICD) zimagwirira ntchito pokhudzana ndi njira zofotokozera ndi kugawa magulu. Pochita izi, tikuganiza kuti ndikofunikira kuyang'ana kwambiri pa vuto la kutchova juga (lomwe limadziwikanso kuti pathological gambling) ndi momwe linaganiziridwira mu DSM-IV ndi DSM-5 (komanso mu ICD-10 ndi ICD-11 yomwe ikubwera). Mu DSM-IV, kutchova juga kwa matenda kunagawidwa ngati "Impulse-Control Disorder Not Everywhere Classified." Mu DSM-5, kunasinthidwanso kukhala "Zokhudzana ndi Mankhwala ndi Zosokoneza."…. "Njira yofananayo iyenera kugwiritsidwa ntchito pa CSB, yomwe pakadali pano ikuganiziridwa kuti iphatikizidwe ngati vuto la impulse-control disorder mu ICD-11 (Grant et al., 2014 ; Kraus et al., 2018 )". Mawu awa atengedwa kuchokera ku Gola ndi Potenza 2018.
chithandizo
Pambuyo poti bungwe la World Health Organization (WHO) laika matenda amasewera ndi CSBD ngati matenda amisala, lipoti la nyuzipepala ya Guardian linati chipatala china ku London chikukonzekera kuyambitsa malo oyamba ogwiritsira ntchito intaneti omwe amathandizidwa ndi National Health Service kwa achinyamata ndi akuluakulu. Akatswiri ogonana m'malo ena awona kuwonjezeka kwa makasitomala achinyamata omwe amagwiritsa ntchito mapulogalamu ochezera pa intaneti komanso malo ochezera pa intaneti, ndipo chifukwa chake akuvutika ndi mavuto amisala.
Malinga ndi Phwando la Mateusz Gola, wofufuza pa Polish Academy of Sciences komanso ku University of California San Diego, kachilombo ka HIV kameneka kakupezekanso phindu lina. "Icho chimapereka ndondomeko yoyenera yowunikira. Komanso, akatswiri azachipatala ndi odwala matenda opaleshoni azaphunzira tsopano matendawa. Popanda kuzindikiritsa za HIV, akatswiri ambiri a zachipatala sankadziwa zambiri zokhudza nkhani zokhudzana ndi kugonana. Potsirizira pake, matendawa angaperekenso odwala ambiri kupeza chithandizo cha inshuwalansi. "Gola anawonjezera kuti, matenda atsopanowa," sathetsa vuto la momwe angagwiritsire ntchito CSBD mogwira mtima, koma amalola maphunziro ochuluka kwambiri, omwe angathe kuwatsogolera njira zovomerezeka, zodalirika. "
Kuwonjezeka kwa Odwala
Shane W. Kraus, Ph.D. Pulofesa Wothandizira wa Psychiatry ndi Director of the Behaeveal Addictions Clinic ku Edith Nourse Rogers Memorial Veterans Hospital, University of Massachusetts Medical School adati ponena za gulu latsopanoli: "Ichi ndi gawo loyambirira. Kuphatikizidwa kwa CSBD mu ICD-11 kumatha kuwonjezera mwayi wosamalira odwala (padziko lonse lapansi komanso ku US). Kuphatikiza apo, kuphatikizidwaku kudzawonjezeranso ndalama zofufuzira zomwe zakhala zikuyang'aniridwa kale pazovuta zakuchipatala. Kuphatikiza apo, ndikuganiza kuti zitha kuchepetsa kusalidwa kwa anthu omwe akhudzidwa ndikukweza maphunziro owonjezera pankhaniyi. ”
Kuphunzitsa Ophunzira Zaumoyo
Cholinga chenicheni cha kutulutsidwa kwa ICD-11 posachedwapa ndi kulola mayiko kuti aphunzitse akatswiri azaumoyo pamaphunziro a manual. Ochita kafukufuku akulimbikitsanso kuti madokotala ndi alangizi aphunzitsidwe ndi kumvetsetsa makhalidwe abwino okhudzana ndi kugonana:
"Ndikofunikanso kuti opereka chithandizo (monga madokotala ndi alangizi) omwe anthu angapemphe thandizo kwa iwo azidziwa bwino ma CSB. Pa maphunziro athu okhudza anthu opitilira 3,000 omwe akufuna chithandizo cha CSB, takhala tikumva kuti anthu omwe akudwala CSB amakumana ndi zopinga zambiri akamafunafuna thandizo kapena akamakumana ndi asing'anga ( Dhuffar & Griffiths, 2016 ). Odwala amanena kuti asing'anga angapewe nkhaniyi, kunena kuti mavuto oterewa kulibe, kapena kunena kuti munthu ali ndi chilakolako chachikulu chogonana, ndipo ayenera kuvomereza m'malo mochiza (ngakhale kuti kwa anthuwa, ma CSB angamve ngati odzikuza ndipo angayambitse zotsatirapo zoipa zambiri). Tikukhulupirira kuti njira zodziwika bwino za matenda a CSB zidzalimbikitsa khama la maphunziro kuphatikizapo kupanga mapulogalamu ophunzitsira momwe angayesere ndikuchiza anthu omwe ali ndi zizindikiro za matenda a CSB. Tikukhulupirira kuti mapulogalamu oterewa adzakhala gawo la maphunziro azachipatala kwa akatswiri azamisala, asing'anga amisala, ndi ena opereka chithandizo chamankhwala amisala, komanso opereka chithandizo ena kuphatikiza opereka chithandizo choyamba, monga asing'anga wamba." ( Kraus et al 2018 )
Mphoto Yopindulitsa
Reward Foundation ndi bungwe lothandiza anthu pa nkhani za kugonana lomwe limapangitsa kuti anthu ambiri azitha kupeza sayansi ya kugonana ndi chikondi. Cholinga chathu ndi kuyang'ana kwambiri momwe zithunzi zolaula pa intaneti zimakhudzira achinyamata ndi achinyamata. Tavomerezedwa ndi Royal College of General Practitioners ku London kuti tizichita misonkhano ya tsiku limodzi kwa akatswiri pankhani ya momwe zithunzi zolaula pa intaneti zimakhudzira thanzi la maganizo ndi thupi. Izi zikugwirizana ndi zolinga za World Health Organization zomwe lipoti lake pansipa likugogomezera kufunika kophunzitsa akatswiri. Timaphunzitsanso m'masukulu ndipo tipereka mapulani a maphunziro ndi maphunziro kwa aphunzitsi kumapeto kwa chaka chino. Timapereka chithandizo cha upangiri kwa mabungwe omwe akufuna kupanga mapulogalamu odziwitsa anthu za kuvulaza zolaula.
Kuti mudziwe zambiri zokhudza kuyankhulana kapena kudziwa zambiri kuphatikizapo makope athunthu a magwero omwe atchulidwa, chonde lemberani ku [email protected].
FOOTNOTE
Nkhani yonse ya ICD-11 Press Release.
WHO imatulutsa mitundu yatsopano ya matenda (ICD 11) 18 June 2018 News Release Geneva
Bungwe la World Health Organization (WHO) lero likumasula Chigwirizano Chake Chakumayiko cha Matenda (ICD-11).
ICD ndiye maziko ozindikiritsa mayendedwe azaumoyo ndi ziwerengero padziko lonse lapansi, ndipo ili ndi nambala 55 000 yapadera yovulala, matenda ndi zoyambitsa imfa. Amapereka chilankhulo chomwe chimalola akatswiri azaumoyo kuti azigawana zambiri zaumoyo padziko lonse lapansi.
"ICD ndi mankhwala omwe WHO amanyadira kwambiri," akutero Dr Tedros Adhanom Ghebreyesus, Mtsogoleri Wa bungwe la WHO. "Zimatithandiza kumvetsetsa zambiri zomwe zimapangitsa anthu kudwala ndi kufa, komanso kuti athetse mavuto ndikusunga miyoyo."
ICD-11, yomwe yakhala yoposa zaka khumi ndikupanga, imapereka kusintha kwakukulu pamitundu yapitayi. Kwa nthawi yoyamba, ndi yamagetsi kwathunthu ndipo ili ndi mawonekedwe osavuta kugwiritsa ntchito. Ndipo pakhala kuchitapo kanthu kosadalirika kwa ogwira ntchito zaumoyo omwe alowa nawo pamisonkhano yothandizana nawo ndikupereka malingaliro awo. Gulu la ICD ku likulu la WHO lalandila malingaliro opitilira 10 000 kuti awunikenso.
ICD-11 idzaperekedwa ku Msonkhano Wadziko Lonse wa Zaumoyo mu Meyi 2019 kuti ivomerezedwe ndi Mayiko Omwe Ali Mamembala, ndipo iyamba kugwira ntchito pa 1 Januwale 2022. Kutulutsidwa kumeneku ndi chiwonetsero chamtsogolo chomwe chidzalola mayiko kukonzekera momwe angagwiritsire ntchito mtundu watsopanowu, kukonzekera kumasulira, ndikuphunzitsa akatswiri azaumoyo mdziko lonselo.
ICD imagwiritsidwanso ntchito ndi ogulitsa inshuwalansi omwe kubwezeredwa kwawo kumadalira kulemba kwa ICD; oyang'anira ndondomeko ya zaumoyo; akatswiri osonkhanitsa deta; ndi ena omwe amayang'ana kupita patsogolo kwa thanzi la padziko lonse ndikudziwe kugawa kwa chuma.
ICD-11 yatsopano imasonyezanso kupita patsogolo kwa mankhwala ndi chitukuko mukumvetsetsa kwa sayansi. Mwachitsanzo, zizindikiro zotsutsana ndi antimicrobial resistance zikugwirizana kwambiri ndi Global Antimicrobial Resistance Monitoring System (GLASS). ICD-11 imathanso kulandira deta yokhudzana ndi chitetezo chaumoyo, zomwe zikutanthauza kuti zochitika zosafunikira zomwe zingawononge thanzi - monga ntchito zosagwiritsidwa ntchito mosalekeza kuchipatala - zikhoza kudziwika ndi kuchepetsedwa.
ICD yatsopano imaphatikizapo mitu yatsopano, imodzi pa mankhwala amtundu: ngakhale kuti anthu mamiliyoni ambiri amagwiritsira ntchito mankhwala amtundu wapadziko lonse lapansi, siinayambe yayikidwa mu dongosolo lino. Chaputala chatsopano chokhudzana ndi chiwerewere chimabweretsa pamodzi zinthu zomwe poyamba zinagawidwa mwa njira zina (mwachitsanzo, kusagwirizana kwa amuna ndi akazi kumatchulidwa pansi pazirombo) kapena kufotokozedwa mosiyana. Matenda a masewera awonjezeredwa ku gawo pa matenda osokoneza bongo.
"Mfundo yofunika kwambiri pazokonzanso izi inali yophweka kupanga zida zogwiritsira ntchito makina komanso zipangizo zamagetsi - izi zidzathandiza akatswiri a zaumoyo kuti azilemba mosavuta komanso kulembetsa zinthu mosavuta," anatero Dr. Robert Jakob, Mtsogoleri wa Mtsogoleri, Zomwe Zimalongosola Zomwe Amalemba ndi Malamulo, WHO.
Dokotala Lubna Alansari, Mthandizi Wachiwiri wa WHO wa Health Metrics ndi Measurement, akuti: "ICD ndi mwala wapangodya wokhudza zaumoyo ndipo ICD-11 idzawunikira momwe angayang'anire matenda."