Zosintha ndi kusintha kwa ICD-11 mndandanda wa matenda a maganizo, khalidwe ndi neurodevelopmental (2019)

Ndemanga za YBOP: Muli ndi gawo lokhudza "Zovuta zogonana":

Kusokonezeka kwa khalidwe la kugonana

Matenda opatsirana okhudzana ndi kugonana amadziwika ndi chizoloŵezi cholephera kuthetsa zofuna zokhudzana ndi kugonana mobwerezabwereza kapena zolimbikitsa, zomwe zimabweretsanso khalidwe la kugonana mobwerezabwereza kwa nthawi yaitali (mwachitsanzo, miyezi isanu ndi umodzi kapena kuposerapo) yomwe imayambitsa kukhumudwa kapena kuwonongeka kwaumwini, banja, chikhalidwe , maphunziro, ntchito kapena mbali zina zofunika pakugwira ntchito.

Zisonyezero zomwe zingachitike pakuphatikizika ndikuphatikizira: Kugonana mobwerezabwereza kumakhala chinthu chofunikira kwambiri pamoyo wa munthu mpaka kunyalanyaza thanzi ndi chisamaliro chaumwini kapena zokonda zina, zochita ndi maudindo; munthu amene akuyesetsa kangapo kuti athetse kapena kuchepetsa kwambiri machitidwe obwerezabwereza ogonana; munthu akupitilizabe kuchita zachiwerewere mobwerezabwereza ngakhale atakumana ndi zovuta monga kusokonekera kwaubwenzi mobwerezabwereza; ndipo munthuyo akupitilizabe kuchita zachiwerewere mobwerezabwereza ngakhale pomwe sakupezanso chisangalalo.

Ngakhale kuti gululi likuwoneka ngati likudalira kudzidalira, limaphatikizidwanso mu chigawo cha ICD-11 matenda osokoneza bongo chifukwa cha kusowa kwachinsinsi chodziwikiratu ngati njira zomwe zikukhudzidwa ndi chitukuko ndi kukonzanso matendawa ndizofanana ndi zomwe zikuwonetsa vutoli ndi zizoloŵezi zamakhalidwe. Kuikidwa kwake ku ICD-11 kudzakuthandizani kuthetsa zosowa zosayenera zosamalira odwala komanso mwina kuchepetsa manyazi ndi kudzimvera chisoni kuphatikizapo kuthandiza pakati pa anthu ovutika maganizo50.

Reed, GM, Choyamba, MB, Kogan, CS, Hyman, SE, Gureje, O., Gaebel, W., Maj, M., Stein, DJ, Maercker, A., Tyrer, P. ndi Claudino A., 2019.

World Psychiatry, 18 (1), pp.3-19.

Kudalirika

Pambuyo povomerezedwa ndi ICD-11 ndi World Health Assembly mu Meyi 2019, mayiko mamembala a World Health Organisation (WHO) asintha kuchoka ku ICD-10 kupita ku ICD-11, ndikufotokozera ziwerengero zaumoyo kutengera dongosolo latsopanoli kuyamba Januware 1, 2022. Dipatimenti ya WHO ya Mental Health and Substance Abuse idzafalitsa Clinical Descriptions and Diagnostic Guidelines (CDDG) ya ICD-11 Mental, Behavioral and Neurodevelopmental Disorder kutsatira kuvomerezedwa ndi ICD-11. Kukula kwa ICD-11 CDDG pazaka 11 zapitazi, kutengera mfundo zakuchipatala komanso kugwiritsidwa ntchito kwapadziko lonse lapansi, yakhala njira yowunikiranso yapadziko lonse lapansi, zilankhulo zambiri, mitundu yambiri komanso kutengapo gawo pamagulu amisala. Zatsopano mu ICD-11 zimaphatikizapo kupereka chidziwitso chofananira komanso chodziwika bwino, kukhazikitsidwa kwa njira yamoyo, ndi chitsogozo chokhudzana ndi chikhalidwe pamavuto aliwonse. Njira zowoneka bwino zakhala zikuphatikizidwa mgulu, makamaka zovuta zamunthu komanso zovuta zoyambirira zama psychotic, m'njira zomwe zikugwirizana ndi umboni wapano, ndizogwirizana kwambiri ndi njira zochotsera, kuthana ndi zovuta, komanso kusintha kusintha kwakanthawi. Pano tikulongosola kusintha kwakukulu kwa kapangidwe ka ICD-10 yamavuto amisala poyerekeza ndi ICD-11, ndikukula kwa mitu iwiri yatsopano ya ICD-11 yokhudzana ndi thanzi lamisala. Tikuwonetsera magulu atsopano omwe awonjezedwa ku ICD-11 ndikuwonetsa chifukwa chophatikizira. Pomaliza, tikufotokozera zosintha zofunika zomwe zachitika mgulu lililonse la ICD-11. Izi zimapangidwa kuti zikhale zothandiza kwa onse azachipatala komanso ofufuza kuti adziwongolere ku ICD-XNUMX ndikukonzekera kukhazikitsa m'malo mwa akatswiri awo.

Mu June 2018, World Health Organisation (WHO) inatulutsa ndondomeko yomaliza ya 11th kukonzanso kwa International Classification of Matenda ndi Matenda Okhudzana ndi Matenda (Related ICD-11) chifukwa cha kufa ndi chiwerengero cha anthu odwala matendawa ku mayiko ena a 194, kukonzekera kukhazikitsidwa1. World Health Assembly, yomwe idakhazikitsidwa ndi atumiki a thanzi la mayiko onse, ikuyembekezeredwa kuti ivomereze ICD-11 pamsonkhano wotsatira, mu May 2019. Pambuyo pa kuvomerezedwa, mayiko omwe akulowa nawo ayambanso kusintha kuchokera ku ICD-10 kupita ku ICD-11, ndi kupereka malipoti okhudza zaumoyo kwa WHO akugwiritsa ntchito ICD-11 kuyamba pa January 1, 20222.

Dipatimenti ya WHO ya Mental Health and Substance Abuse ndi yomwe yathandizira kukonza chitukuko cha mitu inayi ya ICD-11: zovuta zamaganizidwe, machitidwe ndi ma neurodevelopmental; Matenda ogona; matenda amanjenje; ndi zikhalidwe zokhudzana ndi kugonana (molumikizana ndi dipatimenti ya WHO ya Uchembele Wathanzi ndi Kafukufuku).

Mutu wokhudzana ndi matenda a ICD-10, womwe ulipo tsopano wa ICD, ndi umene umagwiritsidwa ntchito kwambiri mndandanda wa matenda a maganizo padziko lonse lapansi3. Panthawi yopititsa patsogolo ICD-10, Dipatimenti ya WHO ya Matenda a Mitsempha ndi Matenda Osokoneza Bongo anaganiza kuti mitundu yosiyanasiyana ya mndandandayo iyenera kupangidwa kuti ikwaniritse zosowa za ogwiritsa ntchito awo osiyanasiyana. Mndandanda wa ICD-10 kwa malipoti owerengetsera uli ndi zochepa zapadera monga ziganizo za chigawo chilichonse cha matenda, koma izi sizinkayenera kuti zigwiritsidwe ntchito ndi akatswiri a zamaganizo m'maganizo4.

Kwa akatswiri a zaumoyo, Dipatimentiyi inakhazikitsa malangizo a Clinical Descriptions and Diagnostic Guidelines (CDDG) kwa ICD-10 Makhalidwe Abwino ndi Makhalidwe4, osadziwika bwino kuti ndi "buku la buluu", lofunikila ntchito zachipatala, maphunziro ndi ntchito. Pa matenda aliwonse, kufotokozedwa kwa zipatala zazikulu ndi zina zogwirizana zinaperekedwa, motsogozedwa ndi njira zowonjezereka zogwiritsidwa ntchito zomwe zinapangidwa kuti zithandize othandizira azaumoyo kuti adziwe bwinobwino. Zotsatira kuchokera kafukufuku waposachedwapa5 akusonyeza kuti madokotala amagwiritsira ntchito nthawi zonse mu CDDG ndipo nthawi zambiri amayang'anitsitsa mwachidwi poyambitsa matenda oyamba, omwe amatsutsana ndi chikhulupiliro chofala kuti madokotala amagwiritsa ntchito chiwerengerocho kuti athe kupeza zizindikiro zogwiritsira ntchito pazinthu zoyendetsera ndi zolipira. Dipatimentiyi idzasindikiza ma CDDG ofanana ndi ICD-11 mwamsanga mutatha kuvomereza dongosolo lonse la World Health Assembly.

Zaka zoposa khumi za ntchito yaikulu zapita patsogolo ku ICD-11 CDDG. Zakhudzana ndi akatswiri ambiri okhudzidwa ngati a Advisory and Working Groups ndi alangizi, komanso mgwirizanowu waukulu ndi mayiko omwe ali ndi bungwe la WHO, mabungwe opereka ndalama, komanso magulu a zaumisiri ndi a sayansi. Kupititsa patsogolo kwa ICD-11 CDDG yakhala ndondomeko yowonongeka kwambiri padziko lonse, yambirimbiri, yambirimbiri komanso yowonongeka yomwe inagwiritsidwa ntchito potsata mndandanda wa matenda a maganizo.

KUGWIRITSA ICD-11 CDDG: NTCHITO NDI ZOFUNIKA KWAMBIRI

Tinafotokozera kale kufunikira kwa ntchito zamagetsi monga njira yokonzekera CDDG ya ICD-116, 7. Maphunziro a zaumoyo amaimira mawonekedwe pakati pa zochitika zaumoyo ndi mauthenga azaumoyo. Ndondomeko yomwe imapereka chidziwitso chofunikira kwachipatala pamlingo wa thanzi sichidzagwiritsidwa ntchito mokhulupirika ndi azachipatala choncho sangathe kupereka chidziwitso choyenera cha chidziwitso cha zaumoyo zomwe zimagwiritsidwa ntchito popanga zisankho kuntchito yaumoyo, dziko lonse lapansi.

Choncho, ntchito zachipatala zinkatsindika kwambiri mu malangizo operekedwa ku Mndandanda wa Magulu Ogwira Ntchito, omwe amachitidwa ndi magulu okhudzana ndi chisokonezo, osankhidwa ndi bungwe la WHO la Matenda a Mitsempha ndi Matenda Osokoneza Bongo kuti apange malingaliro okhudzana ndi kapangidwe ka zinthu za ICD-11 CDDG .

Inde, kuphatikizapo kukhala othandiza kuchipatala komanso padziko lonse lapansi, ICD-11 iyenera kukhala yovomerezeka mwasayansi. Chifukwa chake, Magulu Ogwira Ntchito amafunsidwanso kuti awunikenso umboni womwe ulipo wasayansi wogwirizana ndi madera awo ngati maziko opangira malingaliro awo ku ICD-11.

Kufunika kwa dziko lonse kugwiritsidwa ntchito6 idalimbikitsidwanso kwambiri ku Magulu Ogwira Ntchito. Magulu onse anali ndi nthumwi zochokera kumadera onse a WHO - Africa, America, Europe, Eastern Mediterranean, Southeast Asia, ndi Western Pacific - komanso anthu ambiri ochokera kumayiko otsika ndi apakati, omwe amakhala oposa 80% anthu padziko lonse lapansi8.

Kuperewera kwa ICD-10 CDDG ndiko kusowa kosawerengeka kwazinthu zoperekedwa pazigawo zovuta9. Kwa ICD-11 CDDG, Magulu Ogwira Ntchito adafunsidwa kuti apereke malingaliro awo ngati "mafomu okhutira", kuphatikiza chidziwitso chofananira komanso chododometsa chavuto lirilonse lomwe limapereka maziko a malangizo azidziwitso.

Tinalemba kale ndondomeko yokhudza ntchito ndi kapangidwe ka malangizo a ICD-119. Kupititsa patsogolo kwa ICD-11 CDDG kunachitika panthawi yomwe inagwedezeka kwambiri ndi kupanga DSM-5 ndi American Psychiatric Association, ndipo magulu ochuluka a ICD-11 Working Group anali kuphatikiza mamembala ndi magulu omwe akugwira ntchito pa DSM-5. Magulu Ogwira Ntchito a ICD-11 akufunsidwa kuti aganizire za ntchito zamagetsi komanso zofunikira zopezeka pa DSM-5. Cholinga chake chinali kuchepetsa kusiyana pakati pa ICD-11 ndi DSM-5, kuphatikizapo kusiyana kwa malingaliro ovomerezeka.

MAVUTO MU ICD-11 CDDG

Chofunika kwambiri cha ICD-11 CDDG ndi njira yawo yofotokozera zofunikira za matenda aliwonse, omwe amaimira zizindikilo kapena zizindikiro zomwe wodwala angathe kuyembekezera kuti awone m'mavuto onsewa. Ngakhale mndandandanda wa zofunikira zomwe zili mu ndondomekoyi zimakhala zofanana ndi zizindikiro zoganizira, zifukwa zomveka zokhudzana ndi chidziwitso cha chidziwitso ndi nthawi zambiri zimapewa, pokhapokha izi zakhazikitsidwa m'mayiko ndi zikhalidwe kapena pali chifukwa china choyikira.

Njirayi ikukhudzidwa ndi momwe madokotala amadziwira, ndi kuchita zinthu zolimbitsa thupi, komanso kuwonjezera chithandizo chamaganizo mwa kulola kuti chikhalidwe chikhale chosiyana ndi zochitika komanso zaumoyo zomwe zingakhudze kugonana. Njira yosinthikayi ikugwirizana ndi zotsatira za kafukufuku wa akatswiri a zaumulungu ndi a psychologist omwe adayambanso kukambirana za ICD-11 pokhudzana ndi zofunikira za matenda a maganizo3, 10. Maphunziro a masukulu m'makonzedwe a makanema m'mayiko a 13 atsimikizira kuti madokotala akuwona kuti njira imeneyi ndi yofunika kwambiri11. Chofunika kwambiri, kutsimikiziridwa kwachidziwitso kwa malangizo a ICD-11 akuwoneka kuti ndi oposa momwe anagwiritsira ntchito njira yodalirika yovomerezeka12.

Zina mwazinthu zina za ICD-11 CDDG zinayambitsidwanso kudzera muzithunzi zoperekedwa ku Magulu Ogwira ntchito kuti apange malingaliro awo (omwe ali, "mawonekedwe okhutira"). Monga gawo la mfundo zomwe zafotokozedwa muzitsogozozo, chidwi chinali choperekedwa kwa matenda aliwonse kuti awonetsere malirewo ndi malire osiyana siyana komanso kufalikira kwa mfundo zomwe zimaperekedwa pa malire ndi zovuta zina.

Njira yowonjezera moyo yomwe inagwiritsidwa ntchito ku ICD-11 imatanthawuza kuti magulu osiyana a makhalidwe ndi maganizo omwe amayamba nthawi zambiri amapezeka mu ubwana ndi unyamata amachotsedwa, ndipo mavutowa amagawidwa ku magulu ena omwe amagawana nawo zizindikiro. Mwachitsanzo, vuto lodzipatula lokhazika mtima pansi linasunthika ku magulu oda nkhawa komanso okhudzana ndi mantha. Komanso, ICD-11 CDDG imapereka chidziwitso cha matenda alionse ndi / kapena kugawana kumene pali deta yomwe ikufotokoza kusiyana kwa kusokonezeka kwa ana ndi achinyamata komanso akuluakulu.

Mfundo zokhudzana ndi chikhalidwe zinakhazikitsidwa mwachindunji pogwiritsa ntchito ndondomeko ya zolemba zokhudzana ndi chikhalidwe cha matenda a maganizo ndi mafotokozedwe a gulu lililonse la ICD-11 ndikudziwitsanso mwatsatanetsatane za chikhalidwe cha ICD-10 CDDG ndi DSM- 5. Chikhalidwe cha chikhalidwe cha chisokonezo cha mantha chimaperekedwa mu Table 1 monga chitsanzo.

Gulu 1. Zotsatira za chikhalidwe cha mantha a mantha
  • Chiwonetsero cha chiwonetsero cha kuopsezedwa kungakhale kosiyana pakati pa zikhalidwe zosiyanasiyana, kutsogozedwa ndi chikhalidwe cha chikhalidwe cha chiyambi chawo kapena matenda opatsirana. Mwachitsanzo, anthu a ku Cambodian angayambe kugogomezera mantha omwe amachititsidwa chifukwa cha kusokonezeka kwa khyâl, chida cha mphepo mu Cambodian ethnophysiology (mwachitsanzo, chizungulire, tinnitus, kupweteka kwa khosi).
  • Pali zikhulupiliro zambiri zokhudzana ndi chikhalidwe choopsya chokhudzidwa ndi mantha a mantha, omwe amawopsya mantha, mantha, kapena nkhawa ku maudindo okhudza zachilengedwe pokhudzana ndi zokhudzana ndi chikhalidwe ndi zachilengedwe. Zitsanzo zimaphatikizapo maudindo okhudzana ndi mkangano wachinsinsi (mwachitsanzo, mayendedwe a nervios pakati pa anthu a ku Latin America), ntchito kapena orthostasis (khyâl cap pakati pa Cambodia), ndi mphepo yamkuntho (trúng gió pakati pa anthu a Chivietinamu). Zilembedwe za chikhalidwechi zingagwiritsidwe ntchito ku ziwonetsero zamaganizo osati kuopsezedwa (mwachitsanzo, kukwiya kwapsa mtima, mwachitsanzo mayendedwe a nervios) koma nthawi zambiri amachititsa mantha kapena ziwonetsero zoopsa zomwe zimachitika ndi mantha.
  • Kufotokozera zikhalidwe za chikhalidwe ndi zomwe zikuchitika zokhudzana ndi zizindikiro zimatha kudziwitsa ngati kuopsezedwa kwa mantha kukuyenera kuyembekezera kuti mukuyembekezeka kapena mosayembekezereka, monga momwe zingakhalire ndi vuto la mantha. Mwachitsanzo, kuopsezedwa kungaphatikizepo mantha ena omwe amafotokozedwa bwino ndi matenda ena (mwachitsanzo, chikhalidwe cha anthu mu matenda a chikhalidwe cha anthu). Komanso, chikhalidwe cha mantha chikuyang'aniridwa ndi zowonekera (mwachitsanzo, mphepo kapena kuzizira ndi trúng gió mantha) atha kunena kuti kuda nkhawa kwambiri kumayembekezeredwa poyang'ana chikhalidwe cha munthuyo.

Chinthu chinanso chofunika kwambiri mu chiwerengero cha ICD-11 chakhala chikugwirizanitsa njira zogwirizana ndi zochitika zenizeni m'kati mwa dongosolo lodziwika bwino lomwe liri ndi zovuta zowonongeka. Khama limeneli linalimbikitsidwa ndi umboni wakuti matenda ambiri a m'maganizo akhoza kufotokozedwa bwino pamaganizo angapo owonetsera kusiyana ndi magulu osamvetsetseka13-15, ndipo yathandizidwa ndi zojambula muzithunzi za ICD-11. Mmene mphamvu za ICD-11 zingakhazikitsire zikudziwikiratu bwino mwazigawo za mavuto a umunthu16, 17.

Kwa zosagwiritsa ntchito akatswiri, kukula kwake kwa zovuta za umunthu za ICD-11 kumapereka kuphweka komanso kugwiritsidwa ntchito kwazachipatala kuposa momwe ICD-10 imagwirizira zovuta zamunthu, kusiyanitsa kwabwino kwa odwala omwe amafunikira zovuta poyerekeza ndi mankhwala osavuta, komanso bwino Njira yotsatirira kusintha kwakanthawi. M'malo ena apadera, kuwundana kwa mikhalidwe yaumunthu kumatha kudziwitsa njira zina zothetsera vutoli. Makulidwe amachotsa zovuta zamatenda amunthu komanso zovuta zosadziwika zaumunthu, komanso kupereka maziko ofufuzira pazoyambira ndi kulowererapo pamitundu yosiyanasiyana yamatenda.

Chiwerengero cha ziyeneretso za mawonekedwe chimayambitsidwanso kuti chifotokozere kuwonekera kwa schizophrenia ndi matenda ena oyamba amisala.18. M'malo momangoganizira za zizindikiro zogwiritsira ntchito, chigawochi chimayang'ana pa zofunikira pazochitika zamakono zomwe zikugwirizana kwambiri ndi njira zowonongeka za matenda a maganizo.

Kuyandikira kwa maonekedwe a umunthu ndi mawonetseredwe a zizindikiro za matenda oyambirira a psychotic akufotokozedwa mwatsatanetsatane mu zigawo zomwe zapitazo pamapepala.

MAPHUNZIRO A DZIKO LA ICD-11

Pulogalamu ya ICD-11 yopita kumidzi imayimiranso dera lalikulu la luso. Pulogalamuyi yaphatikizapo kugwiritsa ntchito njira zamakono zogwiritsa ntchito njira zogwiritsira ntchito ndondomeko yowunikira, kuphatikizapo kulondola ndi kusagwirizana kwa ntchito ndi madokotala poyerekeza ndi ICD-10 komanso zinthu zomwe zimayambitsa chisokonezo chilichonse19. Mphamvu yayikulu ya pulogalamu yafukufuku yakhala kuti maphunziro ochuluka achitidwa panthawi yomwe alola zotsatira zawo kuti zikhale ndi maziko othandizira ndondomeko kuti athetsere zofooka zilizonse20.

Kuphatikizidwa kwa dziko lonse kwakhala chidziwitso cha pulogalamu ya ICD-11 CDDG. Pulogalamu ya Global Clinical Practice Network (GCPN) inakhazikitsidwa kuti apange odwala matenda aumoyo ndi ophunzirira apadziko lonse kuti athe kutenga nawo mbali mwachitukuko cha kayendetsedwe ka ICD-11 CDDG kupyolera pa maphunziro a masukulu a intaneti.

Patapita nthawi, GCPN yakula ndikuphatikizapo madokotala pafupifupi 15,000 ochokera m'mayiko a 155. Mayiko onse a WHO omwe amaimiridwa m'zinthu zambiri zomwe zimayang'anitsitsa kupezeka kwa akatswiri a thanzi la m'madera ndi dera, ndizomwe zikuchokera ku Asia, Europe ndi America (pafupifupi pakati pa US ndi Canada ndi dzanja limodzi ndi Latin America pa zina). Oposa theka la mamembala a GCPN ndi madokotala, makamaka amatsenga, ndipo 30% ndiwo amalingaliro a maganizo.

Pafupifupi mayeso khumi ndi awiri a GCPN apangidwa mpaka lero, ambiri akuyesa kufanizitsa ndondomeko za matenda a ICD-11 ndi malangizo a ICD-10 mwachindunji ndi kusasinthasintha kwa akatswiri odwala matenda opatsirana pogwiritsa ntchito zida zovomerezeka zomwe zimagwiritsidwa ntchito pofuna kuyesa kusiyana kwakukulu19, 21. Kafukufuku wina adafufuza kuti adziwe kuti ali ndi matenda otani22 komanso momwe madokotala amagwiritsira ntchito zolemba5. Maphunziro a GCPN apangidwa ku Chinese, French, Japanese, Russian and Spanish, kuphatikizapo Chingerezi, ndipo aphatikizapo kufufuza zotsatira ndi dera ndi chinenero kuti adziwe mavuto omwe angakhale nawo padziko lonse kapena chikhalidwe chokhazikika komanso mavuto omasulira.

Kafukufuku wamakilomita adayambanso kupyolera m'magulu a malo ophunzirira amtundu wapadziko lonse kuti adziwe momwe ntchito yogwiritsira ntchito matenda a ICD-11 ikuyendera komanso momwe angagwiritsire ntchito pogwiritsa ntchito zochitika zachilengedwe, pamalo omwe akuyenera kugwiritsidwa ntchito11. Kafukufukuyu adawonanso kuti kudalirika kwa matendawa kumagwiritsidwa ntchito kwambiri12. Maphunziro apadziko lonse anali m'mayiko a XNUM kudera lonse la WHO, ndipo oyankhulana ndi oleza mtima pa maphunzirowo anachitidwa m'chinenero cha m'dzikolo.

KUKHALA KWAMBIRI KWA ICD-11 CHAPULE PA ZOCHITIKA ZOCHITA, ZOPHUNZITSIDWA NDI ZOCHITA ZOPHUNZITSA NTCHITO

Mu ICD-10, chiwerengero cha magulu a matendawa chinali choponderezedwa ndi dongosolo la chikhododomali chomwe chimagwiritsidwa ntchito pamagulu, kotero kuti zinangotheka kukhala ndi magulu khumi akuluakulu okhudzana ndi mavuto m'mutuwu pa zovuta za m'maganizo ndi khalidwe. Chotsatira chake, magulu owonetsa matenda omwe adagwiritsidwa ntchito omwe sankagwiritsidwa ntchito ndichipatala kapena umboni wa sayansi (mwachitsanzo, matenda opsinjika maganizo akuphatikizidwa ngati gawo limodzi la magulu okhudzana ndi maganizo, maganizo, ndi masoka). Kugwiritsidwa ntchito kwa ICD-11 yokhala ndi zolembera zowonongeka kwa alphanumeric kunathandiza kuti pakhale magulu ochulukirapo a magulu, kuti athe kukonza magulu ozindikira omwe amatsatira kwambiri zokhudzana ndi sayansi komanso zosowa za kuchipatala.

Kuti apereke deta kuti athandizidwe pokonza dongosolo la bungwe lomwe lingakhale lothandiza kwambiri, maphunziro awiri opanga masewerawa amapangidwa23, 24 kuyesa malingaliro omwe agwiridwa ndi akatswiri azaumoyo padziko lonse pokhudzana ndi maubwenzi pakati pa matenda a maganizo. Deta iyi inadziwitsa zisankho zokhudzana ndi momwe angakhalire. Mchitidwe wa bungwe la ICD-11 unakhudzidwanso ndi zoyesayesa za WHO ndi American Psychiatric Association kuti zigwirizane ndi dongosolo lonse la ICD-11 chaputala pa mavuto a maganizo ndi makhalidwe ndi dongosolo la DSM-5.

Kukhazikitsidwa kwa mutu wa ICD-10 wonena za zovuta zamisala ndi machitidwe makamaka kumawonetsera mutu womwe bungwe lidagwiritsidwa ntchito poyambirira mu Kraepelin's Textbook of Psychiatry, yomwe idayamba ndi zovuta zamagulu, zotsatiridwa ndi ma psychoses, matenda amanjenje, komanso mavuto amunthu25. Mfundo zomwe zimatsogolera bungwe la ICD-11 zikuphatikizapo kuyesa kulongosola magulu otsogolera polojekiti (onani, matenda a neurodevelopmental akuwoneka kuti akudwala matenda oyambitsa matenda ndi ubongo). kugwirizanitsidwa ndi nkhawa) komanso zomwe zimagawana zochitika (mwachitsanzo, matenda a dissociative). Tchati 2 limapereka mndandanda wa magulu opatsirana m'maganizo a ICD-11 chaputala pazovuta za maganizo, khalidwe ndi neurodevelopmental.

Gulu 2. Magulu okhudzidwa m'maganizo a ICD-11 chaputala pa matenda a maganizo, khalidwe ndi neurodeveloppmental
Matenda a Neurodevelopmental
Schizophrenia ndi mavuto ena oyambirira a maganizo
Catatonia
Matenda a maganizo
Nkhawa ndi matenda okhudzana ndi mantha
Matenda osokoneza maganizo ndi ofanana
Matenda okhudzana ndi nkhawa
Matenda a dissociative
Kudyetsa ndi matenda odwala
Matenda othetsa mavuto
Kusokonezeka kwa masautso ndi thupi
Kusokonezeka chifukwa cha kugwiritsira ntchito mankhwala ndi makhalidwe oledzera
Pewani kusokoneza maganizo
Zosokoneza khalidwe ndi matenda a dissocial
Matenda a umunthu
Matenda a Paraphilic
Zovuta zenizeni
Matenda osokoneza maganizo
Matenda a maganizo ndi makhalidwe omwe amapezeka ndi mimba, kubala ndi puerperium
Zinthu zamaganizo ndi zamakhalidwe zomwe zimakhudza matenda kapena matenda omwe amapezeka kumadera ena
Matenda a m'maganizo kapena achikhalidwe omwe amagwirizana ndi matenda kapena matenda omwe amagawidwa kwina kulikonse

Mndandanda wa matenda a kugona mu ICD-10 inadalira kusiyana komwe kuli kosalekanitsidwa komwe kulipo pakati pa matenda osakanikirana ndi aumunthu, zomwe zimapangitsa kuti "matenda osagwirizana" omwe akuphatikizidwa mu mutu wokhudzana ndi vuto la maganizo ndi khalidwe la ICD-10, ndi "matenda" ogona akuphatikizidwa mu mitu ina (mwachitsanzo, matenda a mitsempha ya matenda, matenda a mpweya wopuma, ndi endocrine, matenda a zakudya ndi kagayidwe kachakudya). Mu ICD-11, chaputala chosiyana chinayambitsidwa chifukwa cha matenda omwe akugona nawo omwe akuphatikizitsa matenda onse ogonana.

ICD-10 imaphatikizapo kusiyana pakati pa zinthu zachilengedwe ndi zosagwirizana ndi kugonana, ndi "zosagwirizana ndi zachilengedwe" zomwe zimaphatikizidwa mu chaputala pa zovuta za m'maganizo ndi zamakhalidwe, komanso zovuta zokhudzana ndi kugonana kwazinthu zambiri zomwe zalembedwa m'mutu wokhudzana ndi matenda a maginitowa. Mutu watsopano wokhudzana ndi chiwerewere wagwiritsidwa ku ICD-11 kuti apange mgwirizano wogwirizana wa zovuta zogonana ndi matenda opatsirana pogonana26 komanso kusintha kwa chibadwa cha amuna ndi akazi. Kuwonjezera pamenepo, matenda a ICD-10 azimayi adatchedwanso "kusagwirizana kwa amuna ndi akazi" mu ICD-11 ndipo adachokera ku mutu wa matenda opatsirana pogonana chaputala26, kutanthauza kuti chizindikiro cha transgender sichingakhalenso ngati matenda a maganizo. Kugonana kwa amuna kapena akazi sikutchulidwa pofuna kuthetsa ku ICD-11 chifukwa m'mayiko ambiri kupeza chithandizo chamankhwala choyenera kumadalira matenda oyenerera. Mauthenga a ICD-11 amanena mosapita m'mbali kuti khalidwe losiyana pakati pa amai ndi abambo palokha sikokwanira kuti apeze matenda.

ZINTHU ZATSOPANO, ZOKHUDZA NDIPONSO ZOKHUDZA NTCHITO MU ICD-11

Potsata ndemanga ya umboni womwe ulipo pa sayansi, komanso kulingalira za ntchito zamagetsi ndi zochitika zapadziko lonse, matenda ena atsopano awonjezeredwa ku chaputala cha ICD-11 pa matenda, maganizo ndi makhalidwe omwe amachititsa anthu kuti asinthe. Kufotokozera za matendawa monga momwe tafotokozera mu malangizo a ICD-11 ndi chiganizo cha kulowetsedwa kwawo amaperekedwa pansipa.

Catatonia

Mu ICD-10, catatonia inaikidwa ngati imodzi mwa mankhwala a schizophrenia (ie, catatonic schizophrenia) ndipo ndi imodzi mwa matenda a chilengedwe (ie, matenda a catatonic disorder). Pozindikira kuti matenda a catatonia angathe kuchitika pogwirizana ndi matenda osiyanasiyana27, kagulu kakang'ono ka matenda opatsirana ka catatonia (pa msinkhu wofanana nawo monga mavuto a maganizo, nkhawa ndi mantha okhudzana ndi mantha, ndi zina zotero) zawonjezedwa ku ICD-11.

Catatonia imadziwika ndi zizindikiro zambiri monga chiphuphu, catalepsy, kusinthasintha kwa thupi, mutism, kunyalanyaza, kunyalanyaza, zizoloŵezi, kusokoneza maganizo, kugwedezeka kwa maganizo, grimacing, echolalia ndi echopraxia. Zitatu zikuphatikizidwa m'magulu atsopano a matenda: a) catatonia yogwirizanitsidwa ndi matenda ena aumphawi (monga matenda a maganizo, schizophrenia kapena matenda ena oyambirira a maganizo, kapena matenda a autism spectrum); b) catatonia imapangidwanso ndi mankhwala osokoneza bongo, kuphatikizapo mankhwala (monga antipsychotic drugs, amphetamines, phencyclidine); ndipo c) catatonia yachiwiri (mwachitsanzo, chifukwa cha matenda, monga matenda a shuga ketoacidosis, hypercalcemia, kupweteka kwapadera, homocystinuria, neoplasm, matenda aakulu, matenda a cerebrovascular, kapena encephalitis).

Matenda a bipolar mtundu wa II

DSM-IV idabweretsa mitundu iwiri yamatenda amisala. Matenda amtundu wa bipolar ndimagwiritsa ntchito ziwonetsero zomwe zimachitika kamodzi kokha, pomwe matenda amtundu wa bipolar amafunika gawo limodzi lokha la hypomanic kuphatikiza gawo limodzi lokhumudwitsa, pakalibe mbiri yamankhwala. Umboni wotsimikizira kusiyanasiyana kwa mitundu iwiriyi umaphatikizaponso kusiyana pakuthana ndi kupsinjika kwa monotherapy28, njira zodzidzimutsa28, 29, zotsatira za chibadwa28, 30, ndi zofufuza zamaganizo28, 31, 32.

Kupatsidwa umboni umenewu, komanso kugwiritsira ntchito mankhwala osiyana pakati pa mitundu iwiriyi33, matenda ochititsa munthu kusinthasintha maganizo ku ICD-11 adagwirizananso ndi mtundu wa mtundu wa I ndi mtundu wa II wodwala matenda osokoneza bongo.

Matenda a dysmorphic disorder

Anthu omwe ali ndi matenda opatsirana thupi amakhala okhudzidwa ndi vuto limodzi kapena angapo kapena zolakwika mu maonekedwe awo omwe sadziwika kapena amazindikiridwa pang'ono ndi ena34. Kuchita chidwi kumaphatikizapo ndi kubwereza mobwerezabwereza komanso kuchita zinthu mopitirira muyeso, kuphatikizapo kuyesa mobwerezabwereza kuoneka kapena kuuma kwa chilakolako cholakwika kapena cholakwika, kuyesa mwakuya kugwiritsira ntchito kapena kusintha kusokonekera kwadzidzidzi, kapena kupeŵa kukanika kwa zochitika za anthu kapena zokopa zomwe zimachulukitsa kusautsika pa vuto lozindikira kapena kulakwitsa.

Poyambirira amatchedwa "dysmorphophobia", vutoli poyamba linaphatikizidwa mu DSM-III-R. Idawoneka mu ICD-10 monga mawu ophatikizidwa koma osagwiritsidwa ntchito mwachindunji pansi pa hypochondriasis, koma odwala adalangizidwa kuti azindikire kuti ndi matenda osokoneza bongo pamene zikhulupiriro zomwe zimagwirizanitsidwa zinkaonedwa ngati zopanda pake. Izi zinayambitsa matenda omwewo kuti apatsidwe matenda osiyanasiyana popanda kuzindikira kukula kwa matendawa, omwe angaphatikizepo zikhulupiliro zomwe zimawoneka zosokonezeka chifukwa cha chikhulupiliro kapena kukonzekera komwe akugwiritsidwa ntchito.

Pozindikira chizindikiro chake chodziwika bwino, kufalikira kwa chiwerengero cha anthu komanso zofanana ndi zovuta zokhudzana ndi zovuta zowonjezereka (OCRD), matenda okhudza thupi amatha kuikidwa m'gulu lino la ICD-1135.

Zovuta zowonongeka

Chikhalidwechi chimakhala ndi nkhawa yochuluka ndi chikhulupiliro chakuti wina akuchotsa fungo loipa kapena loipa la thupi kapena mpweya, womwe mwina sungatheke kapena umazindikiridwa pang'ono ndi ena34.

Poyankha, iwo amachita zinthu mobwerezabwereza komanso mobwerezabwereza monga kufufuza mobwerezabwereza fungo la thupi kapena kuyang'ana fungo la fungo; chidziwitso; kuyesayesa mwakuya kuyesa, kusintha kapena kuteteza fungo lodziwika; kapena kutetezedwa kwa zochitika za anthu kapena zokopa zomwe zimachulukitsa kusautsika chifukwa cha fungo loipa kapena lopweteka. Anthu okhudzidwa amaopa kapena amakhulupirira kuti ena akuwona fungo amawakana kapena kuwachititsa manyazi36.

Matenda owonetsa zovuta amaphatikizidwa mgulu la ICD-11 OCRD, popeza imagawana zofananira ndi zovuta zina mgululi pokhudzana ndi kupezeka kwachitetezo chokhazikika komanso machitidwe obwerezabwereza35.

Kusokoneza matenda

Kusokonezeka maganizo kumadziwika ndi kusungidwa kwa katundu, chifukwa cha kupezeka kwawo kwakukulu kapena kuvutika kuwataya, mosasamala kanthu za mtengo wawo weniweni35, 37. Kupeza zochulukira kumakhala ndi zofuna zobwerezabwereza kapena makhalidwe okhudzana ndi kugulitsa kapena kugula zinthu. Kuvuta kutaya kumadziwika ndi kufunika koti tisunge zinthu ndi vuto lomwe likugwirizana ndi kuwataya. Kuwonjezeka kwa chuma kumapangitsa malo okhalamo kukhala ochuluka mpaka momwe ntchito yawo kapena chitetezo chawo chimasokonekera.

Ngakhale zizolowezi zodzikongoletsera zitha kuwonetsedwa ngati gawo limodzi lamavuto amisala ndi machitidwe ena ndi zina - kuphatikiza kukakamira, kukhumudwa, schizophrenia, dementia, matenda a autism spectrum ndi Prader - Willi matenda - pali umboni wokwanira wotsimikizira kusungidwa chisokonezo ngati matenda osiyana ndi osiyana38.

Anthu omwe akhudzidwa ndi vuto lodzikongoletsa samadziwika ndipo amachitidwa zinthu zochepa, zomwe zimafotokoza zaumoyo wa anthu chifukwa chophatikizidwa mu ICD-1139.

Chisokonezo chachisokonezo

Magulu atsopano ogwiritsira ntchito, omwe akugwiritsidwa ntchito mobwerezabwereza, akuwonjezeredwa ku gulu la OCRD. Zimaphatikizapo trichotillomania (yomwe idaphatikizidwa mu kagulu ka chizolowezi ndi matenda osokoneza bongo ku ICD-10) ndi matenda atsopano, matenda osokoneza bongo (omwe amadziwikanso kuti matenda otola khungu).

Matenda okhumudwa amadziwika ndikutola khungu lako mobwerezabwereza, komwe kumabweretsa zotupa pakhungu, limodzi ndi zoyesayesa zakulephera kapena kuletsa khalidweli. Kutola khungu kuyenera kukhala kokwanira kuthana ndi vuto lalikulu kapena kuwonongeka kwa magwiridwe antchito. Matenda a Excoriation (ndi trichotillomania) ndi osiyana ndi ma OCRD ena chifukwa chikhalidwecho sichimayambitsidwa ndi zochitika zazidziwitso monga malingaliro olowerera, kutengeka kapena chidwi, koma m'malo mwake zimatha kutsogozedwa ndi zokumana nazo.

Kuphatikizidwa kwawo ku gulu la OCRD kumachokera ku zochitika zogawidwa, zochitika za mabanja, komanso njira zowonongeka ndi zovuta zina m'gululi35, 40.

Kusokonezeka kwapweteka kwapweteka kwambiri

Matenda osokoneza maganizo omwe amatha kupweteka kwambiri (PTSD yovuta)41 zambiri zimayambitsa mavuto aakulu a chikhalidwe chokhalitsa, kapena zochitika zambiri zobwerezabwereza zomwe zimakhala zovuta kapena zosatheka, monga kuzunzika, ukapolo, ndondomeko ya chiwawa, nkhanza zapakhomo nthawi yayitali, kapena kugwiriridwa mobwerezabwereza kugonana kapena kugwiriridwa.

Chizindikiro cha chizindikiro chimadziwika ndi zinthu zitatu zazikuluzikulu za PTSD (mwachitsanzo, kukumana ndi zoopsa kapena zochitika pakadali pano monga zikumbukiro zowoneka bwino, zoopsa kapena zoopsa; kupewa malingaliro ndikukumbukira zomwe zidachitika kapena zochitika, zochitika kapena anthu okumbutsa za mwambowu; malingaliro opitilira chiwopsezo chamakono), zomwe zimatsagana ndi zosokoneza zowonjezereka, zofalikira komanso zopirira zomwe zimakhudza malamulo, malingaliro anu ndi magwiridwe antchito.

Kuwonjezera kwa PTSD yovuta ku ICD-11 kumakhala koyenera chifukwa cha umboni wakuti anthu omwe ali ndi matenda ali ndi vuto losauka kwambiri ndipo amapindula ndi mankhwala osiyanasiyana poyerekezera ndi anthu omwe ali ndi PTSD42. PTSD yovuta imalowetsa mbali ya ICD-10 yomwe ili ndi kusintha kwa umunthu pambuyo pa zovuta zowopsya41.

Matenda achisoni nthawi yaitali

Matenda afupipafupi omwe amatha kufotokozera amatsutsa mosalekeza komanso amalepheretsa mayankho a imfa41. Kutsatira kumwalira kwa wokondedwa, kholo, mwana kapena munthu wina aliyense wapafupi ndi womwalirayo, pamakhala kulira kwachisoni komwe kumafalikira komwe kumadziwika ndikulakalaka wakufayo kapena kulimbikira kutanganidwa ndi womwalirayo, limodzi ndi zowawa zam'mtima. Zizindikiro zimaphatikizaponso kukhumudwa, kudziimba mlandu, kukwiya, kukana, kudzudzula, kuvuta kuvomereza imfayo, kumva kuti munthuyo wataya gawo lake, kulephera kukhala ndi malingaliro abwino, kufooka kwam'mutu, komanso kuvutika kuchita nawo zochitika zina kapena zina. Kuyankha kwachisoni kuyenera kupitilirabe kwa nthawi yayitali kutsatira kutayika (opitilira miyezi isanu ndi umodzi) ndikuwonekeratu kuti akupitilira miyezo yamakhalidwe, zikhalidwe kapena zachipembedzo pamikhalidwe ndi malingaliro ake.

Ngakhale kuti anthu ambiri amafotokoza kukhululukidwa kwapadera kuchokera ku ululu wachisoni chachikulu pakadutsa miyezi isanu ndi umodzi pambuyo pa imfa, awo omwe akupitirizabe kukhumudwa kwakukulu amakhala osowa kwambiri pakugwira ntchito. Kuphatikizidwa kwa matenda achisoni kwa nthawi yaitali mu ICD-11 ndikumvera umboni wowonjezereka wa zosiyana ndi zolepheretsa zomwe sizinafotokozedwe mokwanira ndi zamakono za ICD-1043. Kuphatikizidwa kwake ndi kusiyana pakati pa chikhalidwe cha chikhalidwe cha chikhalidwe ndi kukhumudwa kwapadera ndikofunika, chifukwa cha zosiyana siyana zomwe zimasankhidwa ndikusokoneza matendawa44.

Kudya matenda osokoneza bongo

Matenda odyera kudya amadziwika ndifupipafupi, nthawi zambiri zomwe zimadya kudya (mwachitsanzo, kamodzi pa sabata kapena kupitirira miyezi ingapo). Kudya chakudya chokwanira ndi nthawi yapadera yomwe munthu amatha kudziletsa kuti asadye zakudya, amadya kwambiri kapena mosiyana ndi momwe amachitira nthawi zonse, ndipo amamva kuti sangaleke kudya kapena kuchepetsa mtundu kapena chakudya chodyedwa.

Kudya chakudya kumakhala kovuta kwambiri ndipo nthawi zambiri kumakhala ndi maganizo oipa monga kudziimba mlandu kapena kunyansidwa. Komabe, mosiyana ndi bulimia nervosa, zizolowezi zodya kudya sizimatsatiridwa ndi makhalidwe osayenera osayenera kuti athetse kulemera kwa thupi (mwachitsanzo, kusanza komweko, kugwiritsa ntchito molakwa mankhwala osokoneza bongo kapena kuchita masewera olimbitsa thupi). Ngakhale kuti kudya zakudya zolimbitsa thupi nthawi zambiri kumakhudzana ndi kulemera kwa thupi ndi kunenepa kwambiri, izi sizowonjezera ndipo vutoli lingakhalepo mwa anthu olemera.

Kuwonjezeka kwa vuto lakudya mopitirira muyeso mu ICD-11 kumadalira kafukufuku wambiri womwe wapezeka mzaka 20 zapitazi zikuthandizira kuyenera kwake komanso kuchipatala45, 46. Anthu omwe amafotokoza zochitika za kudya mowa mopanda chilolezo chosayenerera amaimira gulu lofala kwambiri pakati pa omwe amalandira ICD-10 matenda a matenda enaake osadziwika kapena osadziwika, kotero kuti kuyembekezera kuti kuphatikiza matenda oledzeretsa kudzateteza izi47.

Peŵani matenda / kudya zoletsa kudya

Matenda oletsa kudya (ARFID) amadziwika ndi makhalidwe odyetsa kapena odyetsa omwe amachititsa kuti munthu asadye chakudya chokwanira kapena chokwanira kuti athe kupeza mphamvu kapena zakudya zoyenera. Izi zimapangitsa kulemera kwakukulu, kulephera kulemera monga momwe akuyembekezerekera muubwana kapena mimba, kuchipatala chosowa zakudya, kukhudzana ndi zowonjezera zakudya zamakono kapena kupatsa chubu, kapena kusokoneza mwakuthupi umoyo wa munthuyo kapena zotsatira za kuwonongeka kwakukulu kwabwino.

ARFID imasiyanitsidwa ndi anorexia nervosa posakhala ndi nkhawa zakulemera kwa thupi kapena mawonekedwe. Kuphatikizidwa kwake ku ICD-11 kumatha kuwonedwa kuti ndikokulitsa kwa gulu la ICD-10 "kusokoneza matenda kuyambira ali wakhanda ndi ubwana", ndipo zikuyenera kupititsa patsogolo chithandizo chazachipatala m'moyo wonse (mwachitsanzo, mosiyana ndi mnzake wa ICD-10, ARFID imagwiranso ntchito kwa ana, achinyamata komanso achikulire) komanso kukhala osasinthasintha ndi DSM-545, 47.

Thupi la umphumphu dysphoria

Thupi lachilungamo dysphoria ndi matenda osadziwika omwe amadziwika ndi chilakolako chofuna kukhala ndi chilema chakuthupi (mwachitsanzo, kuchotsa chifuwa, kupweteka, kupunduka, kumva wogontha) kuyambira ali mwana kapena kuyambira48. Chikhumbochi chingasonyezedwe m'njira zosiyanasiyana, kuphatikizapo kuganizira zolephereka thupi, kuchita "kudziyeretsa" (mwachitsanzo, kugwiritsira ntchito maola olumala kapena kugwiritsa ntchito miyendo ya miyendo kuti muyese kukhala wofooka pamapazi), ndikugwiritsa ntchito nthawi yofufuzira njira zopezera ulemala wofunikila.

Kutanganidwa ndi chilakolako chokhala ndi thupi (kuphatikizapo nthawi yogwiritsira ntchito) kumalepheretsa kwambiri zokolola, zosangalatsa, kapena chikhalidwe cha anthu (mwachitsanzo, munthuyo sakufuna kukhala ndi ubale wapamtima chifukwa zingakhale zovuta kudziyerekezera). Kuwonjezera apo, kwa anthu ochepa omwe ali ndi chikhumbochi, nkhawa zawo zimangotengera zongoganizira, ndipo zimapangitsa kuti chilakolakocho chikhale chonchi kupyolera mwa njira zopaleshoni (mwachitsanzo, pochotsa chiwalo chopatsa thanzi labwino) kapena kudzivulaza thupi digiri yomwe amputation ndiyo njira yokhayo yokhayokha (mwachitsanzo, kuzizira kwa nthambi pamsana wouma).

Matenda a masewera

Pamene maseŵera a pa Intaneti awonjezeka kwambiri m'zaka zaposachedwa, mavuto akhala akuwonedwa akukhudzana ndi kulowerera kwambiri pa masewera. Matenda a masewerawa aphatikizidwa mu magulu atsopano omwe amadziwika kuti "matenda chifukwa cha khalidwe lachiwerewere" (lomwe liri ndi vuto lakutchova njuga) poyankha mavuto a padziko lonse pokhudzana ndi masewera ovuta, makamaka mawonekedwe a pa intaneti49.

Matenda a masewera amadziwika ndi kachitidwe kachitetezo chokhazikika kapena chosakhalitsa cha intaneti (kapena "masewera a pakompyuta") omwe amawonetseredwa ndi kusokonekera kwa khalidwe (mwachitsanzo, kulephera kuchepetsa nthawi yomwe amathera masewera), zomwe zimapangitsa kuti maseŵera atenge patsogolo kwambiri kuposa momwe amachitira patsogolo pa zofuna zina za moyo ndi ntchito za tsiku ndi tsiku; komanso kupitiliza kapena kusefukira maseŵera ngakhale kuti zotsatira zake sizikhala zoipa (mwachitsanzo, kupitilizidwanso ntchito chifukwa cha kupezeka kwambiri chifukwa cha masewera). Zimasiyanitsa ndi khalidwe losasewera la masewera chifukwa cha matenda aakulu kapena kuwonongeka kwa ntchitoyi.

Kusokonezeka kwa khalidwe la kugonana

Matenda opatsirana okhudzana ndi kugonana amadziwika ndi chizoloŵezi cholephera kuthetsa zofuna zokhudzana ndi kugonana mobwerezabwereza kapena zolimbikitsa, zomwe zimabweretsanso khalidwe la kugonana mobwerezabwereza kwa nthawi yaitali (mwachitsanzo, miyezi isanu ndi umodzi kapena kuposerapo) yomwe imayambitsa kukhumudwa kapena kuwonongeka kwaumwini, banja, chikhalidwe , maphunziro, ntchito kapena mbali zina zofunika pakugwira ntchito.

Zisonyezero zomwe zingachitike pakuphatikizika ndikuphatikizira: Kugonana mobwerezabwereza kumakhala chinthu chofunikira kwambiri pamoyo wa munthu mpaka kunyalanyaza thanzi ndi chisamaliro chaumwini kapena zokonda zina, zochita ndi maudindo; munthu amene akuyesetsa kangapo kuti athetse kapena kuchepetsa kwambiri machitidwe obwerezabwereza ogonana; munthu akupitilizabe kuchita zachiwerewere mobwerezabwereza ngakhale atakumana ndi zovuta monga kusokonekera kwaubwenzi mobwerezabwereza; ndipo munthuyo akupitilizabe kuchita zachiwerewere mobwerezabwereza ngakhale pomwe sakupezanso chisangalalo.

Ngakhale kuti gululi likuwoneka ngati likudalira kudzidalira, limaphatikizidwanso mu chigawo cha ICD-11 matenda osokoneza bongo chifukwa cha kusowa kwachinsinsi chodziwikiratu ngati njira zomwe zikukhudzidwa ndi chitukuko ndi kukonzanso matendawa ndizofanana ndi zomwe zikuwonetsa vutoli ndi zizoloŵezi zamakhalidwe. Kuikidwa kwake ku ICD-11 kudzakuthandizani kuthetsa zosowa zosayenera zosamalira odwala komanso mwina kuchepetsa manyazi ndi kudzimvera chisoni kuphatikizapo kuthandiza pakati pa anthu ovutika maganizo50.

Matenda osokoneza bongo

Matenda osokoneza bongo amadziwika mobwerezabwereza mwachidule pamaganizo kapena kuwonongedwa kwa katundu omwe akuyimira kulephera kuthetsa chilakolako chokwiya, ndi kupwetekedwa kwa chipolowe kapena kupwetekedwa mtima kwakukulu mopanda kufanana ndi kukhumudwa kapena kusokoneza maganizo a maganizo.

Chifukwa chakuti zigawo zoterezi zingathe kuchitika m'madera osiyanasiyana (mwachitsanzo, kutsutsana ndi matenda osokoneza bongo, matenda osokonezeka maganizo, matenda osokoneza bongo), sichiperekedwa ngati zigawozi zikufotokozedwa bwino ndi matenda ena, maganizo kapena a neurodevelopmental disorder.

Ngakhale kuti matenda oopsa a ziphuphu anayamba kuwonetsedwa mu DSM-III-R, adawonekera ku ICD-10 monga kuikapo pansi pa "chizoloŵezi china ndi matenda osokoneza maganizo". Amaphatikizidwa mu gawo la ICD-11 matenda oletsa kusokoneza maganizo pozindikira umboni wochuluka wosonyeza kuti uli woyenera komanso wopindulitsa m'makonzedwe a chipatala51.

Matenda opatsirana kwambiri

Matenda opatsirana am'mimba (PMDD) amadziwika ndi zizindikiro zoopsa, zovuta kapena zamaganizo zomwe zimayambira masiku angapo kusanayambike, kumayamba kusintha mkati mwa masiku angapo, ndipo zimakhala zochepa kapena sizikhalapo pakatha sabata imodzi isanayambe sungani.

Zowonjezereka, matendawa amafunika kukhala ndi zizindikiro za maganizo (kukhumudwa, kukhumudwa), zizindikiro za m'mimba (kuthamanga, kupweteka pamodzi, kudya mopitirira muyeso), kapena zizindikilo zamaganizo (zovuta, kusaiwala) zomwe zachitika nthawi zambiri m'masiku apitawo chaka. Zizindikiro zimakhala zovuta kwambiri kuti zisawonongeke kwambiri kapena kuwonongeka kwakukulu payekha, banja, chikhalidwe, maphunziro, ntchito kapena zinthu zina zofunika kwambiri, ndipo sizikuyimira matenda ena a m'maganizo.

Mu ICD-11, PMDD imasiyanitsidwa ndi matenda ofala kwambiri omwe amabwera asanakwane msambo chifukwa cha kuopsa kwa zizindikilozo ndikuti zimayambitsa mavuto kapena kuwonongeka52. Kuphatikizidwa kwa PMDD muzinthu zofufuzira za DSM-III-R ndi DSM-IV zinayambitsa kufufuza kwakukulu komwe kwatsimikizira kuti ndiyodalirika komanso yodalirika52, 53, zomwe zimapangitsa kuti zikhale pamodzi mu ICD-11 ndi DSM-5. Ngakhale kuti malo ake enieni ku ICD-11 ali pamutu pa matenda a machitidwe opangira thupi, PMDD imapezeka m'magulu ang'onoang'ono a matenda ovutika maganizo chifukwa cha chizindikiro chachikulu cha maganizo.

SUMMARY OF CHANGES NDI ICD-11 GULU LA GULU

Zigawo zotsatirazi zikufotokozera mwachidule kusintha komwe kunayambika m'magulu akuluakulu a matenda a ICD-11 chaputala pa matenda a maganizo, makhalidwe ndi mavuto a m'mayiko ena kuphatikizapo magulu atsopano omwe afotokozedwa m'gawo lapitalo.

Kusintha kumeneku kwachitika potsata ndondomeko ya sayansi yomwe ilipo ndi ICD-11 Working Groups ndi akatswiri othandizira, kuganizira za ntchito zamagetsi ndi zochitika zonse, ndipo ngati n'kotheka, zotsatira za kuyesedwa kwa munda.

Matenda a Neurodevelopmental

Matenda a Neurodevelopmental ndi omwe akuphatikizapo mavuto aakulu pakudziwa ndi kuchitidwa kwa nzeru, magalimoto, chilankhulo kapena chikhalidwe cha anthu poyambira pa nthawi yopititsa patsogolo. Matenda a ICD-11 a neurodevelopmental akuphatikizana ndi magulu a ICD-10 a kuchepa kwa maganizo ndi mavuto a chitukuko cha maganizo, ndi kuwonjezeredwa kwa kuchepa kwa matenda osokoneza bongo (ADHD).

Kusintha kwakukuru ku ICD-11 kumaphatikizapo kuyambanso kusokoneza nzeru zachitukuko ku matenda a ICD-10, omwe anali nthawi yosatha komanso yonyansa yomwe siinagwire mokwanira mawonekedwe osiyanasiyana ndi malingaliro okhudzana ndi chikhalidwe ichi54. Kusokonezeka kwa chitukuko cha nzeru kumapitiriza kufotokozedwa chifukwa cha zolepheretsa zochepa muzochita zamaganizo ndi zowonongeka, zomwe zatsimikiziridwa ndi zovomerezeka, zovomerezeka ndi zovomerezeka payekha. Pozindikira kuti alibe mwayi wopezeka m'madera ambiri padziko lapansi, kapena kuti ogwira ntchito ophunzitsidwa kuti awathandize, komanso chifukwa cha kufunika kokonzekera chithandizo cha mankhwala, ICD-11 CDDG imaperekanso ndondomeko ya makhalidwe abwino magome55.

Masamba osiyana omwe amagwiritsidwa ntchito mwachidwi ndi magulu ogwira ntchito omwe amagwira ntchito moyenera (amalingaliro, chikhalidwe, othandizira) amalinganiza malinga ndi magulu atatu a zaka (ubwana wawo, ubwana / unyamata ndi munthu wamkulu) ndi zovuta zinayi (zofatsa, zochepa, zazikulu, zakuya). Zizindikiro za makhalidwe zimalongosola maluso awo ndi luso lomwe liyenera kuwonetsedwa mkati mwa magawo awa onse ndipo akuyembekezerekanso kudalirika kwa kuonetsa kuopsa kwake ndikukonzekera deta yaumphawi yokhudzana ndi umoyo wokhudzana ndi zovuta za chitukuko cha nzeru.

Matenda a Autism mu ICD-11 amaphatikiza autism yaubwana ndi Asperger's syndrome kuchokera ku ICD-10 pansi pagulu limodzi lomwe limadziwika ndi kuchepa kwa njira yolumikizirana ndi anthu ochepera, obwerezabwereza komanso osasintha machitidwe, zokonda kapena zochitika. Malangizo a vuto la Autism spectrum adasinthidwa kwambiri kuti awonetse zolemba zomwe zilipo, kuphatikiza ziwonetsero m'moyo wonse. Oyenerera amaperekedwa pamlingo wakusokonekera pakugwira ntchito kwanzeru ndi kuthekera kwa chilankhulo kuti athe kujambula zowonetsera zonse za vuto la autism masanjidwe modabwitsa.

ADHD yasintha matenda a ICD-10 hyperkinetic ndipo yasunthira ku gulu la matenda a neurodevelopmental chifukwa cha kukula kwake, kusokonezeka kwaumisiri, magalimoto ndi chikhalidwe cha anthu, komanso zochitika zofanana ndi matenda ena. Kusunthika uku kumayesetsanso kufooka kwachidziwitso cha kuwona ADHD monga chogwirizana kwambiri ndi makhalidwe okhumudwitsa ndi dissocial, chifukwa anthu omwe ali ndi ADHD sakhala osokoneza mwadala.

ADHD ikhoza kudziwika ndi ICD-11 pogwiritsira ntchito ziyeneretso zopanda chidwi, zowopsa kwambiri, kapena zofanana, ndipo zimafotokozedwa kudutsa moyo wonse.

Mapeto ake, matenda aakulu a chi tichipatala, kuphatikizapo matenda a Tourette, amagawidwa mu chaputala cha ICD-11 pa matenda a mitsempha ya mitsempha, koma amalembedwa mndandandanda wa zovuta zokhudzana ndi matendawa chifukwa cha zochitika zawo zapamwamba (mwachitsanzo, ndi ADHD) ndi zomwe zimayambira nthawi yopititsa patsogolo.

Schizophrenia ndi mavuto ena oyambirira a maganizo

Magulu a ICD-11 a schizophrenia ndi mavuto ena oyambirira a psychotic amaloŵa gulu la ICD-10 la schizophrenia, schizotypal ndi mavuto osokoneza bongo. Mawu akuti "pachiyambi" amasonyeza kuti njira za psychotic ndizofunikira kwambiri, mosiyana ndi zizindikiro za psychotic zomwe zingachitike ngati mbali ya mitundu ina ya maganizo (monga matenda, matenda a maganizo)18.

Mu ICD-11, zizindikiro za schizophrenia sizinasinthidwe kuchokera ku ICD-10, ngakhale kuti kufunika kwa zizindikiro zoyambirira za Schneideri kunatsimikizidwira. Kusintha kwakukulu kwambiri ndiko kuchotseratu mankhwala onse a schizophrenia (mwachitsanzo, paranoid, hebephrenic, catatonic), chifukwa chosowa chitsimikizo kapena chofunikira pa chisankho cha mankhwala. M'malo mwa subtypes, ndondomeko ya zofotokozera zowonjezera zakhazikitsidwa18. Izi zikuphatikizapo: zizindikiro zabwino (zonyansa, malingaliro, malingaliro ndi makhalidwe osasokonezeka, zochitika zowonongeka ndi kulamulira); Zizindikiro zoipa (zowonongeka, zopanda pake kapena zosalala, zokhala ndi mawu otukwana kapena otukwana, kuvomereza, anhedonia); zizindikiro zowopsya; zizindikiro za manic; zizindikiro za maganizo (kugwedezeka kwa maganizo, kuchepa kwa maganizo, zizindikiro za catatonic); ndi zizindikilo zamaganizo (makamaka kuchepa kwachangu, kukambirana, kutsogolera, chiweruzo, kutaya, kuwerenga mawu kapena maonekedwe, ndi kukumbukira ntchito). Zizindikiro zomwezo zimagwiritsidwanso ntchito ku magulu ena mu gulu (schizoaffective disorder, matenda osokoneza maganizo a nthawi yayitali, matenda osokoneza bongo).

Kachilombo ka ICD-11 schizoaffective chimafunikanso kuti pakhale nthawi yomweyo kukhalapo kwa matenda a schizophrenia ndi nthawi yachisokonezo. Matendawa amatanthauza kufotokoza zochitika zomwe zikuchitika pakadwala ndipo sizimangoganizira mozama nthawi zonse.

ICD-11 matenda osokoneza maganizo a m'maganizo ndi omwe amatha nthawi yayitali amadziwika ndi chidziwitso chodziwika bwino cha zizindikiro za psychotic zomwe zimasinthasintha mofulumira m'chilengedwe komanso mwamphamvu pa nthawi yochepa ndikupitirira miyezi itatu. Izi zimangogwirizana ndi vuto la "polymorphic" la matenda a psychotic ovuta kwambiri mu ICD-10, yomwe ndi yofala kwambiri komanso yosagwirizana ndi schizophrenia56, 57. Mankhwala osadziwika bwino a matenda a psychotic a ICD-10 amachotsedwera ndipo amatha kusindikizidwa ku ICD-11 monga "matenda ena oyambirira a maganizo".

Monga momwe zilili ndi ICD-10, matenda a schizotypal amagawidwa mu gululi ndipo sali ngati vuto la umunthu.

Matenda a maganizo

Mosiyana ndi ICD-10, mafilimu a ICD-11 sizomwe amadziwiratu okha, komabe chitsanzo chawo pa nthawi chimagwiritsidwa ntchito ngati maziko a chisokonezo chomwe chimapangitsa kuti munthu adziwe bwino.

Matenda a maganizo amagawidwa m'mabvuto ovutika maganizo (omwe amachititsa vuto limodzi losokonezeka maganizo, matenda osokoneza maganizo, matenda osokoneza bongo, ndi matenda osokonezeka maganizo) komanso matenda ochititsa munthu kusinthasintha zochitika (kuphatikizapo matenda a bipolar, matenda a bipolar, ndi cyclothymia). ICD-11 imagwirizanitsa matenda a ICD-10 matenda a bipolar mu mtundu wa bipolar I ndi mtundu wa II. Magulu osiyana a ICD-10 a matenda osasinthasintha a maganizo, omwe ali ndi dysthymia ndi cyclothymia, achotsedwa58.

Mndandanda wa zowonongeka za nyengo yowawa ndi imodzi mwa malo ochepa mu ICD-11 komwe kuwerengera kochepa kwa chizindikiro kumafunikira. Izi ndi chifukwa cha kufufuza kwa nthawi yaitali ndi chizoloŵezi cha chikhalidwe cha kuganiza movutika maganizo mwa njira imeneyi. Zizindikiro zosachepera zisanu ndizofunika kuposa zizindikiro zinayi zokha zomwe zingatheke ku ICD-10, motero zimakhala zofanana ndi DSM-5. CDDG ya ICD-11 imapanga zizindikiro zosokonezeka m'magulu atatu - okhudzidwa, ozindikira komanso odwala matendawa - kuthandiza madokotala kuti alingalire ndi kukumbukira chiwonetsero chachikulu cha matenda opweteka. Kutopa ndi mbali ya khungu la chizindikiro cha m'magazi koma sichionanso kuti ndikwanira ngati chizindikiro cholowera; M'malo mwake, mwina pafupifupi nthawi zonse maganizo ovutika maganizo kapena kuchepa chidwi pa ntchito zosachepera milungu iwiri yofunikira. Kupanda chiyembekezo kwawonjezeredwa ngati chizindikiro chowonjezeranso cha chidziwitso chifukwa cha umboni wamphamvu wokhudzana ndi matenda ovutika maganizo59. CDD-11 CDDG imapereka chitsogozo choonekeratu pa kusiyana pakati pa chikhalidwe cha chikhalidwe chachisoni ndi zizindikiro zomwe zimafuna kulingalira monga nyengo yowawa mu nkhani yakuferedwa60.

Pachiyambi cha manic, ICD-11 imafuna kukhalapo kwa chizindikiro cha msinkhu wowonjezereka wa ntchito yowonjezereka kapena kudzidzimutsa kwachidziwitso cha mphamvu yowonjezera, kuphatikizapo kuwonjezeka, kukhumudwa kapena kuwonjezeka. Izi zikutanthawuza kuti asamangidwe ndi zolakwika zomwe zingakhale bwino monga chizoloŵezi chosinthika. Magulu a ICD-11 amapangidwa ngati njira yowonongeka ya ziwalo za munthu popanda kukhala ndi vuto lalikulu.

Zithunzi zosokoneza zimatchulidwa mu ICD-11 m'njira yomwe imalinganiza ndi ICD-10, malinga ndi umboni wodalirika wa njirayi61. Chitsogozo chimaperekedwa motsatira zizindikiro zowononga zapopopu zomwe zimawonedwa pamene zizindikiro zamanyazi kapena zipsyinjo zimapangitsa. Kukhalapo kwa chigawo chosakanikirana kumasonyeza mtundu wa bipolar I diagnosis.

ICD-11 imapereka ziyeneretso zosiyanasiyana kufotokozera zochitika zamakono kapena kukhululukidwa (mwachitsanzo, mwachindunji kapena mu chikhululukiro chonse). Zosokonezeka, zaumunthu komanso zowonjezereka zikhoza kufotokozedwa ngati ziri ndi kapena popanda zizindikiro za psychotic. Mipingo yodetsa nkhaŵa yamakono pambali ya matenda opsinjika maganizo kapena ochititsa munthu kusinthasintha zolaula amatha kudziwika kwambiri ndi kuuma (yofatsa, yochepa kapena yovuta); ndi zizindikiro zosakanikirana zomwe zimagwirizana ndi maganizo a somatic syndrome ku ICD-10; ndi choyenerera kuti adziwe zigawo zosalekeza za zaka zoposa ziwiri. Zochitika zonse zapakati pa matenda ovutika maganizo kapena ochititsa munthu kusinthasintha zochitika zingathe kufotokozedwa mogwiritsidwa ntchito pogwiritsa ntchito zizindikilo zapamwamba zozizwitsa; choyimira chosonyeza kuti pali mantha; ndi choyenerera kuti muzindikire kachitidwe ka nyengo. Cholinga cha maulendo oyendetsa njinga amapezekanso pa matenda a bipolar matenda.

ICD-11 imaphatikizapo gulu la chisokonezo chosokonezeka ndi nkhawa chifukwa cha kufunika kwake pa zochitika zapadera62, 63. Chigawochi chachotsedwa ku matenda a nkhaŵa ku ICD-10 ku matenda opsinjika mu ICD-11 chifukwa cha umboni wokhudzana ndi zizindikiro za maganizo64.

Nkhawa ndi matenda okhudzana ndi mantha

ICD-11 imabweretsa pamodzi kusokonezeka ndi nkhawa kapena mantha monga chipangizo chachikulu mu gululi65. Mogwirizana ndi kayendetsedwe ka moyo wa ICD-11, gululi likuphatikizanso kugawanika kwa matenda osokoneza maganizo ndi chisankho chosankha, chomwe chinayikidwa pakati pa mavuto aunyamata ku ICD-10. Kusiyanitsa kwa ICD-10 pakati pa matenda a phobic ndi matenda ena othetsa nkhaŵa kwachotsedwa mu ICD-11 pofuna njira yowonjezereka yogwiritsira ntchito njira yodziŵira nkhawa ndi mantha alionse potsata mantha66; ndiko kuti, zokopa zomwe zimafotokozedwa ndi munthuyo monga kuyambitsa kudetsa nkhaŵa zake, kuwukakamiza kwamtundu wa thupi ndi mayankho okhudza khalidwe. Matenda a chibadwidwe (GAD) amadziwika ndi mantha ambiri kapena osadandaula omwe sali okhudzidwa ndi china chilichonse.

Mu ICD-11, GAD ili ndi zida zofunikira kwambiri, zomwe zikuwonetseratu kupita patsogolo pomvetsetsa zochitika zake zodabwitsa; makamaka, kudandaula kumawonjezeredwa ndi mantha ambiri monga chinthu chachikulu cha matendawa. Mosiyana ndi ICD-10, ICD-11 CDDG imanena kuti GAD ikhoza kugwirizanitsa ndi vuto lachisokonezo malinga ngati zizindikiro zilipo pokhapokha pazigawo zozizwitsa. Mofananamo, malamulo ena a ICD-10 oletsedwa (mwachitsanzo, GAD sangapezedwe ndi matenda a phobic kapena matenda osokoneza maganizo) amachotsedwanso, chifukwa cha kupambana kwa chisokonezo cha ICD-11 komanso umboni wakuti malamulowa kusokoneza ndi kupeza ndi kuchiza zinthu zomwe zimafuna kuti munthu asamangoganizira zachinsinsi.

Mu ICD-11, agoraphobia amadziwika kuti ndi mantha komanso nkhawa kapena nkhawa zomwe zimachitika, kapena kuyembekezera, zochitika zingapo pomwe kuthawa kungakhale kovuta kapena kuthandizira kupezeka. Chowopsya chimakhala mantha a zotsatira zoyipa zomwe zitha kutilepheretsa kapena kuchititsa manyazi munthawiyo, zomwe ndizosiyana ndi lingaliro laling'ono mu ICD-10 kuwopa malo otseguka ndi zochitika zina, monga unyinji, komwe kuthawira ku malo otetezeka atha kukhala ovuta.

Kusokonezeka kwapanikizi kumatanthauzidwa mu ICD-11 ndi zosayembekezereka zosayembekezereka zomwe zimachitika mosayembekezereka zomwe sizingowonjezera zokhumudwitsa kapena zochitika zinazake. CDD-11 CDDG imasonyeza kuti kuopsezedwa kumene kumachitika kwathunthu poyang'ana kuwonetseredwa kapena kuyembekezera chiopsezo chowopsya mu matenda opatsidwa (mwachitsanzo, kuyankhula pagulu mu matenda a chisokonezo cha anthu) sizikutanthauza kuti pali vuto lina lakumangika kwa mantha. M'malo mwake, "ndi mantha" amatha kugwiritsidwa ntchito ku matenda ena odwala matendawa. Cholinga cha "mantha ndi mantha" chingagwiritsidwe ntchito pa zovuta zina zomwe nkhawa ndizodziwika ngakhale kuti sizinapangidwe (mwachitsanzo, mwa anthu ena pa nthawi yachisoni).

Matenda a ICD-11, omwe amawadetsa nkhawa chifukwa cha mantha omwe anthu ena amawayeza, amalowetsa ziwalo za ICD-10.

CDD-11 CDDG imalongosola momveka bwino kupatukana kwa matenda akuluakulu pakati pa anthu akuluakulu, komwe nthawi zambiri imakhala pa wokondedwa kapena mwana.

Matenda osokoneza maganizo ndi ofanana

Kuyamba kwa gulu la OCRD mu ICD-11 likuimira kuchoka kwa ICD-10. Zomwe zimachitika pakupanga gulu la OCRD ndizosiyana ndi matenda ndi nkhawa, ngakhale zochitika zowonjezereka, zimachokera ku chithandizo chogwiritsira ntchito matenda omwe amachititsa kuti anthu asabwerere maganizo awo komanso zizoloŵezi zowonongeka mofanana ndi chiyambi cha chipatala. Kugwirizana kwa chidziwitso cha gululi kumachokera ku umboni wowonekera wa zomwe zimagwirizanitsidwa pakati pa zovuta zomwe zikuphatikizapo zojambula, zojambula zam'mimba ndi zamaganizo35.

ICD-11 OCRD ikuphatikizapo matenda osokoneza bongo, matenda osokoneza thupi, matenda osokoneza bongo, hypochondriasis (matenda ovutika ndi matenda) ndi kusokoneza matenda. Milandu yofanana yomwe ilipo mu ICD-10 ili m'magulu osiyana. Kuphatikizapo OCRD ndi kagulu kakang'ono kamene kamangoyamba kugwiritsidwa ntchito mobwerezabwereza kamene kamakhala ndi trichotillomania (matenda okoka tsitsi) ndi kuwonetsa khungu (zokopa khungu), zonse zigawenga zomwe zimachitika mobwerezabwereza popanda zozindikira za OCRDs zina. Matenda a tourette, matenda a mitsempha ya ICD-11, ndi yolembedwa m'magulu a OCRD chifukwa chakuti nthawi zambiri amakhala ndi vuto losautsa.

ICD-11 imakhala ndi zigawo zazikulu za matenda a ICD-10 ovuta kwambiri, omwe amatanthauza obsessions obsessions ndi / kapena makakamizo, koma ndi zofunikira zina. ICD-11 imakulitsa lingaliro la obsessions kupitirira malingaliro osayenerera kuti aziphatikiza mafano osafunidwa ndi zofuna / zofuna. Kuwonjezera apo, lingaliro la makakamizo likuwonjezeredwa kuphatikizapo chidziwitso (mwachitsanzo, mobwerezabwereza kuwerengera) komanso makhalidwe obwerezabwereza.

Ngakhale kuti nkhaŵa ndizovuta kwambiri zomwe zimagwirizanitsidwa ndi obsessions, ICD-11 imatchula momveka bwino zochitika zina zomwe odwala amanyalanyaza, monga kunyansidwa, manyazi, "kutengeka", kapena kusowa mtendere kuti zinthu siziwoneka kapena "zolondola". ICD-10 subtypes ya OCD imachotsedwa, chifukwa odwala ambiri amafotokoza zonse zovuta ndi zovuta, ndipo chifukwa chakuti alibe umboni wodalirika woti ayankhidwe. Kuletsa kwa ICD-10 kukana matenda osokoneza bongo limodzi ndi matenda ovutika maganizo kumachotsedwa ku ICD-11, kuwonetsa kuchuluka kwa zochitika zina za matendawa ndi kufunikira kwa mankhwala osiyana.

Hypochondriasis (matenda ovutika maganizo) amaikidwa mu OCRD m'malo movutika ndi nkhawa ndi mantha, ngakhale kuti nthawi zambiri thanzi labwino limayanjanitsidwa ndi nkhawa ndi mantha, chifukwa cha zochitika zapadera zomwe zimagwirizanitsa mabanja ndi OCRD67. Komabe, hypochondriasis (matenda ovutika maganizo) ali m'magulu okhudzidwa ndi nkhawa ndi mantha, pozindikira kuti pali zochitika zina zosayembekezereka.

Matenda a dysmorphic, matenda osokoneza bongo, komanso kuletsa matenda ndi magulu atsopano ku ICD-11 omwe aphatikizidwa mu gulu la OCRD.

Mu OCRDs omwe ali ndi chidziwitso, zikhulupiliro zikhoza kuchitika ndi zowonongeka kapena zowonjezera zomwe zimawoneka ngati zonyenga. Pamene zikhulupilirozi zikhale zogwirizana ndi zozizwitsa za OCRD, popanda zizindikilo zina za psychotic, ziyeneretsozo "zoyipa kuti zisamvetsetse" ziyenera kugwiritsidwa ntchito, ndipo matenda sayenera kuperekedwa. Izi ndi cholinga chothandizira kuti asamalandire chithandizo chosayenera kwa psychosis pakati pa anthu ndi OCRDs35.

Matenda okhudzana ndi nkhawa

Mgwirizano wa ICD-11 wa mavuto omwe umagwirizanitsa ndi nkhawa umalowetsa machitidwe a ICD-10 ku zovuta zowonongeka ndi kusintha, kutsindika kuti matendawa amagawana zofunikira (koma zosakwanira) zofunikira kuti athe kukhumudwa, komanso kusiyanitsa kuphatikizapo zovuta kuchokera ku matenda ena osiyanasiyana omwe amayamba monga momwe amachitira ndi zopanikizika (mwachitsanzo, matenda osokonezeka)41. ICD-10 kugwirizanitsa zovuta za ubwana ndi kulepheretsa kusokonezeka kwa ubwana waumunthu kumagwiritsidwa ntchito ku gululi chifukwa cha kayendetsedwe ka moyo wa ICD-11 komanso kuzindikira zokhudzana ndi zovuta zomwe zimayambitsa matendawa. ICD-11 imaphatikizapo maulendo angapo ofunikira kwambiri ku ICD-10 komanso kukhazikitsa PTSD yovuta ndi matenda osokoneza maganizo, omwe alibe ofanana ndi ICD-10.

PTSD imatanthauzidwa ndi zinthu zitatu zomwe ziyenera kukhalapo nthawi zonse ndipo ziyenera kuyambitsa vuto lalikulu. Iwo ali: Kukumana ndi zovuta zomwe zikuchitika pakalipano; kupewa mwachindunji zikumbutso zomwe zingathe kubweretsanso; ndi malingaliro opitilira a zowonjezereka zowopsya zamakono. Kuphatikizidwa kwa chiyeso chokhalanso ndi chidziwitso, chokhudzidwa kapena chikhalidwe cha zovuta zomwe zili pano komanso panopa osati kukumbukira zokhazokha zomwe zikuyembekezeredwa kuti zithetse vuto la PTSD ku ICD-1042.

Matenda osinthika mu ICD-11 amafotokozedwa motengera pa chikhalidwe chachikulu chokhudzidwa ndi nkhawa ya moyo kapena zotsatira zake, pamene ICD-10 matendawa anapezeka ngati zizindikiro zikuchitika chifukwa cha zovuta za moyo sizikugwirizana ndi zofunikira zenizeni wa matenda ena.

Potsirizira pake, kupanikizika kwakukulu sikunayambanso kuganiza kuti ndi matenda a maganizo mu ICD-11, koma kumamveka kuti ndi njira yachizolowezi yowonongeka kwambiri. Motero, amagawidwa mu chaputala cha ICD-11 pa "zinthu zomwe zimakhudza umoyo kapena kukhudzana ndi mautumiki a zaumoyo", koma mndandanda wa zovuta zomwe zimagwirizanitsa ndi nkhawa kuti zithandizidwe ndi matenda osiyanasiyana.

Matenda a dissociative

Magulu a ICD-11 matenda a dissociative amagwirizana ndi matenda a ICD-10 dissociative (kutembenuka), koma akhala akukonzedwanso mozama komanso ophweka, kusonyeza zochitika zatsopano zamakono komanso kupititsa patsogolo ntchito zamagetsi. Malinga ndi mawu akuti "kutembenuka mtima" amachotsedwa pa mutu wa gulu68. Matenda a ICD-11 a dissociative neurological symptom matenda akugwirizana kwambiri ndi matenda a ICD-10 a dissociative of movement ndi kumva, koma akuwonedwa ngati matenda amodzi omwe ali ndi matenda khumi ndi awiri (mwachitsanzo, kusokonezeka kwa maso, osagwidwa ndi khunyu , kusokonezeka kwa mawu, kufooka kapena kufooka). ICD-11 dissociative amnesia imaphatikizapo ziyeneretso kuti zisonyeze ngati fukani ya dissociative ilipo, chodabwitsa chimene chimatchulidwa ngati matenda osiyana mu ICD-10.

ICD-11 imagawaniza matenda a ICD-10 kukhala ndi matenda azisokonezo m'matenda osiyanasiyana azovuta zamatenda amisala komanso matendawa. Kulekanitsidwaku kumawonetsera mawonekedwe apadera okhala ndi vuto lamisala momwe malingaliro achikhalidwe aumwini amasinthidwa ndikudziwika "wakunja" komwe kumachitika chifukwa cha mphamvu yamzimu, mphamvu, mulungu kapena chinthu china chauzimu. Kuphatikiza apo, mitundu yambiri yazovuta kwambiri imatha kuwonetsedwa ili ndi vuto lokhala ndi chizimbwizimbwi, pomwe vuto la tulo limangobwereza kubwereza repertoire yaying'ono yazikhalidwe zosavuta.

Matenda osokoneza bongo a ICD-11 amafanana ndi lingaliro la ICD-10 vuto la umunthu ndipo amatchulidwanso kuti likhale logwirizana ndi dzina lomwe likugwiritsidwa ntchito pakadali pano pachipatala komanso pakafukufuku. ICD-11 imayambitsanso vuto losadziwika bwino, posonyeza kuti kusokonekera kwa matenda osadziwika a ICD-10 kumawerengedwa ndi mawonetseredwe omwe sianthu odziwika kwambiri omwe samagwiritsa ntchito mphamvu zawo pakumvetsetsa.

Kusokoneza maganizo ndi matenda osokoneza bongo, omwe ali m'magulu ena a matenda a ubongo ku ICD-10, amasunthira ku magulu a dissociative matenda mu ICD-11.

Kudyetsa ndi matenda odwala

Gulu la ICD-11 la kudyetsa ndi matenda akudya limaphatikizapo matenda a ICD-10 ndi zakudya zoyamwitsa zaunyamata, pozindikira kuti matendawa ndi osiyana pakati pa moyo wawo wonse, komanso kusonyeza umboni wakuti matendawa angagwiritsidwe ntchito kwa anthu pafupipafupi zaka zambiri45, 47.

ICD-11 imapereka ndondomeko zatsopano za anorexia nervosa ndi bulimia nervosa kuti ziphatikize umboni waposachedwa, womwe umathetsa kufunikira kwa ICD-10 "magawo". Zimaphatikizansopo magulu atsopano a matenda oledzeretsa, omwe amawunikira pogwiritsa ntchito thandizo lothandizira kuti likhale lovomerezeka, komanso ARFID, yomwe imawonjezera matenda a ICD-10 kuyambira ukhanda ndi ubwana.

Anorexia nervosa mu ICD-11 imachotsa chofunikira cha ICD-10 kuti pakhale vuto la endocrine, chifukwa umboni ukusonyeza kuti izi sizimachitika nthawi zonse ndipo, ngakhale zilipo, ndizotsatira za kulemera kwa thupi m'malo mosiyana Kufotokozera zakusokonekera. Kuphatikiza apo, milandu yopanda matenda a endocrine makamaka imayambitsa matenda a anorexia. Malire ochepera thupi mu ICD-11 amakwezedwa kuchokera ku 17.5 kg / m2 mpaka 18 kg / m2, koma zotsatilazi zimagwirizana ndi zochitika zomwe mndandanda wa misala ya thupi sungaganizire mokwanira chithunzi choyipitsa chithandizo (mwachitsanzo, kutayika kwapadera pa zochitika zina za matendawa). Anorexia nervosa sikutanthauza "mafuta phobia" monga ICD-10, kulola kuti mitundu yambiri ya chikhalidwe ikhale yotsutsana ndi chakudya komanso maonekedwe a thupi.

Oyenerera amaperekedwa kuti awononge kukula kwa chiwerengero cha kuchepa kwa thupi, chifukwa chakuti chiwerengero chochepa kwambiri cha thupi chimakhudzidwa ndi chiopsezo chachikulu cha kufooka ndi kufa. Choyimira chofotokozera chitsanzo cha makhalidwe ogwirizana chikuphatikizidwa (mwachitsanzo, kuletsa chitsanzo, chitsanzo cha binge-purge).

Bulimia nervosa mu ICD-11 ikhoza kupezedwa mosavuta kulemera kwake kwa munthu payekha, malinga ngati chiwerengero cha misala cha thupi sichiri chochepa kwambiri kuti chikwaniritse zofunikira zenizeni za anorexia nervosa. M'malo mwazigawo zochepa zomwe zimakhala zochepa, zomwe sizigwirizana ndi umboni, ICD-11 imapereka malangizo othandizira. Bulimia nervosa matenda sikutanthauza kuti "cholinga" chabongo ndipo chingapezeke chifukwa cha "mabongo" omwe munthu amadya kwambiri kapena mosiyana ndi momwe amachitira nthawi zonse ndipo amatha kusokonezeka chifukwa chodya limodzi ndi mavuto, mosasamala kanthu za kuchuluka kwake chakudya chomwe amadya. Kusintha kumeneku kuyenera kuchepetsa chiwerengero cha kudyetsedwa kosadziŵika bwino ndi matenda odwala matenda.

Matenda othetsa mavuto

Mawu akuti "non-organic" amachotsedwa ku matenda a ICD-11, omwe amachititsa enuresis ndi encopresis. Matendawa amasiyana kwambiri ndi omwe angakhale abwino chifukwa cha matenda ena kapena ziwalo za thupi.

Kusokonezeka kwa masautso ndi thupi

Matenda a ICD-11 wamavuto amthupi komanso zokumana nazo zathupi zimaphatikizira zovuta ziwiri: kusokonezeka kwa thupi komanso kukhulupirika kwa thupi dysphoria. Matenda achilengedwe a ICD-11 amalowetsa m'matenda a ICD-10 somatoform komanso malingaliro a ICD-10 neurasthenia. ICD-10 hypochondriasis sichiphatikizidwa ndipo m'malo mwake imatumizidwa mgulu la OCRD.

Matenda aumphawi amadziwika ndi kukhalapo kwa zizindikiro za thupi zomwe zimamuvutitsa munthuyo komanso kusamala kwambiri za zizindikiro, zomwe zingawonetseke poyanjana mobwerezabwereza ndi ogwira ntchito zaumoyo69. Matendawa amalingalira ngati akupezekabe mopitirira malire ndipo amatha kukhala oyenerera (wofatsa, wochepetsera kapena wovuta) malingana ndi momwe zimakhudzidwira. Chofunika kwambiri, matenda aumphawi amafotokozedwa molingana ndi kupezeka kwa zinthu zofunika, monga kupsinjika ndi maganizo olakwika ndi makhalidwe, osati chifukwa cha zovuta zachipatala zosonyeza zizindikiro zovutitsa, monga ICD-10 somatoform disorders.

ICD-11 thupi lodalirika dysphoria ndi njira yatsopano yowunikira yomwe ikuphatikizidwa mu gululi48.

Kusokonezeka chifukwa cha kugwiritsira ntchito mankhwala ndi makhalidwe oledzera

Magulu a ICD-11 a mavuto chifukwa cha kugwiritsiridwa ntchito kwa mankhwala ndi zizolowezi zoledzera amaphatikizapo mavuto omwe amayamba chifukwa cha kugwiritsa ntchito zinthu zakuthupi, kuphatikizapo mankhwala, ndi mavuto chifukwa cha khalidwe lachilendo lomwe limakhalapo chifukwa cha kubwereza kowonjezera kopindulitsa ndi kulimbikitsa makhalidwe.

Kugwiritsidwa ntchito kwa matenda a ICD-11 chifukwa chogwiritsa ntchito mankhwala kumagwirizana ndi njira ya ICD-10, kumene syndromes zachipatala zimagawidwa molingana ndi makala70. Komabe, mndandanda wa zinthu zomwe zili mu ICD-11 zowonjezereka kuti ziwonetsetse kupezeka kwaposachedwapa ndi kayendedwe ka ntchito zamakono. Chinthu chilichonse kapena mankhwala amtundu wina akhoza kugwirizanitsidwa ndi mankhwala oyambirira omwe amagwiritsidwa ntchito pokhapokha ngati mankhwala osokoneza bongo kapena mankhwala osokoneza bongo, omwe akuyimira ntchito yowonongeka ya ICD-10; ndi kudalira kwathunthu. Kuledzeretsa kwa thupi ndi kuwonongeka kwa mankhwala kungapezekenso pamodzi ndi syndromes zam'chipatala kapena mwachindunji monga chifukwa chobwezera thandizo la zaumoyo pamene njira yogwiritsira ntchito kapena kuthekera kwa kudalira sikudziwika.

Chifukwa cha matenda aakulu padziko lonse a matenda chifukwa cha kugwiritsa ntchito mankhwala, gululi lakonzedwanso kuti likhale lothandiza kuti athe kulandira chithandizo chaumoyo chomwe chingakhale chothandiza m'magawo osiyanasiyana, kuthandizira kuwunika molondola ndi kulengeza, ndikudziwitsa onse kupewa ndi kuchiza70. Kuwonjezerapo kwa ICD-11 nthawi imodzi yogwiritsira ntchito mankhwala osokoneza bongo kumapereka mpata wochitapo kanthu ndikuletsa kuwonjezereka kwa ntchito ndi kuvulaza, pamene matenda a chizolowezi chogwiritsira ntchito ndi kugonjera mankhwala akusonyeza kufunikira kochita zambiri molimbika.

ICD-11 imafotokoza lingaliro la kuvulaza kwa thanzi chifukwa cha mankhwala ogwiritsira ntchito mankhwala kuti awononge thanzi la anthu ena, zomwe zingaphatikizepo kuvulaza thupi (mwachitsanzo, chifukwa choyendetsa mowa mwauchidakwa) kapena kuvulaza maganizo (mwachitsanzo, kukula kwa PTSD kutsatila ngozi ya galimoto).

ICD-11 imaphatikizapo matenda omwe amachititsa munthu kukhala ndi matenda monga syndromes omwe amadziwika ndi zizindikiro zamaganizo kapena zamakhalidwe zomwe zimakhala zofanana ndi matenda ena amtima koma zomwe zimachitika chifukwa cha kugwiritsa ntchito mankhwala osokoneza bongo. Matenda omwe amachititsa kuti thupi likhale ndi vutoli akhoza kugwirizana ndi kuledzeretsa kapena kutaya mankhwala, koma kukula kwake kwa nthawi yaitali kapena kuchuluka kwa zizindikiro zimakhala zochulukirapo pazoledzeretsa kapena kutaya chifukwa cha zinthu zomwe zafotokozedwa.

ICD-11 imaphatikizapo magulu omwe amagwiritsa ntchito mankhwala osokoneza bongo, omwe sagwiritsidwa ntchito ngati matenda osokonezeka maganizo koma amakhala mu chaputala pa "zifukwa zomwe zimakhudza umoyo kapena kukhudzana ndi zaumoyo". Magulu amenewa angagwiritsidwe ntchito ngati njira yogwiritsira ntchito mankhwala imapangitsa kuti pakhale mavuto omwe amachititsa munthu wogwiritsa ntchito mankhwala kapena ena kuopsa kwa thanzi kapena kwa ena, malinga ndi zomwe zimapereka malangizo ndi uphungu kuchokera kwa akatswiri azaumoyo, koma palibe choipa choposa chomwe chinachitika. Amafuna kuti awonetsere mwayi wochitapo kanthu mofulumira komanso mwachidule, makamaka m'makonzedwe apadera.

Matenda a ICD-11 chifukwa cha zizoloŵezi zosokoneza bongo ali ndi magawo awiri a matenda: kutchova njuga (kutchova njuga ku ICD-10) ndi vuto la masewera, lomwe lafalitsidwa posachedwa49. Ku ICD-10, kutchova njuga kumatchulidwa ngati chizoloŵezi ndi matenda osokoneza maganizo. Komabe, umboni wamakono umasonyeza kufunikira kofanana pakati pa zovuta chifukwa cha khalidwe lachiwerewere ndi mavuto ogwiritsa ntchito mankhwala, kuphatikizapo zochitika zawo zapamwamba komanso zomwe zimagwirizanitsa poyambirira kukondweretsa ndikutsatiridwa ndi kupititsa patsogolo kutaya mtengo wa hedonic ndi kusowa kwa ntchito yowonjezereka. Komanso, vutoli chifukwa cha kugwiritsiridwa ntchito kwa mankhwala ndi zovuta chifukwa cha khalidwe lachiwerewere zimawoneka kuti likugawanitsa zokhudzana ndi matenda a ubongo, makamaka kutsegulira ndi kukonzanso njira mkati mwa mphotho ndi maulendo opatsa mphamvu71.

Pewani kusokoneza maganizo

Matenda a ICD-11 amachititsa kuti munthu asamangokhalira kumangokhalira kukakamizika, kuyendetsa galimoto kapena kukakamiza kuchita zinthu zomwe zimapindulitsa munthuyo, panthawi yochepa, ngakhale pangozi yowononga munthuyo kapena kwa ena.

Gululi limaphatikizapo pyromania ndi kleptomania, zomwe zimayikidwa mu ICD-10 pansi pa chizoloŵezi ndi matenda osokoneza.

ICD-11 imayambitsa matenda osokoneza bongo komanso imatsitsimula kwambiri kugonana kwa ICD-10 ku gululi monga ICD-11 matenda osokoneza bongo50, 72, 73.

Zosokoneza khalidwe ndi matenda a dissocial

Magulu a ICD-11 a mikhalidwe yosokoneza ndi matenda a dissocial amachititsa matenda a ICD-10. Mawu atsopano bwino akuwonetsa kukula kwathunthu kwa makhalidwe ndi zozizwitsa zomwe zimachitika muzigawo ziwiri zomwe zikuphatikizidwa mu magulu awa: kutsutsana ndi matenda osokoneza bongo komanso khalidwe la dissocial. Kusintha kwakukulu komwe kunayambika mu ICD-11 ndikuti matenda onsewa angathe kupezeka pa nthawi yonse ya moyo, pamene ICD-10 imawauza ngati mavuto a ubwana. Kuonjezerapo, ICD-11 imayambitsa ziyeneretso zomwe zimayambitsa makhalidwe okhumudwitsa ndi matenda a dissocial omwe cholinga chawo chikuthandizira kusintha chithandizo chamagetsi (mwachitsanzo, mwatsatanetsatane).

ICD-11 kutsutsana ndi matenda osokoneza maganizo amalinganiza mofanana ndi gulu lofanana nalo la ICD-10. Komabe, "kukhala ndi chilema chosapsa mtima ndi kupsa mtima" kumaperekedwera kuti ziwonetsere zomwe zikuwonetseratu za matendawa ndi zovuta, zomwe zimapsa mtima komanso zokwiya. Msonkhanowu ukuzindikiritsidwa kuti uwonjezere chiopsezo chachikulu chotengera kuvutika maganizo ndi nkhawa. Chidziwitso cha ICD-11 cha mafotokozedwe ameneŵa ngati mawonekedwe a kutsutsana ndi matenda osokoneza maganizo ali ovomerezana ndi umboni wamakono komanso osiyana kuchokera ku DSM-5 njira yakuyambitsa matenda atsopano, kusokoneza maganizo kwa matenda osokoneza maganizo74-76.

Matenda a ICD-11 amalimbitsa zizindikiro zitatu zosiyana siyana zomwe zimachitika ku ICD-10 (mwachitsanzo, kutsekeredwa ku banja, kusagwirizana, kusagwirizana). ICD-11 imavomereza kuti mavuto okhumudwitsa ndi a dissocial nthawi zambiri amakhudzidwa ndi zovuta zochitika m'maganizo ndi zoopsa za maganizo, monga kukanidwa kwa anzanga, zovuta za anzawo, komanso matenda a maganizo a makolo. Kusiyana kwakukulu pakati pa ubwana ndi chiyambi cha matendawa kungasonyezedwe ndi chidziwitso, malinga ndi umboni wakuti poyamba wayamba kudwala matenda ovuta kwambiri komanso matenda osauka.

Woyenerera kuwonetsa kukondera kwakanthawi kochepa atha kupatsidwa zochitika zosokoneza komanso zovuta zamtundu wina. Potengera matenda omwe amatsutsana ndi omwe akutsutsana, chiwonetserochi chimalumikizidwa ndi chikhalidwe chokhazikika komanso chotsutsana kwambiri. Pankhani yamakhalidwe osokoneza bongo, imalumikizidwa ndi chizolowezi chokhwima, chankhanza komanso chokhazikika pamakhalidwe osagwirizana ndi anthu.

Matenda a umunthu

Mavuto ndi ICD-10 mndandanda wa zovuta khumi za umunthu zimaphatikizapo kuchepa kwakukulu pakati pa anthu omwe ali ndi matenda ena aumphawi, kuti ndi ziwiri zokha zaumunthu (umunthu wosasinthasintha wa umunthu, mtundu wa borderline, ndi dissocial personality disorder) zinalembedwa ndi mafupipafupi onse m'mabuku opezeka pamsonkhanopo, ndipo malingaliro omwe analipo anali okwera kwambiri, ndipo anthu ambiri omwe ali ndi vuto lalikulu amakwaniritsa zofunikira za matenda osiyanasiyana16, 17.

ICD-11 CDDG imufunsa wachipatala kuti adziwe ngati zomwe akuwonetserako zachipatala zikukwaniritsa zofunikira za matenda amunthu. Wodwala ndiye amalingalira ngati kuzindikira kuti ali ndi vuto lofatsa, lochepa kapena lovuta la umunthu ndiloyenera, kutengera: a) kuchuluka ndi kufalikira kwa zosokoneza pakugwira ntchito zaumwini (mwachitsanzo, kukhazikika ndi mgwirizano wazidziwitso, kudzidalira, kulondola odziwonera wekha, kuthekera kodziwongolera); b) kukula ndi kufalikira kwa kusagwirizana pakati pa anthu (mwachitsanzo, kumvetsetsa malingaliro a ena, kukulitsa ndikusunga maubwenzi apamtima, kukonza mikangano) m'malo osiyanasiyana ndi maubale; c) kufalikira, kulimba komanso kufalikira kwamalingaliro amalingaliro, ozindikira komanso machitidwe a kusokonekera kwa umunthu; ndi d) momwe izi zimalumikizidwira ndi mavuto kapena kuwonongeka kwamalingaliro.

Mavuto amunthu amafotokozedwanso ndikuwonetsa kukhalapo kwa mikhalidwe yolakwika. Madera asanu ali ndi magawo omwe akuphatikizidwa: kusakhudzidwa (kukonda kukhala ndi malingaliro osiyanasiyana); gulu (chizolowezi chokhala kutali ndi anthu ena); kusagwirizana (kunyalanyaza ufulu ndi malingaliro a ena, kuphatikiza kudzikonda komanso kusamvera chisoni); Disinhibition (chizolowezi chochita zinthu mopupuluma poyankha zoyambitsa zamkati kapena zachilengedwe popanda kulingalira za zotsatira zazitali); ndi anankastia (kuyang'ana pang'ono pamiyeso yokhwima ya ungwiro ndi chabwino ndi cholakwika ndikuwongolera mayendedwe anu ndi ena kuti mutsimikizire kutsatira miyezoyo). Madera ambiri amtunduwu atha kugawidwa ngati gawo la matendawa omwe amaweruzidwa kuti ndiwodziwika bwino ndipo amathandizira pakusokonezeka kwa umunthu komanso kuuma kwake.

Kuonjezerapo, choyimira chotsatira chimaperekedwa kwa "patternline pattern". Choyenerera ichi ndi cholinga choonetsetsa kuti chisamaliro chisamalire panthawi ya kusintha kuchokera ku ICD-10 kupita ku ICD-11 ndipo izi zingapangitse kuti ntchito zachipatala zitheke powunikira anthu omwe angayankhe matenda ena opatsirana pogonana. Kafukufuku wowonjezera adzafunika kuti adziwe ngati zimapereka chidziwitso chosiyana ndi chimene chinaperekedwa ndi madera a makhalidwe.

ICD-11 imaphatikizapo gulu la vuto laumunthu, lomwe silikuwoneka kuti ndi matenda a maganizo, koma mndandanda wa zovuta zomwe zimagwirizanitsidwa ndi kugwirizana pakati pa mutu pa "zinthu zomwe zimakhudza umoyo wabwino kapena kukhudzana ndi mautumiki a zaumoyo". Vuto laumunthu limatanthawuza umunthu wotchulidwa ndi umunthu umene ungakhudze chithandizo kapena kupereka thandizo la zaumoyo koma sichikwera pamlingo wovuta kuti chidziwitso cha kusokonezeka kwa umunthu.

Matenda a Paraphilic

Magulu a ICD-11 a matenda a paraphilic amaloŵa magulu a ICD-10 a zovuta za kugonana, mogwirizana ndi mawu amodzi omwe amagwiritsidwa ntchito pa kafukufuku ndi zochitika zachipatala. Cholinga chachikulu cha matenda a paraphilic ndi chakuti zimakhudza zokhudzana ndi kugonana zomwe zimaganizira anthu ena omwe sali ololedwa77.

Matenda a paradilic a ICD-11 ndi odwala matenda owonetserako zizindikiro, matenda a voyeuristic, ndi matenda a pedophilic disorder. Magulu atsopano omwe amadziwika amachititsa kuti anthu azivutika ndichisoni chogonana, chisokonezo cha frotteuristic, ndi matenda ena a paraphilic omwe sali ovomerezeka. Gawo latsopano la matenda ena a paraphilic omwe ali ndiokhaokha kapena omwe amavomerezana nawo akuphatikizidwanso, omwe angaperekedwe ngati kugonana, malingaliro, zolimbikitsa kapena makhalidwe akugwirizana ndi kukhumudwa kwakukulu (koma osati chifukwa cha kukana kapena kukanidwa kukanidwa ndi ena) kapena kuika chiopsezo chodzivulaza cha kuvulaza kapena kufa (mwachitsanzo, asphyxophilia).

ICD-11 imasiyanitsa pakati pa zikhalidwe zomwe zimakhudzana ndi thanzi labwino ndi matenda opatsirana maganizo ndi omwe amangoonetsa khalidwe laumwini, ndipo chifukwa chaichi zigawo za ICD-10 za sadomasochism, fetishism, ndi transvestism ya fetishoni zachotsedwa26.

Zovuta zenizeni

ICD-11 imayambitsa magulu atsopano a zovuta zomwe zimaphatikizapo matenda opatsirana omwe amadzipangira okha ndi matenda enieni omwe amaperekedwa kwa wina. Gululi ndilofanana ndi ICD-10 matenda omwe amawoneka mwadzidzidzi kapena kuwonetsa zizindikiro kapena zolemala, kaya thupi kapena maganizo (matenda oopsa), koma akuonjezeranso kuti pali zochitika zachipatala zomwe munthu amadzipangira, amachititsa, kapena amachititsa kuti adziwe ngati akudwala. , zizindikiro zokhudzana ndi maganizo kapena khalidwe linalake (makamaka mwana).

Makhalidwewa samangotengeka ndi mphotho zoonekeratu zakunja kapena zolimbikitsa, ndipo amasiyanitsidwa ndi izi chifukwa chakuwononga, komwe sikunatchulidwe ngati matenda amisala, machitidwe kapena ma neurodevelopmental, koma kumawonekera mchaputala cha "zinthu zomwe zimakhudza thanzi kapena kulumikizana ndi zaumoyo ".

Matenda osokoneza maganizo

Matenda a ICD-11 amapezedwa zinthu zomwe zimadziwika ndi zovuta zogwiritsira ntchito zachipatala, komanso zimakhala zovuta kwambiri zomwe zimafotokozedwa pakati pa ICD-10 organic, kuphatikizapo matenda, matenda. Choncho, gululi limaphatikizapo matenda okhudzidwa bwino, omwe amatchedwa matenda ozindikira ku ICD-10, matenda a amnestic, ndi dementia. Delirium ndi matenda amnestic amatha kusankhidwa chifukwa cha matenda omwe amagawidwa kwina kulikonse, chifukwa cha mankhwala kapena mankhwala, kapena chifukwa cha zinthu zambiri zamatenda. Dementia ikhoza kusankhidwa kukhala yofatsa, yochepa kapena yovuta.

Zizindikiro za matenda a dementia zomwe zimagwirizana ndi zosiyana siyana (mwachitsanzo, matenda a dementia chifukwa cha matenda a Alzheimer, matenda a chiwombankhanga chifukwa cha matenda a immunodeficiency virus) amagawidwa ndikufotokozedwa mu chaputala pa matenda, maganizo, ndi neurodevelopmental, pamene zolembazo zimagwiritsidwa ntchito pogwiritsa ntchito magulu chaputala pa matenda a dongosolo la mitsempha kapena zigawo zina za ICD, ngati zoyenera78. Matenda ochepa a ubongo angathenso kudziwika mogwirizana ndi matenda opatsirana pogonana, akuwonetsera njira zowonetsera bwino zowonongeka, zomwe zikuimira mwayi wopereka chithandizo pofuna kuchepetsa matenda. ICD-11 imamvetsetsa momveka bwino chidziwitso, khalidwe ndi maganizo omwe ali ndi vuto la matendawa komanso zomwe zimayambitsa.

MAFUNSO

Kukula kwa ICD-11 CDDG yamavuto amisala, machitidwe ndi ma neurodevelopmental and their statistical classification limayimira kukonzanso kwakukulu koyambirira kwapadziko lonse lapansi kwamatenda amisala pafupifupi zaka 30. Zaphatikizaponso gawo lomwe linali lisanachitikepo pamlingo wambiri komanso kutengapo gawo kwapadziko lonse lapansi, zilankhulo zambiri komanso maphunziro osiyanasiyana. Zosintha zazikulu zapangidwa kuti ziwonjezere kutsimikizika kwasayansi potengera umboni wapano komanso kupititsa patsogolo ntchito zakuchipatala ndi kugwiritsidwa ntchito kwapadziko lonse potengera pulogalamu yoyeserera m'minda.

Tsopano, mutu wonse wa ICD-11 womwe ungagwiritsidwe ntchito ndi mayiko mamembala a WHO pazowerengera zaumoyo ndi CDDG kuti ugwiritsidwe ntchito m'malo azachipatala ndi akatswiri azaumoyo wamaliza kwathunthu. Kuti ICD-11 ichite bwino padziko lapansi, cholinga cha WHO chidzagwira ntchito ndi mayiko ena komanso akatswiri azaumoyo pakukhazikitsa ndi kuphunzitsa.

Kukhazikitsidwa kwa dongosolo latsopanoli kumaphatikizapo kulumikizana kwa magawidwewo ndi malamulo adziko lililonse, mfundo zake, machitidwe azaumoyo ndi zomangamanga. Njira zingapo ziyenera kupangidwa kuti ziziphunzitsa akatswiri osiyanasiyana azaumoyo padziko lonse lapansi. Tikuyembekeza kupitiliza mgwirizano wathu wopindulitsa kwambiri ndi WPA ndikugwira ntchito ndi mayiko mamembala, malo ophunzirira, akatswiri ndi mabungwe asayansi komanso mabungwe aboma mgawo lotsatira lantchito.

ZIZINDIKIRO

Olemba okha ndiwo omwe amachititsa maganizo omwe amapezeka mu pepala lino ndipo sakuimira ziganizo, ndondomeko kapena maganizo a WHO. Olembawo akuyamikira anthu otsatirawa omwe athandiza kwambiri pakukula kwa magulu a ICD-11 a matenda okhudza maganizo, makhalidwe ndi mavuto ena: G. Baird, J. Lochman, LA Clark, S. Evans, BJ Hall, R. Lewis -Fernández, E. Nijenhuis, RB Krueger, MD Feldman, JL Levenson, D. Skuse, MJ Tassé, P. Caramelli, HG Shah, DP Goldberg, G. Andrews, N. Sartorius, K. Ritchie, M. Rutter, R Thara, Y. Xin, G. Mellsop, J. Mezzich, D. Kupfer, D. Regier, K. Saeed, M. van Ommeren ndi B. Saraceno. Amayamikila mamembala ena a ICD-11 Working Groups ndi alangizi, ochuluka kwambiri omwe angatchule apa (chonde onani http://www.who.it/mental_health/evidence/ICD_11_contributors kuti mupeze mndandanda wathunthu).