Kusokoneza bongo kwa intaneti pa mankhwala osokoneza bongo operekera kuchipatala cha public rehab (2019)

World J Psychiatry. 2019 Jun 10; 9 (3): 55-64.

Idasindikizidwa pa intaneti 2019 Jun 10. do: 10.5498 / wjp.v9.i3.55

PMCID: PMC6560498

PMID: 31211113

Stefano Baroni, Donatella Maraziti, Federico Mucci, Elisa Diademandipo Liliana Dell'Osso

Kudalirika

MALANGIZO

Kugwiritsa ntchito kovuta pa intaneti (PIU) kapena chizolowezi chapa intaneti kwadziwika kuti ndi chizolowezi chodziwika bwino kwambiri, zolimbikitsa kapena zolimbikitsa pa kugwiritsa ntchito makompyuta komanso intaneti zomwe zimayambitsa kusokonezeka kapena kuvutikanso ngati kugwiritsa ntchito mankhwala osokoneza bongo.

AIM

Kuti afufuze kuchuluka ndi machitidwe ogwiritsa ntchito intaneti ndikuzunza pagulu la ogwiritsa ntchito mankhwala osokoneza bongo ochokera ku Southern Italy, pogwiritsa ntchito pulogalamu yofunsa mafunso [“Mafunso a sull'Utilizzo delle Nuove Tecnologie” (QUNT)].

NJIRA

Maphunziro onse (183) anali osuta kwambiri, pafupifupi 50% a iwo amagwiritsa ntchito mankhwala osokoneza bongo a heroin ndi / kapena opioid, 30% mowa, 10% cannabis, 8% cocaine, ndi 5% anali ogwiritsa ntchito polydrug. Pafupifupi 10% yaanthu nawonso anali ndi vuto la kutchova juga.

ZINTHU

Nthawi yomwe idagwiritsidwa ntchito pa intaneti inali yoposa maola a 4 patsiku muzolemba zonsezo, komanso kuchuluka pang'ono pa maphunziro a amuna. Ogwiritsa ntchito mankhwala a Cocaine komanso a cannabis amakhala maola opitilira 6 pa intaneti, mochuluka kuposa opioid ndi omwe amamwa mowa mwauchidakwa. Kugawidwa kwa zinthu za QUNT sikunali kosiyana pakati pa akazi ndi amuna. Ogwiritsa ntchito Cocaine adawonetsa kuchuluka kwa "kuwongolera", "zolaula", komanso "kugwiritsa ntchito malo ochezera a pa Intaneti" pazinthu zomwe zimapangitsa chidwi cha zinthuzi. Kuphatikiza apo, 15 mwa ogwiritsa ntchito cocaine a 17 okwanira anali otchovera njuga. Maubwenzi abwino komanso owerengera amawonekera pakati pa zinthu zina za QUNT ndi cholozera cha thupi.

POMALIZA

Zotsatira izi zikuwonetsa kuti PIU siili yovuta kwambiri pamaphunziro omwe amatenga zinthu zoyeserera, monga heroin / opioids ndi mowa, kuposa pamaphunziro omwe amatenga zolimbikitsira. Mwinanso, itha kugwiritsidwa ntchito ngati choyambitsa “chopatsa” cha ogwiritsa ntchito mankhwala a cocaine ndi a cannabis. Mphamvu yofulumira ya mankhwala osokoneza bongo idawonekera pazosiyana zokhudzana ndi kugonana pazinthu za QUNT. Tinaona mtundu wina wa “zoteteza” za ubale wokondana ndi / kapena kukhala limodzi ndi mnzathu, popeza zomwe anachita zimawonetsa zambiri pazinthu zosiyanasiyana kuposa mitu imodzi kapena omwe amakhala okha. Chibale chomwe chimagwiritsidwa ntchito pa intaneti (komanso moyo wokhudzana ndi moyo wongokhala) ndi cholozera cha thupi zitha kuonetsa kuti kugwiritsa ntchito intaneti kungakhale gawo lothandizira kukulitsa kunenepa komanso kunenepa kwambiri pakati pa achinyamata ndi achinyamata padziko lonse lapansi. Zotsatira zathu zidanenanso za kusatetezeka kwenikweni kwa omwe ali ndi vuto lofuna kugwiritsa ntchito mankhwala osokoneza bongo omwe amagwiritsa ntchito zolimbikitsa, m'malo mophatikizira zina, pazinthu zina zamtundu wankhanza, monga vuto la kutchova njuga.

Keywords: Kugwiritsa ntchito intaneti, Mavuto pa intaneti, kukhudzana ndi zikhalidwe, kugwiritsa ntchito mankhwala osokoneza bongo, malo a Rehab

Mfundo yaikulu: Kafukufukuyu adafufuza za kugwiritsidwa ntchito kwa intaneti komanso kuvuta kwamavuto pa intaneti (PIU) m'mankhwala osokoneza bongo kudzera pazofunsa mafunso. Zotsatira zake zidawonetsa kuti PIU imakhala yofala kwambiri m'maphunziro omwe amamwa mankhwala a cocaine ndi cannabis kuposa omwe amamwa ma opioids kapena mowa, komanso omwe amakhudzidwa ndi vuto la juga la pathological. Izi zikusonyeza gawo labwino la mankhwala olimbikitsira kupititsa patsogolo zizolowezi zakakhalidwe. Kugwirizana pakati pa nthawi yomwe mumagwiritsa ntchito intaneti komanso kuchuluka kwa thupi kumawonetsa kuti kugwiritsa ntchito intaneti kungakhale chinthu chomwe chimalimbikitsa kunenepa kwambiri komanso kunenepa kwambiri. Kupewa kuledzera kuyenera kuganizira PIU, yomwe ikuyimira mliri wapadziko lonse lapansi.

MAU OYAMBA

Tekinoloje zatsopano, zikagwiritsidwa ntchito moyenera, mosakayikira zimapanga chida chomwe chitha kukonza bwino moyo wamunthu. Intaneti mwina ndi imodzi mwazosintha kwambiri pazaka zingapo zapitazi chifukwa yasintha njira yolankhulirana, kusinthana zidziwitso, kutenga nawo mbali pazomwe zikuchitika zenizeni makilomita masauzande kutali, ndikupeza mosavuta komanso mwachangu mtundu uliwonse wa chidziwitso [,]. Momwemonso, ziyenera kudziwidwa kuti kugwiritsidwa ntchito molakwika kwa ma intaneti, makamaka komwe kuli zangozi za psychopathological zomwe zili pangozi, chiopsezo chenicheni cha thanzi lamutu wamutu, chifukwa chitha kukhala chovuta kuwongolera.

Makamaka, kugwiritsa ntchito molakwika intaneti kuimira chiopsezo chowopsa komanso chovuta kwambiri chomwe chitha kuyambitsa kusokonezeka kwa chikhalidwe, malingaliro, ntchito, komanso malingaliro. Pazaka zapitazi za 15, kuchuluka kwa ogwiritsa ntchito intaneti kwawonjezeka ndi 1000% [], monga zalembedwera ndi Internet World Stats, Pigdom, gulu lomwe lakhala likugwiritsa ntchito kwambiri intaneti, ziwerengero za anthu, ndi zina []. Zosadabwitsa, chifukwa chake, maphunziro okhudzana ndi intaneti awonjezeka. Vutoli silikumveka bwino, ndipo kafukufuku pa ukadaulo wake udakali pachiyambi chake [].

Kugwiritsa ntchito pamavuto pa intaneti (PIU) kapena kugwiritsa ntchito intaneti ndi chizolowezi [] zomwe zitha kufotokozedwa ngati "kugwiritsa ntchito intaneti komwe kumayambitsa zovuta m'malingaliro, chikhalidwe, masukulu, komanso / kapena ntchito m'moyo wamunthu" [].

Kuchulukitsa mabuku pa PIU kunatsogolera American Psychiatric Association kuphatikiza Intaneti Masewera Osakanikira mu gawo 3 la Diagnostic and Statistical Manual for Mental Dis shida (DSM-5), koma lingaliro lipano ndilakuti zambiri zimafunikira musanaziphatikize mu bukulo ngati buku. chikhalidwe chopanda ulemu [-]. Mu 2008, Block [] adalimbikitsa njira zinayi zoyesera kuti adziwe matenda a PIU ngati njira yowonjezera, motere: “Kugwiritsa ntchito intaneti kwambiri chifukwa cha kuchepa kwa nthawi; kusiya, kuphatikizira kumverera kwa mkwiyo, kukhumudwa ndi kusokonezeka pamene intaneti sichitha; kulolerana, kuphatikizapo kufunikira kwa zida zamakompyuta zabwino, mapulogalamu ambiri, kapena kugwiritsa ntchito maola ambiri, ndi zotsatirapo zina, monga kuyambitsa mikangano, kunama, kusawerengera bwino sukulu / ntchito kapena kuchita bwino pantchito, kudzipatula pagulu, komanso kutopa ”[].

Nthawi zambiri, maphunziro a PIU sakudziwa kuti ali ndi vuto [-] zomwe zingawononge pang'onopang'ono banja, sukulu, ntchito, kapena moyo wamunthu [] kapenaatsogolera kuti muchoke kwambiri pagulu [,] ngakhale kudzipha [,-]. Kafukufuku angapo adalemba zoyipa za PIU, koma zolembedwazo sizikuwonetsa kutsimikiza kwa khalidweli [,]. Mwachindunji, sizikudziwika ngati PIU iyenera kufotokozedwa ngati mtundu wamakhalidwe osokoneza bongo [], vuto loletsa kusokonekera, vuto laling'ono lodziletsa [-], kapena njira yolakwika yothanirana ndi kupsinjika [-].

Zizindikiro zodziwika bwino za PIU ndizofanana ndi zomwe zimapangitsa kuti pakhale vuto la kugwiritsa ntchito mankhwala osokoneza bongo (SUDs) malinga ndi DSM-5 [] kuphatikiza mayendedwe osasinthika ndi malingaliro [,], kukhumba, kuda nkhawa kwambiri ndi zochitika za pa intaneti, ndikulephera kuchepetsa kugwiritsidwa ntchito kwake [,]. Ofufuzawo adafanana.,]. Apanso, kafukufuku wa neurobiological amawonetsa kuti PIU imagawana ndi SUDs zingapo zama neurobiological [,-]. Ngakhale PIU yapezeka pafupipafupi comorbid ndimatenda ena amisala [], mabuku pazokhudza ubale wa PIU ndi SUDs ndizochepa.

Zilinso chimodzimodzi ndi deta yakufalikira kwa PIU ndi mikhalidwe m'dziko lathu. Chifukwa chake, kafukufuku wapano yemwe cholinga chake ndi kuwunikira izi mwa anthu achilendo omwe amapangidwa ndi anthu omwe adatsata pulogalamu yobwereranso mankhwala osokoneza bongo m'malo opezeka anthu ambiri (a Serizio Tossicodipendenze, SERT) kudzera mu funso lotchedwa "Mafunsoario sull'Utilizzo delle Nuove Tecnologie" (QUNT) kuti tidapangira ichi.

ZIDA NDI NJIRA

Funso lodzipenda

Pulatifomu inayake yolumikizirana ndi tsamba (http://dronet.araneus.it/questionario) pa matekinoloje atsopano adapangidwa pa seva yakunja. Pulatiyi idalola mwayi wofunsa mafunso owerengera okha kudzera Intaneti.

Nthawi yomweyo, mafunso omwe amadziyesa okha omwe adatchulidwa QUNT adapangidwa. QUNT ili ndi magawo awiri, imodzi ndi ya chiwerengero cha anthu ndipo ina ili ndi zinthu za 101 (Zowonjezera 1). Zinthu makumi anayi ndi zisanu mwa zinthu zonse za 101 zidakhala ndi mayankho asanu otheka, malinga ndi sikert point-point yomwe 1 ikuwonetsa "yabodza kwathunthu" ndi 5 yosonyeza "zowona"; zinthu zitatu zinali mafunso osankha zingapo; khumi adayang'ana kugwiritsidwa ntchito kwa "kutumizirana mameseji" (ndi mayankho asanu otheka, malinga ndi sikert ya nsonga zisanu ndi 1 yowonetsa "yabodza kwathunthu" ndi 5 yosonyeza "zowona"), ndi zinthu za 42 pakugwiritsa ntchito "pagulu mauthenga ”(mauthenga apompopompo: WhatsApp, Telegraph, Skype, ndi malo ochezera a pa Facebook: Facebook, Twitter ndi Instagram) (ndi mayankho asanu otheka, malinga ndi sikert yomwe ili ndi mfundo zisanu ndi 1 zosonyeza kuti" zabodza "komanso 5 zosonyeza kuti" ndizowona " ). Katunduyu #101 kwenikweni anali funso pazokhutira / zofunikira kapena ayi pofunsa mafunso. Zinthu zomwe zikuwoneka kuti ndizofunika kwambiri zimayikidwa limodzi kuti zizindikire zomwe zimamangidwa malinga ndi a priori njira zomwe zachokera pa zomwe zimapezeka m'mabuku asayansi [,,]. Izi zinali "nthawi yogwiritsidwa ntchito pa intaneti" (chinthu 2, 3, 4, 5, 6, 7, 25, 33), "kuchoka pagulu" (chinthu 8, 10, 18, 22, 30, 35), "kutengera zenizeni ”(Item 11, 13, 24)," kutaya mphamvu "(item 19, 20, 32, 36)," bongo "(chinthu 26, 27)," ludopathy "(chinthu 40, 41, 42, 43 ), komanso "kuzolowera intaneti" (49, 50, 51, 52, 53, 54, 55, 56, 57). Chizoloŵezi cha "chizoloŵezi chogwiritsa ntchito malo ochezera a pa Intaneti" chinagawidwanso m'magulu ang'onoang'ono awa: "Chizolowezi cha Facebook" (chinthu 61-75), "chizolowezi cha Twitter" (chinthu 76-86), ndi "chizolowezi cha Instagram" (chinthu Phunziro 86-97). Zambiri zomwe zimawerengedwa zimawerengedwa ngati kuchuluka kwa zinthu zomwe zapezeka pachinthu chilichonse zomwe zidagawidwa ndi ziwongola dzanja zambiri. Tinakhazikitsa yankho 4 (pakati pa 4 ndi 6 hr / d) kapena 5 (> 6 hr / d) wachinthu 2 "nthawi yogwiritsidwa ntchito pa intaneti". Monga malo odulidwa kuti azindikire kupezeka, motsatana, kotheka kapena kovuta / koopsa PIU, mogwirizana ndi zolemba zaposachedwa, ngakhale pali mikangano []. Palibe njira iliyonse yotheka kuzindikira omwe ali nawo omwe anali osavomerezeka.

Njira yosonkhanitsa deta

Ulalo wa QUNT udauzidwa ku maofesi omwe amayang'anira ntchito yopereka kwa anthu omwe amwa mankhwala osokoneza bongo, SERTs, yomwe ili mdera la Calabria, pofuna kufunsa odwala awo kuti alembe. Pafupifupi maphunziro onse a 1500 adafunsidwa kuti adzaze pazofunsa mafunso mwakufuna kwanu. Kafukufukuyu apano adavomerezedwa ndi Komiti ya Ethics ku University ya Pisa.

Kusanthula kusanthula

Oyimira pawokha t-Mayeso adagwiritsidwa ntchito kuyerekezera kuchuluka kwa zinthu pamaziko a izi: Kugonana (M / F); osakwatiwa (inde / osakhala limodzi (inde / ayi) posachedwa idagwiritsidwa ntchito kuyesa kufananiza kwamagulu amthupi a index (BMI). The χ2 kusanthula kunagwiritsidwa ntchito kuyerekezera mitundu yamitundu. Ziwerengero zonse zinachitidwa ndi Statistical Package for Social Sayansi (SPSS), mtundu 22 (Armonk, NY, United States) [].

ZINTHU

Makhalidwe aanthu owerengera

Mafunso obwerera omwe ali ndi 183, omwe 148 (80.87%) anali ochokera kwa amuna ndipo 35 (19.13%) anali ochokera kwa akazi, kunja kwa mayitidwe onse a 1500. Maphunziro ambiri (86, 47%) anali atamaliza maphunziro a 8 zaka, 73 (39.9%) sukulu yasekondale, 14 (7.7%) zaka 5 pasukulu ya pulaimale, ndipo 10 (5.5%) adamaliza maphunziro. Maphunziro makumi asanu ndi anayi mphambu awiri (50.3%) anali osakwatirana, 64 (14.8%) anali okwatirana, ndipo 27 (14.8%) adakhala pachibwenzi. Kutalika kopezeka pa malo osungira anthu wamba kunali pakati pa 1 ndi 60 mo (kutanthauza ± kupatuka wamba (SD): 32 ± 20).

Mitundu ya kugwiritsa ntchito mankhwala osokoneza bongo komanso /

Mankhwala osokoneza bongo kwambiri anali ma heroin kapena ma opioid (n = 88, 48.1%), mowa (n = 55, 30.1%), cannabis (n = 20, 9.8%), cocaine (n = 17, 7.7%), ndi ma amphetamines (n = 3, 1.6%). Kuvutitsidwa kwa Polydrug (amphetamine, cannabis, cocaine, ecstasy) kunalipo mwa anthu asanu ndi anayi (4.9%), pomwe vuto la njuga limapezeka ku 18 (9.3%). Maphunziro onse a 183 anali osuta kwambiri (Gome ​(Table11).

Gulu 1

Mitundu ya kugwiritsa ntchito mankhwala osokoneza bongo komanso /

n (%)
Heroin kapena opioids88 (48.1)
mowa55 (30.1)
cannabis20 (9.8)
Cocaine17 (7.7)
Amphetamines3 (1.6)
Kuvutitsidwa kwa Polydrug9 (4.9)
Kutchova njuga18 (9.3)
Osuta fodya183 (100)

Foni yamakono inapezeka kuti ndiyo chida chofala kwambiri chomwe anthu onse amagwiritsa ntchito intaneti. Nthawi yogwiritsidwa ntchito pa intaneti inali yofanana mwa amuna ndi akazi, 4.12 ± 2.9 h. Chosangalatsa ndichakuti, nthawi yomwe amagwiritsa ntchito pa intaneti ndi 30% ya cocaine ndi 25% ya ogwiritsa ntchito mankhwalawa anali okwera kwambiri (> 6 h) kuposa magulu enawo.

Zofunikira za QUNT komanso jenda

Kugawidwa kwa zinthu za QUNT sikunali kosiyana mumagulu awiriwo; komabe, abambo omwe amagwiritsa ntchito cannabis adawonetsa chidwi chopita ku ma scores apamwamba (amatanthauza ± SD) pazinthu zotsatirazi: "Kuchotsa pagulu" (2.44 ± 0.38 vs 2.23 ± 0.39, P <0.001) ndi "kutengera zenizeni" (3.12 ± 1.74 vs 2.24 ± 0.46, P <0.001). Ogwiritsa ntchito Cocaine adawonetsa kuchuluka kwambiri kuposa maphunziro enawo "kutaya mphamvu" (3.64 ± 1.12 vs 2.51 ± 0.36, P <0.001), "zolaula" (3.59 ± 1.44 vs 2.54 ± 0.41, P <0.001), komanso "chizolowezi chogwiritsa ntchito malo ochezera a pa Intaneti" (3.22 ± 0.98 vs 2.66 ± 0.76, P <0.001) zinthu.

QUNT imayambitsa komanso ubale wolumikizana

Kuwunika kwa kusiyana kwa QUNT pazokhudza kukhala wosakwatiwa (n = 92) kapena wochita chibwenzin = 91) yawonetsa kuti mitu yokhayo yomwe ili ndi zofunikira zambiri pazotsatira izi (zikutanthauza mean SD): "Nthawi yogwiritsidwa ntchito pa intaneti" (2.95 ± 0.47 vs 2.17 ± 0.44, P <0.001); "Kuchoka pagulu" (1.40 ± 0.35 vs 1.34 ± 0.32, P <0.001); "Kupatula zenizeni" (1.90 ± 0.40 vs 1.56 ± 0.62, P <0.001); "Chizolowezi choonera zolaula" (3.12 ± 0.88 vs 1.99 ± 0.79, P <0.001); ndi "chizolowezi chogwiritsa ntchito malo ochezera a pa Intaneti" (2.89 ± 1.08 vs 2.06 ± 0.33, P <0.001).

Kuwunikira kwa kusiyana pakati pa abwenzi omwe akukhala (72) kapena osakhala limodzi (17) ndi mnzakeyo kunawonetsa kusiyana kwakukulu. Zinthu zotsatirazi zidawonetsa kuchuluka kwambiri m'maphunziro omwe sanakhale ndi mnzake vs omwe amakhala ndi mnzake: "Nthawi yogwiritsidwa ntchito pa intaneti" (3.03 ± 0.53 vs 2.16 ± 0.76, P <0.001), "kuzolowera zolaula" (3.15 ± 0.99 vs 2.33 ± 0.71, P <0.001), "ludopathy" (3.42 ± 1.08 vs 2.96 ± 0.66, P <0.001), komanso "chizolowezi chogwiritsa ntchito malo ochezera a pa Intaneti" (2.99 ± 0.91 vs 2.01 ± 0.44, P <0.001).

Zinthu za QUNT ndi BMI

Zitsanzo zonsezo zidagawika molingana ndi mfundo za BMI. Maphunziro khumi ndi khumi ndi asanu anali ndi BMI pansi pa 18.50 (otsika, UW), 69 pakati pa 18.51 ndi 24.9 (kulemera kwina, NW), 60 pakati pa 25 ndi 30 (onenepa kwambiri, OW), 26 pakati pa 30.1 ndi 34.9 (digiri yoyamba ya kunenepa kwambiri, OB1), ndi 13 yayikulu kuposa 35 (digiri yachiwiri ya kunenepa kwambiri, OB2). Magawo omwe OB1 ndi OB2 adalumikizidwa mu gulu la "Obese" (OB). Kuyerekeza kwa zotsatira za QUNT factor m'magulu anayi a BMI kumanenedwa mu tebulo ​Table2,2, zomwe zikuwonetsa kuti BMI yokulirapo imakonda kwambiri kuchuluka. Kuphatikizanso, monga tikuonera Chithunzi ​Figure1,1, BMI itachulukitsa kuchuluka kwa zinthu zisanu zomwe, "nthawi yogwiritsidwa ntchito pa intaneti", "kuchoka pagulu", "kuchoka ku zenizeni", "ludopathy", ndi "kukhudzika ndi malo ochezera a pa Intaneti", ndizowonjezereka. Pomaliza, anthu khumi ndi asanu onse omwe amagwiritsa ntchito mankhwala a cocaine nawonso anali otchova jakisoni (makamaka ochita masewera apakompyuta) ndipo adawonetsa chokwera kwambiri pa "ludopathy" factor (3.20 ± 0.45 vs 2.86 ± 0.51, P <0.001).

Fayilo yakunja yomwe ili ndi chithunzi, fanizo, etc. dzina la chinthu ndi WJP-9-55-g001.jpg

Njira yamaperesenti azinthu zina za QUNT ndi index yamasamba. A: Nthawi yogwiritsidwa ntchito pa intaneti; B: Kuchotsa pagulu; C: Kuchotsera ku zenizeni; D: Ludopathy; Yankho: Kusuta kwa malo ochezera. BMI: Mlozera wamasamba ambiri; UW: Wocheperako; NW: Kulemera wamba; OW: Wambiri; OB: Kunenepa kwambiri; QUNT: Mafunso osowetsa mtendere Nuove Tecnologie.

Gulu 2

Kufanizira kwa zotsatira za QUNT factor m'magulu anayi a BMI

ZinthuUWNWOWOBFP mtengoKutumiza kuyerekezera: Chofunika chifukwa P <0.05
Nthawi yogwiritsidwa ntchito pa intaneti53.44 ± 13.6853.80 ± 13.1254.91 ± 12.7155.83 ± 14.103.870.009OW> UW
Kusuta kwa anthu25.39 ± 6.3527.55 ± 7.6128.73 ± 8.9430.81 ± 10.149.910.001OW> UW; OB> UW; OB> NW
Kuchotsera ku zenizeni32.33 ± 10.0234.90 ± 10.1335.11 ± 12.9836.11 ± 13.442.690.045palibe
Kutaya ulamuliro28,10 ± 9.1129.79 ± 10.1131.04 ± 12.4931.21 ± 10.871.951.98palibe
Kusuta zolaula43.32 ± 12.2841.95 ± 13.7041.34 ± 11.0342.09 ± 13.451.550.250palibe
Ludopathy33.26 ± 13.1736.23 ± 10.8539.88 ± 22.9141.16 ± 22.394.280.005OW> NW
Chizolowezi chomatumizira mauthenga nthawi yomweyo54.05 ± 18.3356.02 ± 16.4756.24 ± 18.3655.60 ± 17.091.720.197palibe
Kusuta kwa malo ochezera41.60 ± 12.6142.13 ± 13.1541.80 ± 12.1944.14 ± 18.901.810.187palibe

QUNT: Mafunso osowetsa mtendere Nuove Tecnologie; BMI: Thupi la Masamba Aakulu; UW: Wocheperako; NW: Kulemera wamba; OW: Wambiri; OB: Kunenepa kwambiri.

KUKANGANANI

Kafukufuku wapanoyu wanena zotsatira za kafukufuku wothandizirana wogwiritsa ntchito matekinoloje atsopano (ma PC, ma foni a m'manja ndi mapiritsi), komanso wa PIU, pakati pa maphunziro omwe akukonzanso zochitika m'malo obwezeretsanso anthu m'malo a anthu ambiri. dera lochokera kumwera kwa Italy. Malinga ndi kudziwa kwathu, uku ndi kafukufuku woyamba wochitidwa mwa anthu achikulire achidwiwa, monga kale zitsanzo za achinyamata zidafufuzidwa [].

Anthu angapo adalandira pempholi kuchokera kwa asing'anga / akatswiri amisala kuti adzaze mafunso, otchedwa QUNT, omwe adapangidwa ndi ife chifukwa chaichi. Kudziwika kwa QUNT, poyerekeza ndi komwe kumagwiritsidwa ntchito m'maphunziro osiyanasiyana, ndikuti ndizatsatanetsatane kuti muwone mawonekedwe azomwe amagwiritsa ntchito pa intaneti komanso PIU. Chinthu 2 "nthawi yogwiritsidwa ntchito pa intaneti" chimawerengedwa kuti ndichofunikira kuzindikira kupezeka kwa PIU pomwe inali pakati pa 4 ndi 6 hr / d (yankho 4), kapena PIU yayikulu, pomwe inali> 6 hr / d (yankho 5) .

Pafupifupi 10% ya maphunzirowo adabwezeretsa ma QUNTs omwe adadzazidwa bwino omwe anali ovomerezeka pakuwunika. Izi zitha kufotokozedwa ku umunthu wachilendo wa osokoneza bongo, makamaka osakhazikika omwe amayimira ambiri mwa zitsanzo zathu, ndipo zingasonyeze kutsika kochepa kochitira maphunziro limodzi ndi kutsatira komanso kutulutsa chidwi []. Chida chomwe chimagwiritsidwa ntchito kwambiri (100% ya maphunziro) kulowa intaneti chinali foni yamakono. Panali kukonzekera kwakukulu kwa amuna kuposa azimayi, komwe kumawonetsera kufalitsa kwa akazi m malo ogona anthu ku Italiya, mogwirizana ndi deta yapadziko lonse yowonetsa kuti chiwerengero cha amuna: akazi ndi 4: 1 [].

Maphunziro onse anali osuta kwambiri, pafupifupi 50% a iwo amagwiritsa ntchito mankhwala osokoneza bongo a heroin ndi / kapena opioid, 30% mowa, 10% cannabis, 8% cocaine, ndi 5% anali ogwiritsa ntchito polydrug. Maphunziro atatu okha ndi omwe amagwiritsa ntchito amphetamine, chifukwa chake, sanaphatikizidwe pazowunikira. Pafupifupi 10% ya anthu nawonso anali ndi vuto la kutchova juga, pomwe kukhalapo kwa zovuta zina zamisala kunakhazikitsidwa ngati chosiyanitsa.

Nthawi yomwe adagwiritsidwa ntchito pa intaneti inali yokwera kwambiri, yoposa 4 hr / d muzolemba zonsezo, pang'onopang'ono, osatengera kuchuluka kwa maphunziro a amuna. Ogwiritsa ntchito mankhwala a Cocaine ndi a cannabis omwe adagwiritsa ntchito ndalama zoposa 6 hr / d pa intaneti, kwambiri kuposa opioid ndi omwe amamwa mowa mwauchidakwa. Chifukwa chake, mwina adakhudzidwa ndi PIU yayikulu, malinga ndi dongosolo lomwe tafotokozera (yankho 5 la chinthu 2) ndi chidziwitso cha mabuku [,-]. Kutengedwa pamodzi, kufufuzaku kukuwonetsa kuti ngakhale PIU ikhoza kukhalapo m'magulu onse a anthu omwe amamwa mankhwala osokoneza bongo, sikuti ndizovuta kwambiri pamaphunziro omwe amatenga zinthu zoyeserera, monga heroin / opioids ndi mowa. Mwinanso, itha kugwiritsidwa ntchito ngati choyambitsa “chopatsa” cha ogwiritsa ntchito mankhwala a cocaine ndi a cannabis. Izi zimathandizidwa ndi kufalikira kwambiri kwa vuto la masewera pakati pa ogwiritsa ntchito mankhwala osokoneza bongo a cocaine, mogwirizana ndi zolemba za mabuku [-].

Kuwunikira kwa magawidwe a zinthu za QUNT sikunawonetse kusiyana kwam'magwiridwe ogonana komanso chizolowezi chambiri chopita ku ziwonetsero zapamwamba zodziwika kuti "abwereke pagulu" komanso "kuchoka ku zenizeni" mwa amuna. Izi ndizosemphana ndi kafukufuku wam'mbuyomu womwe udachitika mu mitu yathanzi yomwe idawonetsa kusiyana kwakukulu pakati pa abambo ndi amai. Kutanthauzira kungakhale zotsatira zoyipa zomwe zimagwiritsidwa ntchito ngati mankhwala omwe amachepetsa kusiyana pakati pa kugonana []. Poyerekeza ndi magulu ena, omwe amagwiritsa ntchito cocaine adawonetsa kuchuluka kwa "kuwongolera", "zolaula", komanso "kuzolowera kucheza". Izi sizosadabwitsa chifukwa chotengera mphamvu ya chinthuchi [].

Zotsatira zathu zatsimikizira "zoteteza" za ubale wachikondi komanso / kapena kukhala limodzi ndi bwenzi [], monga maphunziro osakwatiwa kapena omwe amakhala okha osapeza thandizo la mabanja adawonetsa zinthu zambiri, makamaka "nthawi yomwe amagwiritsidwa ntchito pa intaneti", "kusiya zachikhalidwe", "kusiya zenizeni", "kusiya zolaula", komanso "kusiya kugwiritsa ntchito malo ochezera a pa Intaneti" ". Izi zikuwonetseratu kuti intaneti idagwiritsidwa ntchito kupatula nthawi kapena zosangalatsa.

Zosadabwitsa kuti maphunziro omwe adagwiritsa ntchito nthawi yambiri pa intaneti, monga akuwonetsera ndi kuchuluka kwa "nthawi yomwe adagwiritsa ntchito intaneti", "kuchoka pagulu", "kuchoka pazowona zenizeni", komanso "kuzolowera kucheza pa intaneti", anali ndi BMI yapamwamba. Chifukwa chake, kugwiritsa ntchito intaneti kwambiri kungatchulidwenso ngati chinthu china chomwe chimakulitsa chizolowezi [], ndipo zitha kukhala zowopsa makamaka kwa osokoneza bongo omwe ali kale ovutikirapo kale omwe ali ndi matenda osiyanasiyana []. Nthawi yochepetsera kugona komanso kusintha masinthidwe amizungu chifukwa cha PIU ndizinthu zina zomwe zingakulitse mwayi wamavuto a metabolic, medical, and psychiatric [,,] komanso kusokonezeka kwa ntchito, banja, chikhalidwe cha anthu, kapena masukulu ogwira ntchito [,].

Pomaliza, ambiri (15 mwa anthu onse a 17) omwe anali ogwiritsa ntchito mankhwala a cocaine nawonso anali otchovera njuga (makamaka opanga masewera apa intaneti), ndipo adawonetsa chokwera kwambiri pa "ludopathy". Izi zitha kupereka chiwopsezo chapadera cha omwe amayamba kugwiritsa ntchito mankhwala osokoneza bongo ku mitundu ina ya zizolowezi, makamaka ngati agwiritsa ntchito mankhwala ozunguza bongo m'malo mwa mankhwala osokoneza bongo []. Phunziro lathu lili ndi malire omwe ayenera kuvomerezedwa. Mafunsofunso a QUNT sanavomerezedwe, ngakhale izi ndizofala kwambiri pamaphunziro mugawo lino [,-]. Kukula kwa PIU kumachokera pachinthu chimodzi chokha, koma zinali zofunikira kwambiri pakusanthula komwe amafufuza makamaka pamakhalidwe a intaneti. Momwemonso, palibe zidziwitso zomwe zidasonkhanitsidwa pazokhudzidwa kwamalingaliro kapena makhalidwe osokoneza omwe pakali pano akufufuzidwa.

Kutengedwa palimodzi, zotsatira zathu zikuwonetsa kuti kugwiritsa ntchito intaneti mopitirira muyeso pogwiritsa ntchito mafoni kumakhala kofala kwambiri pazakumwa zomwe zimagwiritsidwa ntchito pa intaneti, komanso kuti PIU ndi yodziwika kwambiri mwa anthu awa, makamaka kwa omwe amamwa cocaine ndi cannabis. Chiyanjano pakati pa nthawi yomwe ndakhala pa intaneti (komanso moyo wofananira) ndi BMI zikusonyeza kuti kugwiritsa ntchito intaneti kungakhale gawo lothandizira kwambiri kunenepa komanso kunenepa kwambiri pakati pa achinyamata ndi achinyamata padziko lonse lapansi [,]. Zomwe tapezazi zingatanthauze kusatetezeka kwa anthu omwe ali ndi vuto losokoneza bongo, makamaka ngati agwiritsa ntchito mankhwala othandizira osati othandizira ena, komanso pazinthu zina zamtundu wa pharma komanso zikhalidwe zina, monga PIU kapena masewera a pathological. Kupewa kugwiritsa ntchito zidakwa kumayeneranso kuganizira za bukuli, komanso lomwe silikufufuzidwa bwino, machitidwe azikhalidwe, makamaka a PIU omwe masiku ano akuimira mliri wapadziko lonse [,-].

NKHANI ZOPHUNZIRA

Mbiri yakutsogolo

Kugwiritsa ntchito pamavuto pa intaneti (PIU) ndichizolowezi chodziwikiratu chomwe chimadziwika ndi kugwiritsa ntchito kwambiri intaneti komwe kukukhala vuto lowonjezeka padziko lonse lapansi. Ngakhale palibe mgwirizano pa njira yolondola yodziwira, PIU imawerengedwa ngati gawo lokhala ndi chizolowezi chogwiritsa ntchito mankhwala osokoneza bongo (SUDs) ndi zina zowonjezera zingapo komanso mwina ma neurobiological under-pininings.

Zoyambitsa

Tsoka ilo, palibe chidziwitso chomwe chilipo pakukula kwa PIU pakati pa anthu omwe amwa mankhwala osokoneza bongo, ngakhale atapatsidwa umboni, kuti anthu awa amakhudzidwa ndi kugwiritsa ntchito mankhwala osokoneza bongo komanso chifukwa cha zizolowezi zoipa, ngati kuti kupezeka kwa munthu mmodzi kapena zingapo kuyimira mtundu wa chiwopsezo chakukula kwa chithunzi cha chipatala kudzera kumayambiriro kwa zovuta zina.

Zolinga zakufufuza

Kafukufuku wokhudzana ndi kukhalapo ndi kufalikira kwa PIU pakati pa omwe amamwa mankhwala osokoneza bongo omwe ali ndi chithandizo chamankhwala kumalo osungirako malo okhala kungathandizenso kukhazikitsidwa kwa chithandizo chamankhwala kuti chisayambike mitundu ina yamankhwala omwe angawononge chithunzi cha chipatala ndi mapulogalamu okonzanso.

Njira zofufuzira

Pulogalamu yofunsidwa kuti idzazidwe pa intaneti, yomwe imatchedwa Mafunsoario sull'Utilizzo delle Nuove Tecnologie (QUNT), idapangidwa kuti ifufuze kuchuluka ndi machitidwe ogwiritsa ntchito intaneti komanso PIU. QUNT ili ndi magawo awiri, imodzi ndi ya chiwerengero cha anthu ndipo ina ili ndi zinthu za 101 zomwe zidakhazikitsidwa malinga ndi zinthu zomangidwa molingana ndi a priori Njira zomwe zimapezeka kuchokera kuzosowa zomwe zimapezeka m'mabuku asayansi. Maphunziro onse omwe adadzipereka kuchita nawo phunziroli (n = 183) adanena kuti QUNT inali yothandiza ndipo idakhutitsidwa nayo. Zambiri zomwe zimawerengedwa zimawerengedwa ngati kuchuluka kwa zinthu zomwe zapezeka pachinthu chilichonse zomwe zidagawika ndi kuchuluka kwakukulu pamiyeso. Tinasankha yankho 4 (pakati pa 4 ndi 6 hr / d), ndi yankho 5 (> 6 hr / d) la chinthu 2 "nthawi yogwiritsidwa ntchito pa intaneti". Pofuna kudziwa kuchuluka kwa kuchuluka kwa thupi (mfundo zake, motsatana, kupezeka kwa PIU.

Zotsatira zakufufuza

Nthawi yogwiritsidwa ntchito pa intaneti inali yoposa 4 hr / d pamulingo wonsewo, pocheperapo, ngakhale osafunikira, kufala pakati pa maphunziro achimuna. Ogwiritsa ntchito Cocaine ndi a cannabis adatha maola oposa 6 pa intaneti, mochuluka kuposa opioid ndi oledzera. Kugawidwa kwa zinthu za QUNT sikunali kosiyana pakati pa akazi ndi amuna. Ogwiritsa ntchito Cocaine adawonetsa kuchuluka kwa "kuwonongeka", "zolaula", komanso "kugwiritsa ntchito malo ochezera a pa Intaneti", mwina chifukwa cha zinthu zomwe zimapangitsa chidwi cha zinthuzi. Kuphatikiza apo, 15 mwa ogwiritsa ntchito cocaine a 17 okwanira onse anali otchovera njuga. Maubwenzi abwino komanso owerengera amawonekeranso pakati pa zinthu zina za QUNT ndi index ya thupi (BMI). Zotsatira izi, ngakhale zikuwonetsa kuti PIU ndi yodziwika pakati pa omwe amagwiritsa ntchito mankhwala osokoneza bongo, amafunikira kuti azisindikizidwa m'masampweya akuluakulu ochokera mayiko ena. Komabe, amaika pachiwopsezo cha kuzolowera kukhala osokoneza bongo, vuto lomwe liyenera kukumbukiridwa pokonzekera kupewa ndi kuchitira limodzi nkhanza.

Malingaliro omaliza

Zotsatira zatsopano za kafukufukuyu zikuyimiriridwa ndi kuchuluka kwakukulu kwa PIU pakati pa omwe amamwa mankhwala osokoneza bongo, makamaka ngati agwiritsa ntchito cocaine kapena cannabis. Izi zikusonyeza kuti, ngakhale nkhanza za pa intaneti zilipo mwa anthu onse omwe ali ndi mankhwala osokoneza bongo, PIU sichachilendo pamaphunziro omwe amatenga zinthu zosokoneza, monga heroin / opioids ndi mowa, pomwe zimatha kukhala "zoyambitsa" zomwe zimapangitsa kuti anthu azigwiritsa ntchito mankhwala osokoneza bongo a cocaine , monga amathandizira ndi kuchuluka kwa masewera a pathological pakati pa ogwiritsa ntchito cocaine. Kupitilira apo, PIU imakonda kukhala mitu imodzi kapena maphunziro omwe amakhala okha, zomwe zimatsindika zoteteza za ubale kapena mgwirizano pakati pathunthu kuyambira kumayambira. Maphunziro omwe adagwiritsa ntchito nthawi yambiri pa intaneti, monga akuwonetsera ndi kuchuluka kwa "nthawi yomwe adagwiritsa ntchito pa intaneti", "kuchoka pagulu", "kudzipatula ku zenizeni", komanso "kuzolowera kucheza", anali ndi BMI yapamwamba. Chifukwa chake, kugwiritsa ntchito intaneti mochulukirapo kungaonedwe ngati chinthu china chowonjezera chomwe chingakhale chiopsezo cha osokoneza bongo, omwe amapezeka kale matenda osiyanasiyana. Kuchepetsa nthawi yogona komanso kusokoneza mizere yoyendayenda chifukwa cha PIU ndizinthu zina zomwe zingakulitse mwayi wamavuto a metabolic, a zamankhwala, ndi matenda amisala komanso kusokonezeka kwa ntchito, banja, chikhalidwe cha anthu, kapena masukulu.

Maganizo ofufuza

Zotsatira za kafukufuku wapano zikuwonetsa kuti zizolowezi zamakhalidwe, monga PIU, zitha kukulitsa kugwiritsa ntchito polydrug, makamaka pamaphunziro omwe amatenga zolimbikitsa kapena cannabis. Kuphatikiza apo, PIU imatha kuonedwa ngati chinthu china chowonjezera chomwe chimapangitsa kukhala ndi moyo woipa, chokhala ndi vuto la mankhwala osokoneza bongo, pomwe chimalimbikitsa kukhala mwamakhalidwe oyipa ndi kusasamala mu madera osiyanasiyana Kafukufuku wamtsogolo akuyenera kuganizira momwe PIU imakhudzira anthu omwe ali ndi vuto losokoneza bongo pogwiritsa ntchito njira zina zowunikira, kuti athe kupewa zovuta zake, komanso zokhudzana ndi kufalikira kwa zizolowezi.

ZIZINDIKIRO

Tili othokoza onse oyang'anira owerengera a SERT ochokera ku Calabria chifukwa cha mgwirizano wawo wopindulitsa.

Mawu a M'munsi

Chiwonetsero cha board ya Institutional Board: Phunziroli lidavomerezedwa ndi Ethics Committee of Pisa University.

Chidziwitso chovomerezeka: Kafukufukuyu adavomerezedwa ndi Ethics Committee of Pisa University, ndipo omwe adatenga nawo gawo adaganiza zotenga nawo mbali modzifunira komanso mosadziwika, kuti sizinawadziwitse.

Chingelezi chokhudza mikangano: Olembawo alibe mikangano yoti afotokozere.

Gwero lamanja: Zolemba pamanja

Zowunikirana za Anzathu zayamba: Epulo 26, 2018

Kusankha koyamba: June 15, 2018

Nkhani mu atolankhani: Meyi 15, 2019

Wowunika P: Wotulutsa Hosak L, Seeman MV S-Mkonzi: Ji FF L-Mkonzi: Filipodi E-Mkonzi: Wang J

Mtundu wapadera: Psychiatry

Dziko lomwe adachokera: Italy

Magulu a mbiri ya anzanu

Kalasi A (Yabwino Kwambiri): 0

Kalasi B (Yabwino kwambiri): 0

Gawo C (Zabwino): C, C

Gulu D (Labwino): 0

Giredi E (Osauka): 0

Zowonjezera Zowonjezera

Stefano Baroni, Dipartimento di Medicina Clinica e Sperimentale, Gawo la Psychiatry, University of Pisa, Pisa 56100, Italy.

Donatella Maraziti, Dipartimento di Medicina Clinica e Sperimentale, Gawo la Psychiatry, University of Pisa, Pisa 56100, Italy. ti.ipinu.dem.ocisp@izzaramd.

Federico Mucci, Dipartimento di Medicina Clinica e Sperimentale, Gawo la Psychiatry, University of Pisa, Pisa 56100, Italy.

Elisa Diadema, Dipartimento di Medicina Clinica e Sperimentale, Gawo la Psychiatry, University of Pisa, Pisa 56100, Italy.

Liliana Dell'Osso, Dipartimento di Medicina Clinica e Sperimentale, Gawo la Psychiatry, University of Pisa, Pisa 56100, Italy.

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