Ndemanga za anthu omwe amagwira nawo ntchito pazochitika za ICD-11 zokhudzana ndi thanzi labwino ndi kugonana (2019)

Ndemanga za YBOP: Pepala lili ndi gawo lokambirana za ndemanga zatsopano za "Compulsive sex behaviour disorder". M'gawo lolimba mtima olemba akufotokoza za Nicole Prause yemwe sanayankhe ka 14 koma kupitilira ka 20. Zambiri mwazolemba zake zidaphatikizapo kuukira kwaumwini, kunena zabodza, kuyimilira molakwika kafukufukuyu, kutola zipatso ndi kuipitsa mbiri.

Matenda okakamiza kugonana ndi omwe adalandira chiwerengero chachikulu cha anthu omwe ali ndi matenda amisala (N=47), koma nthawi zambiri kuchokera kwa anthu omwewo (N=14). Kuyamba kwa gulu lodziwitsa anthu matendawa kwakhala kukambidwa kwambiri 3 ndipo ndemanga pa tanthauzo la ICD-11 zinabwerezanso kusagwirizana komwe kukuchitika m'munda. Zoperekazo zinaphatikizapo ndemanga zotsutsana pakati pa omwe adapereka ndemanga, monga milandu ya kusagwirizana kwa chidwi kapena kusatha (48%; κ=0.78) kapena kunena kuti mabungwe ena kapena anthu angapindule ndi kuphatikizidwa kapena kuchotsedwa mu ICD-11 (43%; κ=0.82) . Gulu lina linasonyeza chithandizo (20%; κ=0.66) ndipo linaganiza kuti pali umboni wokwanira (20%; κ=0.76) wophatikizidwa, pomwe lina linatsutsa kwambiri kuphatikizidwa (28%; κ=0.69), kugogomezera kusaganiza bwino (33%; κ=0.61), umboni wosakwanira (28%; κ=0.62), ndi zotsatira zoyipa (22%; κ=0.86). Magulu onse awiriwa adatchula umboni wa sayansi ya ubongo (35%; κ=0.74) kuti athandizire mfundo zawo. Olemba ndemanga ochepa adapereka kusintha kwenikweni pa tanthauzo (4%; κ=1). M'malo mwake, mbali zonse ziwiri zidakambirana mafunso okhudza nosological monga kuganiza za vutoli ngati kusakhazikika, kukakamizidwa, chizolowezi cha khalidwe kapena kuwonetsa khalidwe labwinobwino (65%; κ=0.62). WHO ikukhulupirira kuti kuphatikizidwa kwa gulu latsopanoli ndikofunikira kuti anthu ovomerezeka azachipatala alandire chithandizo 4. Nkhawa zokhudzana ndi kupitirira muyeso kwafotokozedwa mu CDDG, koma malangizowa sapezeka m'matanthauzidwe achidule omwe alipo kwa olemba ndemanga pa nsanja ya beta.

Ngati mukufuna kuwerenga ndemanga za anthu pazigawo za ICD-11 CSBD (kuphatikizapo zankhanza / zachipongwe / zosokoneza) ntchito izi:

  • https://icd.who.int/dev11/f/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1630268048
  • https://icd.who.int/dev11/proposals/f/en#/http://id.who.int/icd/entity/1630268048
  • https://icd.who.int/dev11/proposals/f/en#/http://id.who.int/icd/entity/1630268048?readOnly=true&action=DeleteEntityProposal&stableProposalGroupId=854a2091-9461-43ad-b909-1321458192c0

Muyenera kulenga dzina lanu kuti muwerenge ndemanga.

Fuss, Johannes, Kyle Lemay, Dan J. Stein, Peer Briken, Robert Jakob, Geoffrey M. Reed, ndi Cary S. Kogan.

Matenda a Maganizo Padziko Lonse 18, nambala 2 (2019): 233-235.

Mphamvu yapadera yothandizira bungwe la ICD-11 la World Health Organisation (WHO) la matenda a maganizo, khalidwe labwino komanso lachisanu ndi chidziwitso chakhala ndizochita zomwe anthu ambiri amagwira nawo.

Mabaibulo oyambilira a ICD-11 for Morbidity and Mortality Statistics (MMS), kuphatikizapo matanthauzo achidule, apezeka pa nsanja ya beta ya ICD-11 ( https://icd.who.int/dev11/l‐m/en ) kuti anthu awerenge ndi kupereka ndemanga zawo kwa zaka zingapo zapitazi . 1. Mafomu operekedwa adawunikidwanso ndi WHO kuti apange mtundu wa MMS wa ICD-11 komanso mtundu wogwiritsidwa ntchito kuchipatala ndi akatswiri azaumoyo, Mafotokozedwe a Zachipatala ndi Malangizo Odziwitsa Anthu (CDDG) 1. Pano, tikufotokozera mwachidule mitu yodziwika bwino ya ma fomu omwe adapereka mayankho abwino kwambiri.

Ndemanga zonse ndi malingaliro adawunikidwanso m'magulu omwe ali m'gulu la matenda amisala ndi machitidwe mu ICD-10, ngakhale ena mwa awa asinthidwa ndikusamutsidwira ku mitu yatsopano ya ICD-11 yokhudza matenda ogona ndi kudzuka komanso mikhalidwe yokhudzana ndi thanzi la kugonana 2.

Pakati pa Januware 1, 2012 ndi Disembala 31, 2017, ndemanga 402 ndi malingaliro 162 adatumizidwa pamavuto amisala, machitidwe ndi ma neurodevelopmental, zovuta za kugona, ndi mikhalidwe yokhudzana ndi thanzi la kugonana. Chiwerengero chachikulu kwambiri chazomwe zimakhudzana ndi zovuta zamisala, zamakhalidwe ndi ma neurodevelopmental zimayang'ana pamavuto okakamiza azogonana (N = 47), matenda ovuta pambuyo pozunzika (N = 26), kusokonezeka kwa thupi (N = 23), matenda a autism spectrum disorder ( N = 17), ndi vuto la masewera (N = 11). Kutumiza pazinthu zokhudzana ndi thanzi lakugonana makamaka kumayang'ana kusakwanira kwa jenda paunyamata ndi ukalamba (N = 151) komanso kusamvana pakati pa amuna ndi akazi (N = 39). Malingaliro ochepa okha anali okhudzana ndi vuto la kugona (N = 18).

Tidachita kuwunika kwamakhalidwe abwino kuti tipeze mitu yayikulu yamaphunziro okhudzana ndi magulu omwe panali ndemanga zosachepera 15. Chifukwa chake, ndemanga 59% ndi malingaliro onse 29% adasungidwa. Kutumiza kunayesedwa pawokha ndi owunika awiri. Ma code angapo okhutira atha kugwiritsidwa ntchito pakaperekedwe kalikonse. Kudalirika kwapakati pa ziwerengero kumawerengedwa pogwiritsa ntchito kapeni wa Cohen; ma codings okha okhala ndi kudalirika kwapakatikati (κ≥⃒0.6) amawerengedwa pano (82.5%).

Matenda okakamiza kugonana ndi omwe adalandira chiwerengero chachikulu cha anthu omwe ali ndi matenda amisala (N=47), koma nthawi zambiri kuchokera kwa anthu omwewo (N=14). Kuyamba kwa gulu lodziwitsa anthu matendawa kwakhala kukambidwa kwambiri 3 ndipo ndemanga pa tanthauzo la ICD-11 zinabwerezanso kusagwirizana komwe kukuchitika m'munda. Zoperekazo zinaphatikizapo ndemanga zotsutsana pakati pa omwe adapereka ndemanga, monga milandu ya kusagwirizana kwa chidwi kapena kusatha (48%; κ=0.78) kapena kunena kuti mabungwe ena kapena anthu angapindule ndi kuphatikizidwa kapena kuchotsedwa mu ICD-11 (43%; κ=0.82). Gulu lina linasonyeza chithandizo (20%; κ=0.66) ndipo linaganiza kuti pali umboni wokwanira (20%; κ=0.76) wophatikizidwa, pomwe lina linatsutsa kwambiri kuphatikizidwa (28%; κ=0.69), kugogomezera kusaganiza bwino (33%; κ=0.61), umboni wosakwanira (28%; κ=0.62), ndi zotsatira zoyipa (22%; κ=0.86). Magulu onse awiriwa adatchula umboni wa sayansi ya ubongo (35%; κ=0.74) kuti athandizire mfundo zawo. Olemba ndemanga ochepa adapereka kusintha kwenikweni pa tanthauzo (4%; κ=1). M'malo mwake, mbali zonse ziwiri zidakambirana mafunso okhudza nosological monga kuganiza za vutoli ngati kusakhazikika, kukakamizidwa, chizolowezi cha khalidwe kapena kuwonetsa khalidwe labwinobwino (65%; κ=0.62). WHO ikukhulupirira kuti kuphatikizidwa kwa gulu latsopanoli ndikofunikira kuti anthu ovomerezeka azachipatala alandire chithandizo 4. Nkhawa zokhudzana ndi kupitirira muyeso kwafotokozedwa mu CDDG, koma malangizowa sapezeka m'matanthauzidwe achidule omwe alipo kwa olemba ndemanga pa nsanja ya beta.

Zolinga zingapo zokhudzana ndi vuto loopsya la matenda osokonezeka maganizo pambuyo pa vuto loopsya lazitsulo linathandizira kuikidwa mu ICD-11 (16%; κ = 0.62), popanda kutsutsana momveka bwino motsutsana nawo (κ = 1). Komabe, zolemba zingapo zimapereka kusintha kwa tanthawuzo (36%; κ = 1), kutumiza ndemanga zofunikira (24%; κ = 0.60) (mwachitsanzo, pokhudzana ndi kulingalira), kapena kukambirana za chizindikiro cha matenda (20%; κ = 1) . Ndemanga zingapo (20%; κ = 0.71) zinatsindika kuti kuzindikira kuti matendawa ndi matenda a maganizo kungachititse kufufuza ndikuthandizira kupeza chithandizo ndi mankhwala.

Zambiri zomwe zinaperekedwa zokhudza matenda a kuvutika maganizo m'thupi zinali zofunika kwambiri, koma nthawi zambiri zinkaperekedwa ndi anthu omwewo (N=8). Kutsutsa kwakukulu kunayang'ana kwambiri pa kulingalira (48%; κ=0.64) ndi dzina la matenda (43%; κ=0.91). Kugwiritsa ntchito mawu ozindikiritsa matenda omwe amagwirizana kwambiri ndi matenda a kuvutika maganizo m'thupi 5 kunawonedwa ngati vuto. Kutsutsa kwina kunali kwakuti tanthauzoli limadalira kwambiri chisankho chachipatala chomwe odwala amaganizira zizindikiro za thupi ndi "chopitirira muyeso". Ndemanga zingapo (17%; κ=0.62) zinawonetsa nkhawa kuti izi zingapangitse odwala kugawidwa ngati odwala matenda amisala ndikulepheretsa kulandira chithandizo choyenera cha zamoyo. Ena omwe adapereka malingaliro osintha tanthauzo (30%; κ=0.89). Ena adatsutsa kuphatikiza matendawa konse (26%; κ=0.88), pomwe palibe kugonjera (κ=1) komwe kunasonyeza kuthandizira kuphatikizidwa. Bungwe la WHO linaganiza zosunga matenda a m'thupi ngati gulu la 6 ndipo linathetsa nkhawa pofunsa CDDG kuti ikhale ndi zinthu zina zowonjezera, monga kuwonongeka kwakukulu kwa magwiridwe antchito.

Zopereka zokhudzana ndi matenda okhudzana ndi thanzi la kugonana zasonyeza kuti zathandiza kwambiri kuchotsa mavuto okhudzana ndi kugonana komanso matenda okhudza kugonana kuchokera ku chaputala cha matenda amisala komanso kupanga chaputala china (35%; κ=0.88) 7. Zopereka zambiri (25%; κ=0.97) zidagwiritsa ntchito uthenga woperekedwa ndi World Association for Sexual Health. Zopereka zingapo zidanena kuti kusunga kusagwirizana kwa amuna ndi akazi m'gulu la matenda kungavulaze ndikunyoza anthu osintha mtundu wa matenda (14%; κ=0.80), kunapereka mawu osiyana a tanthauzo (18%; κ=0.71) kapena chizindikiro china chodziwitsa matenda (23%; κ=0.62). WHO inasintha matanthauzidwewo pang'ono kutengera ndemanga zomwe zalandiridwa 7.

Chochititsa chidwi n'chakuti, gulu lalikulu la anthu omwe adapereka tanthauzo la ICD-11 lokhudzana ndi kusagwirizana pakati pa amuna ndi akazi paubwana linasonyeza kusagwirizana ndi miyezo ya chisamaliro yomwe ilipo panopa potsutsa momveka bwino kusintha kwa chikhalidwe cha anthu komanso chithandizo chotsimikizira kugonana kwa ana aang'ono (46%; κ=0.72), nkhani zomwe, ngakhale zili zofunika komanso zotsutsana, zimagwirizana ndi chithandizo osati kugawa magulu. Tanthauzo lomwe laperekedwalo linatsutsidwa kapena kutsutsidwa mu 31% ya omwe adapereka (κ=0.62), pomwe ena adagwiritsa ntchito chitsanzo choperekedwa ndi World Association for Sexual Health kuti alimbikitse kusinthidwa kutengera upangiri wochokera kwa anthu ammudzi (15%; κ=0.93). Ena adatsutsa matendawa akuwonetsa mantha oyambitsa kusiyanasiyana kwa amuna ndi akazi (15%; κ=0.93) ndikunena kuti sizofunikira chifukwa sipadzakhala mavuto (11%; κ=0.80) kapena kufunikira kwa chisamaliro chotsimikizira kugonana (28%; κ=0.65) mwa ana. Ena adanenanso kuti matenda si ofunikira pa kafukufuku, ponena kuti kafukufuku wokhudza kugonana kwa amuna kapena akazi okhaokha wakula kuyambira pomwe adachotsedwa ku ICD (9%; κ=0.745). Ngakhale kuti adavomereza mikangano yokhudza chithandizo, WHO idasunga gululi kuti lithandize kuonetsetsa kuti anthu akupeza chithandizo choyenera chachipatala pomwe akulimbana ndi manyazi kudzera mu gawo latsopano la matenda okhudzana ndi thanzi la kugonana komanso kudzera mu CDDG 7.

Potanthauzira ndemanga izi, n'zoonekeratu kuti zambiri mwa zomwe zaperekedwa zaperekedwa kuchokera ku lingaliro lolimbikitsa, nthawi zambiri limayang'ana pa gulu linalake. Ndikoyenera kuti akatswiri asayansi ayang'anenso malingaliro awo poganizira zomwe odwala akumana nazo komanso mayankho awo. Bungwe la WHO lagwiritsa ntchito ndemanga ndi malingaliro omwe ali pa nsanja ya beta pamodzi ndi magwero ena azidziwitso, makamaka maphunziro a chitukuko 8 , 9 , ngati maziko opangira kusintha mu MMS ndi CDDG.

Zothandizira