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 opatsirana okhudzana ndi kugonana adalandira chiwerengero chachikulu cha matenda onse a m'maganizo (N = 47), koma nthawi zambiri kuchokera kwa anthu omwewo (N = 14). Kuyamba kwa chigawo ichi chakumvetsetsa chakhala chotsutsana kwambiri3 ndipo ndemanga pa ndondomeko ya ICD-11 inayambitsanso kufotokoza poyera m'munda. Zophatikizira zikuphatikizapo ndemanga zotsutsana pakati pa owonetsa, monga zotsutsana za kusagwirizana kapena chidwi (48%; κ = 0.78) kapena kunena kuti mabungwe ena kapena anthu angapindule chifukwa chosaloledwa kapena kuchotsedwa mu ICD-11 (43%; κ = 0.82). Gulu limodzi lidawonetsa kuthandizira (20%; κ = 0.66) ndikuwona kuti pali umboni wokwanira (20%; κ = 0.76) woti aphatikizidwe, pomwe winayo adatsutsa mwamphamvu kuphatikiza (28%; κ = 0.69), kutsindika kulingalira molakwika (33 %; κ = 0.61), umboni wosakwanira (28%; κ = 0.62), ndi zotsatira zoyipa (22%; κ = 0.86). Magulu onsewa adatchulapo umboni wama neurosciology (35%; κ = 0.74) kuti athandizire zifukwa zawo. Ndi owerengeka ochepa omwe amafotokoza zosintha zenizeni kumatanthauzidwe (4%; κ = 1). M'malo mwake, mbali zonse ziwiri zimakambirana mafunso okhudzana ndi mayankho monga kuyerekezera momwe zinthu zilili monga kutengeka, kukakamizidwa, kuzolowera kapena kuwonetsa machitidwe abwinobwino (65%; κ = 0.62). A WHO amakhulupirira kuti kulowetsedwa kwa gululi ndilofunikira kuti anthu ogwira ntchito zachipatala alandire chithandizo4. Kuda nkhaŵa za kugwiritsidwa ntchito mopitirira malire kumatchulidwa mu CDDG, koma malangizo awa sapezeka m'mawu achidule omwe akupezeka kwa owonetsera ndondomeko 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.

World Psychiatry 18, ayi. 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.

Mndandanda wa ma ICD-11 owerengetsera maulendo ndi imfa (MMS), kuphatikizapo ndemanga zing'onozing'ono, zakhala zikupezeka pa nsanamira ya beta ya ICD-11 (https://icd.who.int/dev11/l‐m/en) kuti awerenge pagulu ndi ndemanga kwa zaka zingapo zapitazo1. Ndemanga zanenedwa ndi WHO kuti zithumbidwe za ma MMS ndi ICD-11 komanso mavoti ogwiritsira ntchito zachipatala ndi akatswiri a zaumoyo, a Clinical Descriptions and Diagnostic Guidelines (CDDG)1. Pano, tifotokozera mwachidule zowonjezera nkhani zomwe zafotokozedwa pazinthu zomwe zinayambitsa yankho lalikulu kwambiri.

Ndemanga zonse ndi ndondomeko zowonongedwa kwazinthu zomwe zafotokozedwa mu chaputala pazovuta za m'maganizo ndi zamakhalidwe ku ICD-10, ngakhale kuti ena mwa iwo adakonzedwanso ndikusunthira ku mitu yatsopano ya ICD-11 pa zovuta za kugona ndi zochitika zokhudzana ndi kugonana2.

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 opatsirana okhudzana ndi kugonana adalandira chiwerengero chachikulu cha matenda onse a m'maganizo (N = 47), koma nthawi zambiri kuchokera kwa anthu omwewo (N = 14). Kuyamba kwa chigawo ichi chakumvetsetsa chakhala chotsutsana kwambiri3 ndi ndemanga pamatanthauzidwe a ICD-11 adabweretsanso kugawanika kumunda. Kutumiza kunaphatikizaponso ndemanga zotsutsana pakati pa omwe amapereka ndemanga, monga milandu yokhudza kusamvana kapena kusachita bwino (48%; κ = 0.78) kapena akuti mabungwe kapena anthu ena angapindule ndi kuphatikizidwa kapena kuchotsedwa mu ICD-11 (43%; κ = 0.82) . Gulu limodzi lidawonetsa kuthandizira (20%; κ = 0.66) ndikuwona kuti pali umboni wokwanira (20%; κ = 0.76) woti aphatikizidwe, pomwe winayo adatsutsa mwamphamvu kuphatikiza (28%; κ = 0.69), kutsindika kulingalira molakwika (33 %; κ = 0.61), umboni wosakwanira (28%; κ = 0.62), ndi zotsatira zoyipa (22%; κ = 0.86). Magulu onsewa adatchulapo umboni wama neurosciology (35%; κ = 0.74) kuti athandizire zifukwa zawo. Ndi owerengeka ochepa omwe amafotokoza zosintha zenizeni kumatanthauzidwe (4%; κ = 1). M'malo mwake, mbali zonse ziwiri zimakambirana mafunso okhudzana ndi mayankho monga kuyerekezera momwe zinthu zilili monga kutengeka, kukakamizidwa, kuzolowera kapena kuwonetsa machitidwe abwinobwino (65%; κ = 0.62). WHO ikukhulupirira kuti kuphatikiza gulu latsopanoli ndikofunikira kuti anthu ovomerezeka azachipatala alandire chithandizo4. Kuda nkhaŵa za kugwiritsidwa ntchito mopitirira malire kumatchulidwa mu CDDG, koma malangizo awa sapezeka m'mawu achidule omwe akupezeka kwa owonetsera ndondomeko 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 zokhudzana ndi matenda aumphawi zinali zovuta, koma nthawi zambiri zimapangidwa ndi anthu omwewo (N = 8). Kudzudzula makamaka kuganiza za kuganiza (48%; κ = 0.64) ndi dzina lachisokonezo (43%; κ = 0.91). Kugwiritsira ntchito mawu otanthauzira omwe akugwirizana kwambiri ndi matenda osiyanasiyana okhudzidwa5 ankawoneka ngati ovuta. Chotsutsa chimodzi chinali chakuti tanthawuzoli limadalira kwambiri chidziwitso chachipatala chimene odwala amachilandira ku zizindikiro za thupi ndi "kupitirira". Ndemanga zingapo (17%; κ = 0.62) zinkadandaula kuti izi zingawathandize odwala kukhala osokonezeka maganizo ndi kuwaletsa kulandira chisamaliro choyenera cha sayansi. Othandizira ena adapereka malingaliro a kusintha kwa tanthauzo (30%; κ = 0.89). Ena amatsutsa kuphatikizidwa kwa matendawa (26%; κ = 0.88), pomwe palibe kugonjera (κ = 1) akuwathandiza kuthandizira. WHO inaganiza zoteteza matenda a thupi monga matenda6 ndipo analankhula za nkhawa pofuna kuti CDDG ikhalepo ndi zina zowonjezera, monga kuwonongeka kwakukulu kwa ntchito.

Zolinga zokhudzana ndi chikhalidwe zokhudzana ndi kugonana zimasonyeza chithandizo cholimba cha kuchotsedwa kwa zovuta za kugonana ndi matenda opatsirana pogonana ku mutu ndi kulengedwa chaputala chosiyana (35%; κ = 0.88)7. Zowonjezera zambiri (25%; κ = 0.97) zimagwiritsa ntchito mauthenga apamwamba omwe amaperekedwa ndi World Association for Sexual Health. Zolinga zingapo zatsutsa kuti kusungira chiwerewere pakati pa amuna ndi akazi pa chiwerengero cha matendawa kungawononge ndi kusokoneza anthu ochimwa (14%; κ = 0.80), akupempha kufotokozera mosiyana kwa tanthawuzo (18%; κ = 0.71) kapena chizindikiro china chodziwiratu (23%; κ = 0.62). WHO inasintha malingaliro mbali imodzi kuchokera pa ndemanga zopezedwa7.

Chosangalatsa ndichakuti, gulu lalikulu lazomvera pazotanthauziridwa za ICD-11 zakusagwirizana pakati pa amuna ndi akazi paubwana zikuwonetsa kutsutsana ndi miyezo yaposamalirayi pokana kukana kusintha kwamachitidwe ndi chithandizo chotsimikizira jenda kwa ana (46%; κ = 0.72), ndizofunika kuti , ngakhale zili zofunika komanso zotsutsana, zimakhudzana ndi chithandizo m'malo mongogawika magulu. Kutanthauzira kumeneku kunatsutsidwa kapena kutsutsidwa mu 31% ya zomwe adapereka (κ = 0.62), pomwe ena amagwiritsa ntchito template yoperekedwa ndi World Association for Sexual Health kuti akalimbikitse kukonzanso kutengera kufunsira kwa anthu ammudzi (15%; κ = 0.93). Ena adatsutsa matendawa akuwonetsa mantha akuwathandiza kusiyanasiyana pakati pa amuna ndi akazi (15%; κ = 0.93) ndikunena kuti ndizosafunikira chifukwa sipadzakhala mavuto (11%; κ = 0.80) kapena kufunika kwa chithandizo chamankhwala chotsimikizira kuti ndi amuna kapena akazi okhaokha (28%) ; κ = 0.65) mwa ana. Ena ananenanso kuti kuzindikira sikofunikira pakufufuza, ndikuwonetsa kuti kafukufuku wokhudzana ndi kugonana amuna kapena akazi okhaokha wayenda bwino kuyambira pomwe adachotsedwa ku ICD (9%; κ = 0.745). Povomereza mikangano yokhudzana ndi chithandizo chamankhwala, a WHO adasungabe gululi kuti athandizire kupeza chithandizo chamankhwala choyenera polimbana ndi mchitidwe wosalongosoka poyikika mu chaputala chatsopano chazokhudza zokhudzana ndi kugonana komanso kudzera pazowonjezera mu CDDG7.

Potanthauzira ndemanga izi, zikuonekeratu kuti zowonjezera zowonjezera zapangidwa kuchokera ku lingaliro lolondolera, nthawi zambiri limayang'ana pa gulu linalake. Ndikoyenera akatswiri a sayansi kubwereza malingaliro awo potsatira zochitika za opirira komanso mayankho. WHO inagwiritsa ntchito ndemanga ndi malingaliro pa nsanja ya beta kuphatikiza ndi magwero ena a chidziwitso, makamaka maphunziro a kumunda8, 9, monga maziko opanga kusintha kwa MMS ndi CDDG.