YBOP Comments: Lingaliro lakukonda zamakhalidwe limatsutsana kwa akatswiri ena ndi akatswiri azakugonana. Komabe, zikuwonekeratu kwa ofufuza kuti zizolowezi zamakhalidwe zimapangitsa kusintha kwa ubongo komwe kumawonekera pakukonda mankhwala osokoneza bongo. Izi ziyenera kutero, monga momwe mankhwala onse angathere ndikukweza kapena kuletsa mawonekedwe abwinobwino amthupi. Njira zosokoneza bongo zili kale muubongo - kulumikizana ndi chitsanzo chofunikira. Chifukwa chake ndizomveka kuti zizolowezi zomwe zimakhudza kukondoweza kwamphamvu kwamachitidwe amenewo zimakhalanso ndi mphamvu zotsogolera ku kusintha kwa ubongo wokhudzana ndi zosokoneza.
Background:
Makhalidwe angapo, kupatula kuyamwa kwa mankhwala osokoneza bongo, kumabweretsa mphotho yayifupi yomwe imatha kuyambitsa machitidwe osalekeza, ngakhale akudziwa zovuta zoyipa, mwachitsanzo, kuchepa kwamphamvu pakakhalidwe. Zovuta izi zakhala zikuganiziridwa m'njira zingapo. Lingaliro lina limanena kuti mavutowa amakhala atagona mopupuluma mopupuluma, pomwe ena amatchedwa zovuta zakuwongolera. Kusintha kwina, koma kosagwirizana, malingaliro amatenga zovuta ngati zosokoneza bongo kapena zosokoneza. Zolinga: Dziwitsani zokambirana zanu za ubale womwe ulipo pakati pa mankhwala osokoneza bongo ndi zosokoneza bongo. Njira: Timakumbukira zomwe zikuwonetsa kufanana ndi kusiyana pakati pamavuto owongolera kapena zizolowezi zomwe mumachita komanso zosokoneza bongo. Nkhaniyi ndiyofunika makamaka pakukhazikitsa bwino kwamavutowa m'kope lachisanu lomwe likubwera la American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorder (DSMV). Zotsatira: Umboni wochulukirapo umasonyeza kuti zizoloŵezi zowonongeka zimakhala ngati mankhwala osokoneza bongo m'madera ambiri, kuphatikizapo mbiri yakale, zochitika zozizwitsa, kulekerera, kunyalanyaza, kuphatikizana kwa ma genetic, njira zokhudzana ndi matenda, ndi njira zothandizira kuchipatala, kuthandiza DSM-V Task Force kuphatikizapo mavuto onse ogwiritsira ntchito mankhwala ndi mankhwala osokoneza bongo. Ndalama zamakono zimasonyeza kuti gululi likhonza kukhala loyenera kutchova njuga ndi zina zochepetseratu zowonongeka, mwachitsanzo, kuledzera kwa intaneti. Pakalipano palibe deta yosakwanira kulongosola mtundu uliwonse wa zizoloŵezi zowonongeka. Zotsatira ndi Zofunika Zokhudza Sayansi: Magulu oyenera a zizoloŵezi za khalidwe kapena zovuta zowonongeka zimakhudza kwambiri njira yopititsira patsogolo njira zothandizira.
Mndandanda wa maadiresi kwa Dr. David A. Gorelick, 251 Bayview Boulevard, Baltimore, MD 21224, USA. Imelo: [imelo ndiotetezedwa] Mfundo zowonongeka, khalidwe, matenda, matenda osokoneza bongo, matenda osokoneza bongo
MAU OYAMBA
Makhalidwe angapo, kupatula kuyamwa kwa mankhwala osokoneza bongo, amatulutsa mphotho yayifupi yomwe imatha kubweretsa machitidwe osasunthika ngakhale mukudziwa zovuta zoyipa, mwachitsanzo, kuchepa kwamphamvu pakakhalidwe. Kuchepetsa kulamulira ndi lingaliro lotanthauzira kudalira kwa mankhwala osokoneza bongo kapena chizolowezi. Kufanana kumeneku kwadzetsa lingaliro lazosagwiritsa ntchito mankhwala osokoneza bongo kapena "zizolowezi zina", mwachitsanzo, ma syndromes ofanana ndi zosokoneza bongo, koma ndimakhalidwe ena kupatula kumeza chinthu chopatsa chidwi. Lingaliro la zizolowezi zamakhalidwe ali ndi tanthauzo lina lasayansi komanso lachipatala, koma limangokhala lotsutsana. Nkhani zokhudzana ndi zizolowezi zamakhalidwe pakadali pano zikukambirana pankhani yakukula kwa Diagnostic and Statistical Manual of Mental Disways Fifth Edition (DSM-V) (1, 2)
Zizoloŵezi zingapo zowonongeka zimakhala zongoganiziridwa monga zofanana ndi zakumwa zoledzeretsa. Buku lachidziwitso komanso lofufuza, Gawo Lachinayi (DSM-IV-TR) lakhala likudziwika kuti ndi njira zotani zowonjezera matendawa (mwachitsanzo, kutchova juga, kleptomania), kuwatcha iwo ngati vuto loletsa kupanikizika, gulu losiyana ndi matenda osokoneza bongo. Zochita zina (kapena zovuta zoletsa kupanikizika) zakhala zikuganiziridwa kuti zidzalowetsedwa mu kugula kwa DSM-kukakamiza, kugwiritsira ntchito khungu, kugonana kwachisawawa (kugonana kosagonana ndi paraphilic), kuyaka koopsa, masewera a pakompyuta / kanema, ndi kusewera kwa intaneti. Makhalidwe ati omwe angaphatikizepo monga zizolowezi za khalidwe labwino adakali otseguka pazokambirana (3). Sizitsulo zonse zowonongeka, kapena zosokonezeka zomwe zimadziwika ndi kusaganizira zinthu, ziyenera kuonedwa ngati zizoloŵezi zowonongeka. Ngakhale zovuta zambiri zowonongeka (mwachitsanzo, kutchova njuga, kleptomania) zimawoneka kuti zikugawana zigawo zazikulu ndi zakumwa zoledzeretsa, ena, monga matenda osokoneza bongo, sangathe. Pokhala ndi chiyembekezo chothandizira pazokambirana izi, nkhaniyi ikuwonetsa umboni wofanana pakati pa zizolowezi za khalidwe labwino ndi vuto la kugwiritsira ntchito mankhwala, kusiyana kwawo ndi matenda osokoneza bongo, ndikudziwitsidwa za malo osatsimikiziridwa oyenera kufufuza kafukufuku wamtsogolo. Zimatithandizanso kukhala zofotokozera zotsatila za nkhaniyi, zomwe zikuwongolera makhalidwe ena oledzeretsa mwatsatanetsatane.
MFUNDO ZOCHITIKA ZA ZOCHITA ZOCHITA: UFUMU WOFUNIKA KUGWIRITSA NTCHITO MALANGIZO
Mbali yofunika kwambiri ya zizolowezi zamakhalidwe abwino ndi kulephera kukana kuganiza, kuyendetsa galimoto, kapena kuyesedwa kuchita chinthu chovulaza munthu kapena ena (4). Kugonana kulikonse kumakhala ndi khalidwe lobwerezabwereza lomwe liri ndi mbali yofunikayi mu malo enaake. Kubwerezabwereza kumagwirizanitsa ndi makhalidwe amenewa pamapeto pake kumalepheretsa kugwira ntchito m'madera ena. Pachifukwa ichi, zizoloŵezi zokhudzana ndi khalidwe zimafanana ndi mavuto osokoneza bongo. Anthu omwe ali ndi zizolowezi zoledzeretsa amafotokoza zovuta kuti apewe kumwa mowa kapena kugwiritsa ntchito mankhwala osokoneza bongo.
Khalidwe lokhala ndi zizolowezi zosokoneza bongo zimafanana m'mbiri yachilengedwe, zozizwitsa, ndi zotsatirapo zoyipa. Onsewa ayamba unyamata ndi uchikulire ndi milingo yayikulu m'magulu azaka izi kuposa achikulire (5). Zonsezi zili ndi mbiri yakale yomwe imatha kuwonetsa njira zosakhalitsa, zobwereranso, koma anthu ambiri akuchira pawokha popanda chithandizo chamankhwala (chomwe chimatchedwa "kusiya mwadzidzidzi" kusiya) (6).
Zizolowezi zomwe mumakonda kukhala nazo nthawi zambiri zimayamba chifukwa chokhala ndi "nkhawa kapena chidwi musanachite izi" komanso "zosangalatsa, kukhutitsidwa, kapena kupumula panthawi yochita izi" (4). Makhalidwe a ego-syntonic amakhalidwe amenewa amafanana mofananamo ndi machitidwe azikhalidwe. Izi ndizosiyana ndi chikhalidwe chodzidalira chomangokhalira kukakamira. Komabe, zizolowezi zamakhalidwe ndi zizolowezi zina zimatha kukhala zocheperako komanso zopitilira muyeso pakapita nthawi, chifukwa machitidwe (kuphatikiza kutenga zinthu) nawonso amakhala osasangalatsa komanso ambiri chizolowezi kapena kukakamizidwa (2, 7), kapena amalimbikitsidwa pang'ono ndikulimbikitsidwa ndikuwonjezeredwa ndikulimbikitsidwa koyipa (mwachitsanzo, kupumula kwa dysphoria kapena kusiya).
Khalidwe labwino komanso lokonda kugwiritsa ntchito mankhwala osokoneza bongo limafanana modabwitsa. Anthu ambiri omwe ali ndi zizolowezi zosokoneza bongo amafotokoza zakukhumba kapena kulakalaka asanayambe khalidweli, monganso anthu omwe ali ndi vuto logwiritsa ntchito mankhwala osokoneza bongo asanagwiritse ntchito mankhwala osokoneza bongo. Kuphatikiza apo, machitidwewa nthawi zambiri amachepetsa nkhawa ndipo amadzetsa mkhalidwe wamaganizidwe kapena "okwera," ofanana ndi kuledzera. Kusokonekera m'maganizo kumatha kuthandizira kulakalaka pamavuto amachitidwe komanso kugwiritsa ntchito mankhwala osokoneza bongo (8). Anthu ambiri omwe ali ndi vuto la kutchova njuga, kleptomania, chizolowezi chogonana, komanso kukakamizidwa kugula kugula kumachepetsa kuchepa kwamaganizidwe obwerezabwereza kapena kufunikira kowonjezera chidwi chamakhalidwe kuti akwaniritse zomwezo, zofananira ndi kulolerana (9-11) . Anthu ambiri omwe ali ndi zizolowezi zamakhalidwezi amanenanso kuti ali ndi vuto lochita zachiwerewere pomwe amapewa zizolowezi zawo, zofananira ndi kusiya. Komabe, mosiyana ndi kusiya mankhwala osokoneza bongo, palibe malipoti am'magazi odziwika kapena azachipatala omwe amayamba chifukwa cha zizolowezi zina.
Matenda a njuga, omwe amaphunzira mozama kwambiri za makhalidwe oipa, amapereka chidziwitso chokwanira pa machitidwe oledzeretsa makhalidwe ndi mavuto osokoneza bongo (onani Wareham ndi Potenza, nkhaniyi). Kutha njuga kumayambira muunyamata kapena unyamata, ndi amuna omwe akufuna kuyamba pa msinkhu wawo (5, 12), akuwonetsera chitsanzo cha matenda osokoneza bongo. Malamulo apamwamba otchova njuga amawoneka mwa amuna, ndi zochitika zowoneka ngati zazikazi zomwe zimawoneka mwazimayi (mwachitsanzo, amayi ali ndi chizolowezi choyamba chochita chizolowezi choledzera, koma nthawi yoyesedwa nthawi yoyamba kuledzera) (13). Chiwonetsero chowonetserako choterechi chakhala chikulembedwa kwambiri mu zovuta zosiyanasiyana zogwiritsa ntchito mankhwala (14).
Monga momwe mukugwiritsira ntchito mankhwala, mavuto a zachuma ndi a m'banja amapezeka m'zoledzeretsa. Anthu omwe ali ndi zizolowezi zowonongeka, monga omwe ali ndi zakumwa zoledzeretsa, nthawi zambiri amachita zinthu zoletsedwa, monga kuba, kupondereza, ndi kulemba zolakwika, kuti apeze ndalama zolimbana ndi khalidwe lawo kapena kuthana ndi zotsatira za khalidwe (15).
umunthu
Anthu omwe ali ndi zizoloŵezi zowonongeka ndi omwe ali ndi vuto la kugwiritsiridwa ntchito kwa mankhwala amagwiritsira ntchito mapepala omwe amadzipangitsa kuti asamangokhalira kuchita zinthu komanso kuti asamavutike kwambiri. (16-20). Komabe, anthu omwe ali ndi zizoloŵezi zowonongeka, monga chizoloŵezi cha intaneti kapena kutchova njuga, angathenso kulongosola zovuta zowonongeka (21) (onaninso Weinstein ndi Lejoyeux, nkhaniyi). Kafukufuku wina wanena kuti mbali zamaganizo, kugwirizana pakati pa anthu, komanso zofuna zawo zonsezi zingathe kukhala ndi chizoloŵezi chosokoneza intaneti (onani Weinstein ndi Lejoyeux, nkhaniyi). Mosiyana ndi zimenezi, anthu omwe ali ndi matenda osokoneza bongo amachititsa kuti anthu asamasokonezeke kwambiri (17, 21). Anthu omwe ali ndi zizoloŵezi zowonongeka amatsindikanso kwambiri pazinthu zowakakamiza, koma izi zikhoza kukhala zolepheretsa kuchitapo kanthu pamaganizo ndi zovuta zokhudzana ndi kutaya khalidwe la ma motor (22). Kulepheretsa kufooka kwa magalimoto (kukhumudwa) kwapezeka mwa anthu omwe ali ndi matenda osokoneza bongo komanso opaleshoni ya khungu (chizoloŵezi cha khalidwe labwino chimene chimachititsa kuti munthu asamangokhalira kumangokhalira kumangokhalira kukakamizidwa). matenda osokoneza bongo (23, 24).
MASAMBA 1. Kuwerengera nthawi zonse za kugwiritsira ntchito mankhwala osokoneza bongo m'makhalidwe oipa.
Matenda ochotsera njuga 35% -63%
Kleptomania 23% -50%
Kuthandizira khungu khungu 38%
Chizolowezi chogonana 64%
Kugwiritsa ntchito Intaneti 38%
Kugwiritsa ntchito mokakamiza 21% -46% Gwero: (102).
Kusokonezeka
Ngakhale kuti maphunziro ambiri omwe akuyimira anthu a dziko lonse sanaphatikizepo ndondomeko ya zizoloŵezi za khalidwe labwino, deta yomwe ilipo kale imathandizira mgwirizano pakati pa kutchova njuga ndi vuto la kugwiritsira ntchito mankhwala, ndi kuchuluka kwa zochitika pambali iliyonse (25, 26). Kafukufuku wa St. Louis Epidemiologic Catchment Area (ECA) anapeza kuchuluka kwa mgwirizano wa mankhwalawa (kuphatikizapo kutengera kwa nicotine) ndi kutchova njuga, zomwe zimakhala zovuta kwambiri pakati pa njuga, matenda osokoneza bongo, ndi matenda osokoneza bongo ( 25). Kafukufuku wina wa ku Canada odwala matenda oledzeretsa anawonjezera kuti 3.8 panthawi yomwe kutchova njuga kunalibe (27). Pakati pa anthu omwe ali ndi chidaliro chodzidalira, chiopsezo chokhalira kutchova njuga kwambiri chinali nthawi 2.9 yapamwamba (28). Mavuto osiyana siyana kuyambira ku 3.3 mpaka ku 23.1 awonetsedwa pakati pa kutchova njuga ndi mavuto ozunguza mowa m'mabungwe a US (25, 29). Kuledzera kwa intaneti kunagwirizanitsidwa ndi kugwiritsa ntchito mowa mwauchidakwa (kusiyana kwa chiwerengero cha 1.84) pofufuza ophunzira a 2,453 koleji, atatha kuyang'anira za chikhalidwe cha amuna, zaka, ndi kuvutika maganizo (30).
Zochitika zachipatala za zizoloŵezi zina zokhudzana ndi khalidwe zimasonyeza kuti kugwirizanitsa ndi vuto logwiritsa ntchito mankhwala ndilofala (Table 1). Zotsatirazi zikusonyeza kuti zizoloŵezi za khalidwe labwino zimatha kufanana ndi matenda omwe amagwiritsidwa ntchito ndi mankhwala.
Komabe, chidziwitso chokhudzana ndi mankhwala ogwiritsira ntchito mankhwalawa chiyenera kutanthauziridwa mosamala chifukwa mayanjano aliwonse omwe angayambe kusonyeza kuti ali ndi khalidwe labwino (mwachitsanzo, kugwiritsa ntchito mowa kumateteza mitundu yambiri ya makhalidwe osayenera, kuphatikizapo omwe amadziwika ngati oledzera) kapena pa msinkhu wa syndromal (mwachitsanzo, Kuledzera kumayambitsa kumwa mankhwala osokoneza bongo, mwinamwake monga mmalo mwa kumwa). Vuto la juga ndikumwa mowa mwauchidakwa ndikutchova njuga kwambiri komanso mavuto ambiri a maganizo omwe amachokera ku kutchova juga kusiyana ndi omwe alibe chizolowezi chogwiritsa ntchito mowa (31), komanso achinyamata omwe amamwa mowa kwambiri omwe amamwa mowa nthawi zambiri amakhala othamanga nthawi zambiri kuposa omwe sali (32) kutanthauza kugwirizana pakati pa mowa ndi njuga. Mosiyana, kupeza komweku ponena za kugwiritsira ntchito nicotine kumasonyeza kugwirizana kwa syndromal, monga momwe anthu achikulire omwe ali ndi vuto la kutchova njuga omwe alipo kapena omwe amasuta fodya anali ndi mphamvu zolimbitsa thupi (33). Vuto la juga omwe amagwiritsa ntchito fodya tsiku ndi tsiku amakhala ndi mavuto ozunguza mowa ndi mankhwala osokoneza bongo (34).
Matenda ena a matenda a maganizo, monga matenda aakulu, matenda ochititsa munthu kusinthasintha zochitika, matenda osokoneza maganizo, komanso matenda osokoneza bongo, amadziwika kuti ali ndi zizoloŵezi zowonongeka (35, 36) (onaninsoWeinstein ndi Lejoyeux, nkhaniyi). Komabe, zambiri mwa maphunzirowa ndi zochokera kuchipatala. Zomwe zotsatirazi zimagwiritsidwa ntchito ku zitsanzo za m'derali zimatsimikiziridwa.
Kuzindikira
Zizolowezi za makhalidwe ndi mavuto ogwiritsa ntchito mankhwala angathe kukhala ndi zidziwitso zofanana. Onse omwe amatha kutchova njuga komanso anthu omwe ali ndi vuto la kugwiritsira ntchito mankhwala amagwiritsira ntchito ndalama zochepa (37) ndikuchita zinthu zolakwika pochita zisankho (38) monga Iowa Gambling Task, paradigm yomwe imayesa kupanga mphoto yopanga mphoto (39). Mosiyana ndi zimenezi, kufufuza anthu omwe ali ndi chizoloŵezi cha intaneti sikukuwonetseratu zoperewera zotere pakupanga chisankho pa Iowa Gambling Task (40). Kafukufuku wogwiritsa ntchito betri yokhudzana ndi vuto la kutsekula m'mimba ku 49, omwe amatha kutchova njuga, 48, omwe amatha kumwa mowa mopitirira muyeso, ndipo mauthenga a 49 amapeza kuti juga ndi zakumwa zoledzeretsa zonse zinkasonyeza kuchepa kwa mayesero a chiletso, kusamvetsetsana, komanso ntchito zokonzekera, koma panalibe kusiyana kwa mayesero a ogwira ntchito (41).
Zochitika Zachibadwa za Neurobiological
Mabuku ochulukirapo amachititsa mitundu yambiri ya maurotransmitter (mwachitsanzo, serotonergic, dopaminergic, noradrenergic, opioidergic) pa matenda a zizoloŵezi za makhalidwe ndi mavuto osokoneza bongo (42). Makamaka, serotonin (5-HT), yomwe ikuphatikizidwa ndi kulepheretsa khalidwe, ndi dopamine, yomwe ikukhudzana ndi kuphunzira, zolimbikitsa, ndi kuzindikiritsa zokhazokha, kuphatikizapo mphotho, zingathandize kwambiri pazovuta zonse (42, 43).
Umboni wosokoneza bongo wa serotonergic muzochita zowonongeka ndi kusagwiritsiridwa ntchito kwa mankhwala zimachokera kumayambiriro a kafukufuku wopanga monoamine oxidase B (MAO-B) ntchito, yomwe imagwirizanitsa ndi ma cerebrospinal fluid (CSF) a 5-hydroxyindole acetic acid (5-HIAA, metabolite ya 5-HT) ndipo imatengedwa ngati chizindikiro cha ntchito ya 5-HT. Mafupi a CSF 5-HIAA amagwirizana ndi maulendo apamwamba a kufunafuna zokhumba ndipo amapezeka mukutchova njuga ndi mavuto osokoneza bongo (44). Matenda a Pharmacologic omwe amachititsa kuti mayendedwe a mahomoni athandizidwe pambuyo poyendetsedwa ndi mankhwala otchedwa serotonergic mankhwala amaperekanso umboni wa kuwonongeka kwa serotonergic m'zochita zowonongeka komanso kusokonezeka kwa mankhwala (45).
Kugwiritsira ntchito zinthu mobwerezabwereza kapena kuchita chizoloŵezi chokhala ndi chizoloŵezi chochita khalidwe motsatira malingaliro kungasonyeze njira yogwirizana. Kafukufuku wamakono ndi zachipatala amasonyeza kuti njira yowonongeka yowonjezereka ingaphatikizepo kukonzanso mphotho yoperekedwa kudzera ndi ventral tegmental area / nucleus accumbens / orbital frontal cortex circuit (46, 47). Dera la ventral lili ndi neurons lomwe limatulutsa dopamine ku nucleus accumbens ndi cortex yam'mbali. Kusintha kwa njira za dopaminergic kwapangidwe kuti pakhale kufunafuna mphotho (kutchova njuga, mankhwala) zomwe zimayambitsa kutulutsa dopamine ndi kubweretsa chisangalalo (48).
Umboni wochepa wochokera kufukufuku wokhudzana ndi ubongo umathandizira kugwiritsira ntchito mankhwala osokoneza bongo omwe amachititsa kuti munthu asamangokhalira kumwa mankhwala osokoneza bongo (7). Ntchito yowonongeka yamakina oyandikana nawo (vmPFC) yakhala ikugwirizanitsidwa ndi kupanga chisankho chosadziwika pamayeso a mphoto komanso chifukwa cha kuchepetsa kutchova njuga m'magulu otchova njuga (49). Mofananamo, zachilendo vmPFC ikugwira ntchito mwa anthu omwe ali ndi vuto logwiritsa ntchito mankhwala (50). Kuchita masewera olimbitsa thupi kumaseŵera ochita maseŵera a intaneti kumachitika m'madera omwe amachititsa ubongo (orbitofrontal, dorsolateral prefrontal, chiwonongeko choyamba, nucleus accumbens) monga momwe amachitira ndi mankhwala ozunguza bongo (51) (onani Weinstein ndi Lejoyeux, nkhani).
Kafukufuku wamaubongo akuwonetsa kuti njira ya dopaminergic mesolimbic yochokera ku ventral tegmental mpaka ma nucleus accumbens itha kutenga nawo gawo pamavuto onse ogwiritsa ntchito mankhwala osokoneza bongo komanso njuga zamatenda. Omwe ali ndi vuto la kutchova njuga amawonetsa zochepa zomwe amachita ndi fMRI pochita juga mofananamo kuposa omwe amawongolera maphunziro (52), zofanana ndi zomwe zimawonedwa m'mitu yodalira mowa pokonza mphotho zandalama (53). Kuchepetsa kutsegulira kwamkati mwamphamvu kumathandizanso pakukhumba komwe kumakhudzana ndi zizolowezi zamakhalidwe ndi zizolowezi zamakhalidwe (42). Kuchita nawo ntchito yotchova juga kumawoneka kuti kumapangitsa kuti dopamine imasulidwe kwambiri mu ventral striatum mwa anthu omwe ali ndi matenda a Parkinson (PD) komanso njuga zamatenda kuposa anthu omwe ali ndi PD okha (54), yankho lofanana ndi lomwe limaperekedwa ndi mankhwala osokoneza bongo kapena mankhwala osokoneza bongo (55).
Kuphatikizidwa kwa dopamine m'zovuta za khalidwe kumatchulidwanso ndi maphunziro a odwala PD odzipereka (56, 57). Maphunziro awiri a odwala omwe ali ndi PD adapeza kuti oposa 6% anali ndi vuto loyambitsa khalidwe loyamba kapena matenda osokoneza bongo (mwachitsanzo, kutchova njuga, kugonana), omwe ali ndi vuto lapamwamba kwambiri pakati pa omwe amatenga dopamine agonist mankhwala (58, 59). Mafanidwe apamwamba a levo-dopa a dose anali ogwirizana ndi kukhala ndi chizoloŵezi chokhala ndi khalidwe labwino (59). Mosiyana ndi zomwe zingayembekezeke kuchitidwa kwa dopamine, otsutsa pa dopamine D2 / D3 receptors amachititsa zifukwa zoliva njuga ndi makhalidwe omwe alibe anthu omwe ali ndi PD omwe ali ndi njuga (60) ndipo alibe mphamvu zothandizira kutchova njuga (61, 62) . Kufufuzanso kwina kuli koyenera kufotokoza mbali yeniyeni ya dopamine mu kutchova njuga ndi zina zotayirira.
Mbiri ya Banja ndi Genetics
Zambiri zokhudza mbiri ya banja / maphunziro a chibadwa cha chizoloŵezi chokhala ndi zizoloŵezi zamakhalidwe apangidwa ndi magulu oyenera olamulira (7). Maphunziro a banja laling'ono omwe ali ndi vuto lakutchova njuga (63), kleptomania (64), kapena kugula mokakamiza (65) aliyense amapeza kuti achibale oyambirira a mavutowa anali ndi moyo wapamwamba kwambiri wa mowa ndi mavuto ena ogwiritsira ntchito mankhwala, matenda ena opatsirana ndi matenda, kusiyana ndi zomwe ankachita. Maphunziro a banja omwe amatsogoleredwawo amachirikiza lingaliro lakuti zizoloŵezi zamakhalidwe zingakhale ndi ubale wa chibadwa ndi vuto la kugwiritsira ntchito mankhwala.
Zopereka za chilengedwe ndi zachilengedwe ku zikhalidwe ndi zovuta zina zingathe kulinganitsidwa poyerekeza mgwirizano wawo mofanana (monozygotic) ndi awiri awiri (awiriwa). Pofufuza za mapasa aamuna pogwiritsa ntchito tsamba la Era Twin Registry la Vietnam, 12% mpaka 20% ya kusiyana kwa chibadwa cha chiopsezo cha kutchova njuga ndipo 3% mpaka 8% ya kusiyana kwa chilengedwe ndi chiopsezo cha kutchova njuga kunawerengedwa ndi chiopsezo chakumwa mowa gwiritsani ntchito matenda (66). Awiri mwa magawo atatu (64%) a mgwirizano pakati pa kutchova njuga ndi matenda ozunguza mowa anali okhudzana ndi majeremusi omwe amachititsa mavuto onsewa, omwe amasonyeza kuti akupezeka m'magulu awiriwo. Zotsatirazi zikufanana ndi zomwe zimasonyeza kuti zimapangitsa kuti mitundu yambiri yogwiritsira ntchito mankhwala (67) iziperekedwe.
Pali zochepa kwambiri za maselo a ma genetic of behavioral addictions. Mzere wa D2A1 wa D2 dopamine genetic receptor (DRD2) ukuwonjezeka pafupipafupi kuchokera kwa anthu omwe alibe vuto la kutchova njuga ku kutchova njuga ndi kugawidwa kwachitetezo chogonjetsa ndi vuto la kugwiritsa ntchito mankhwala (68). Ambiri a DRD2 gene gene nucleotide polymorphisms (SNPs) akhala akugwirizanitsidwa ndi umunthu wa zovuta komanso zoyesera za khalidwe labwino mwa odzipereka odzipereka (69), koma izi sizinayesedwe kwa anthu omwe ali ndi zizolowezi za makhalidwe. Ogwiritsa ntchito intaneti ovuta kwambiri anali ndi maulendo apamwamba a mkono wautali wotalika (SS) wa serotonin transporter gene (5HTTLPR) kuposa kuyendetsa bwino, ndipo izi zinkakhudzidwa ndi kupezeka koopsa kwambiri (70) (onaninsoWeinstein ndi Lejoyeux, nkhaniyi).
Kuyankha Kuchiza
Zizolowezi zamakhalidwe ndi zovuta zogwiritsira ntchito mankhwala nthawi zambiri zimayankha bwino kuchipatala chomwecho, zonse za maganizo ndi za mankhwala. Njira ya 12 yothandizira imayandikira, kukondweretsa mtima, komanso njira zamakono zomwe zimagwiritsidwa ntchito pochiza matenda osokoneza bongo zakhala zikugwiritsidwa ntchito bwino pofuna kutchova njuga, khalidwe logonana, kleptomania, kukonda khungu, komanso kugula (71-74) . Kusintha maganizo pazochitika zokhudzana ndi khalidwe lachiwerewere ndi mavuto osokoneza bongo nthawi zambiri zimadalira njira yowonongeka yomwe imalimbikitsa kudziletsa pozindikira zizoloŵezi za nkhanza, kupeŵa kapena kuthana ndi mavuto akuluakulu, ndikupanga kusintha kwa moyo komwe kumawathandiza kukhala ndi makhalidwe abwino. Mosiyana ndi zimenezi, mankhwala opatsirana pogonana chifukwa cha matenda osokoneza bongo amatsindika njira zowonekera komanso zothandizira (2).
Palibe mankhwala omwe amavomerezedwa kuti azitsatira zizoloŵezi za khalidwe, koma mankhwala ena omwe asonyeza malonjezowo pochiza matenda osokoneza bongo akuwonetsanso malonjezano othandizira kuledzera (75). Naltrexone, yemwe amatsutsana ndi opioid receptor antagonist amene amavomereza ndi US Food and Drug Administration pofuna kuthandizira kumwa mowa ndi kudalira opioid, wasonyeza njira zowonongeka pazitsulo zachipatala pofuna kuthandizira kutchova njuga ndi kleptomania (76-79), ndipo akulonjeza mosadziteteza zofufuza za kugula mwamphamvu (80), khalidwe lochita zachiwerewere (81), chizoloŵezi cha intaneti (82), komanso kukonda khungu (83). Zofukufukuzi zikusonyeza kuti ochioid receptors amachitanso chimodzimodzi ndi zizoloŵezi zamakhalidwe monga momwe amachitira ndi mavuto omwe amagwiritsidwa ntchito, mwina kudzera mwa dopaminergic masolimbic njira. Mosiyana ndi zimenezi, kanthawi kochepa kamene kalikonse kamene kamakhala ndi antagonist ndixxone kumapangitsa kuti zizindikilo zikhale zovuta kwambiri (84).
Mankhwala omwe amasintha zochita za glutamatergic amagwiritsidwanso ntchito pochitira zizoloŵezi zowonongeka ndi kudzidalira kwathunthu. Pulogalamu ya topiramate, yomwe imapangitsa AMPA subtype ya glutamate receptor (pakati pa zochitika zina), yasonyeza malonjezano pamabuku otsegulira njuga, kukakamiza kugula, ndi kusakaniza khungu (85), komanso kuthandizira kuchepetsa mowa (86) ), ndudu (87), ndi ntchito ya cocaine (88). N-acetyl cysteine, amino acid yomwe imabweretsanso ndondomeko yowonjezereka ya glutamate mu nucleus accumbens, inachepetsa kutchova njuga ndi zochitika mu kafukufuku wina wa anthu otchova njuga (89), ndipo imachepetsa chikhumbo cha cocaine (90) ndi cocaine (91) mumayendedwe a cocaine. Kafukufukuyu akusonyeza kuti kuthamanga kwa diso la dopaminergic mu nucleus accumbens kungakhale njira yowonongeka komanso kugwiritsa ntchito mankhwala osokoneza bongo (92).
Nkhani Zowononga
Khalidwe limodzi lokha lokhalitsa, kutchova njuga kwamatenda, ndi matenda omwe amadziwika mu DSM-IV ndi ICD-10. Njira zake zowunikira ndizofanana ndi zomwe zimachitika chifukwa chogwiritsa ntchito mankhwala osokoneza bongo / kudalira, kutanthauza, kutanganidwa kwambiri ndi khalidweli, kuchepa kwa mphamvu zowongolera machitidwe, kulolerana, kusiya, komanso zovuta zam'maganizo. DSM-V Task Force yalimbikitsa kusunthira njuga zamatenda kuyambira pano monga vuto lothana ndi zovuta zina kupita pagulu latsopano lotchedwa "Addiction and Related Disorders," zomwe zingaphatikizepo zovuta zamagwiritsidwe ntchito kazinthu komanso "zosokoneza bongo" (www.dsm5. org, opezeka Feb. 10, 2010). Kusintha kokhako komwe kungafotokozeredwe ndikusiya zomwe zikuchitika pofunsa zolakwika kutchova juga, zomwe zimapezeka kuti ndizofala kwambiri ndipo sizimakhudza kwenikweni matendawa.
Zizoloŵezi zina zowonongeka zimaphatikizapo kugwiritsira ntchito mankhwala osokoneza bongo, kuphatikizapo kugula mwamphamvu (93), kuledzera kwa intaneti (94), kusokoneza mavidiyo / kompyuta pamasewera (95), kugonana kwapakati (96), ndi kuyisaka koopsa (onani Kouroush et al., Nkhaniyi) . Izi kawirikawiri zimagwirizana ndi zomwe zilipo DSM-IV zoyenera kugwiritsa ntchito mankhwala osokoneza bongo kapena kudalira, mwachitsanzo, nthawi yambiri yogwiritsira ntchito khalidwe, kuyesayesa mobwerezabwereza kuyesa kapena kusiya khalidwe, kuchepetsa kuthetsa khalidwe, kulekerera, kuchotsa, ndi mavuto osokoneza maganizo zotsatira. Magulu a DSM-V Okhudza Matenda Okhudzana ndi Mavuto Akugwiritsidwa ntchito pogwiritsa ntchito mankhwala osokoneza bongo omwe amalembedwa ku DSM-V, makamaka kutchula za intaneti (www.dsm5.org; kufikira Feb. 10, 2010). Komabe, pazovuta zambiri, pali deta yochepa kapena yosatsimikizirika yowonetsera izi; iwo ali othandizira kwambiri ngati zida zofufuzira kuti azindikire kuchuluka kwa vutoli.
Funso lina lodziŵika bwino lomwe limatchulidwa m'mabuku ndilokuti chizoloŵezi chochita chizoloŵezi cha mankhwala (ndi mankhwala osokoneza bongo) chimakhala ndi chilakolako chokhudzidwa ndi thupi (97), mwachitsanzo, kodi zimakhala ngati zovuta zowonongeka kapena zovuta zowonongeka? Ena adanena kuti njira yofananayi ndi yoposera, ndipo kukhumba ndi kukakamiza kumaimira zosiyana, m'malo moyang'ana mapepala ofanana (98). Zotsutsana ndi zifukwa zomalizazi ndizozipeza monga kusintha kwakukulu pakati pa anthu omwe ali ndi chizoloŵezi chogonana, kusiyana komwe kungagwirizane ndi mayankho a mankhwala (48, 99).
Mu DSM-IV, mankhwala osokoneza bongo (matenda osokoneza bongo) ndi gulu lodziimira, pamene kutchova njuga kumaonedwa ngati vuto loletsa kuthamanga, mofanana ndi, pyromania ndi kleptomania. ICD-10 imasonyeza kuti kutchova njuga ndi "chizoloŵezi ndi vutoli", koma limazindikira kuti "khalidwe silili lopanda nzeru," ngakhale kuti nthaŵi zina limatchedwa "kuthamanga njuga."
Nkhani yofananira ndikumayanjana, kapena kusakanikirana, ngati kulipo, pakati pazikhalidwe zosiyanasiyana. Kafukufuku wamagulu amitundu ndi zithandizo zamankhwala mwa odwala 210 omwe ali ndi vuto lalikulu lokakamira adazindikira magulu awiri a odwala omwe ali ndi zizolowezi zamakhalidwe (100): odwala omwe ali ndi vuto la kutchova njuga kapena chizolowezi chogonana ("hypersexuality") anali ndi zaka zoyambilira ndipo anali otheka wamwamuna, poyerekeza ndi odwala omwe amakonda kugula. Kafukufuku wowonjezereka amafunika kutsimikizira ndikulitsa izi. Njira imodzi yofufuzira yomwe ingathandize kwambiri pamundayo ingakhale kuwunika kwakukulu kwa gulu lalikulu, losagwirizana, lodziwika bwino la anthu omwe ali ndi zizolowezi zosiyanasiyana zakumwa ndi zinthu zosokoneza bongo potengera zomwe zimapangitsa kuti azichita zinthu mopupuluma komanso kukakamira m'malingaliro (mwamalingaliro) komanso mwamakhalidwe ( madera) madera, mwachitsanzo, chidwi chakubweza mphotho (kuchotsera mphotho kwakanthawi), kupanga zisankho pangozi, kukhazikika pamaganizidwe, kuyankha mwachangu, kupirira poyankha, kuletsa mayankho, ndi kuphunzira kubwerera.
SUMMARY AND CONCLUSIONS
Umboni wokulirapo ukuwonetsa kuti zizolowezi zamakhalidwe zimafanana ndi zosokoneza bongo m'maboma ambiri, kuphatikiza mbiri yachilengedwe (matenda obwerera m'mbuyo, omwe ali ndi kuchuluka komanso kufalikira kwa achinyamata ndi achikulire), zozizwitsa (kulakalaka, kudziletsa ["kwambiri", ndi kusiya), kulolerana , comorbidity, kulowererana kwa majini, njira zamaubongo (ndi maudindo aubongo wa glutamatergic, opioidergic, serotonergic, ndi dopamine mesolimbic system), komanso kuyankha kuchipatala. Komabe, zomwe zilipo ndizochuluka kwambiri pamtundu wa njuga zamatenda (onani Wareham ndi Potenza, nkhaniyi), ndizochepa zochepa zogulira mokakamiza (onani Lejoyeaux ndi Weinstein, nkhani iyi), kugwiritsa ntchito intaneti (onani Weinstein ndi Lejoyeaux, nkhaniyi), ndi makanema osokoneza bongo / makompyuta (onani Weinstein, nkhaniyi), ndipo pafupifupi palibe chidziwitso cha zizolowezi zina monga chizolowezi chogonana (onani Garcia ndi Thibaut, nkhaniyi), chizolowezi chachikondi (onani Reynaud, nkhaniyi), kutola khungu (onani Odlaug ndi Grant, iyi), kapena kusenda khungu kwambiri (onani Kouroush et al., Nkhani iyi).
Pali umboni wokwanira wokwanira kutchova njuga monga mankhwala osokoneza bongo; DSM-V Task Force yasankha kusuntha zigawo zake mu DSM-V kuchokera ku matenda osokoneza bongo kupita ku matenda osokoneza bongo komanso zovuta zokhudzana ndi vutoli (gulu latsopano lomwe limaphatikizapo mankhwala osokoneza bongo komanso osagwiritsa ntchito mankhwala). Pakali pano, pokhapokha ngati palibe chidziwitso chotsimikizirika komanso kafukufuku wotsogola, nthawi isanakwane kuganizira zovuta zina zomwe zimayambitsa matenda osagwirizana ndi ena, makamaka zofanana ndi zoledzeretsa, m'malo mozizira kwambiri monga kusokoneza maganizo. Kafukufuku wapadera, kuphatikizapo maphunziro a anthu ndi zinyama (101), amafunika kuti tidziwitse za zizoloŵezi za khalidwe lachizoloŵezi pamtundu wa mankhwala osokoneza bongo, makamaka m'madera a genetics, neurobiology (kuphatikizapo kuganizira ubongo), ndi chithandizo.
ZIZINDIKIRO
Othandizidwa ndi Intramural Research Program, National Institutes of Health, National Institute on Drug Abuse (DAG); NIH (NIDA) amapereka ndalama za R01 DA019139 (MNP) ndi RC1 DA028279 (JEG); ndi Minnesota ndi Yale Centers of Excellence mu Kafukufuku wa Juga, omwe amathandizidwa ndi National Center of Gaming Responsable ndi Institute of Research on Gambling Disorders. Dr. Weinstein akuthandizidwa ndi bungwe la Israel National Institute for Psychobiology. Zomwe zili m'bukuli ndizo udindo wa olemba ndipo siziyimilira malingaliro a boma a National Center of Gaming Responsable kapena Institute of Research on Gambling Disorders kapena mabungwe ena opereka ndalama.
Chidziwitso cha chidwi
Olemba onse adanena kuti palibe kutsutsana kwa chidwi pa nkhaniyi. Dr. Grant adalandira zopereka zofufuzira kuchokera ku NIMH, NIDA, National Center for Gaming Responsable ndi bungwe la Institute for Research on Gambling Disorders, ndi Forest Pharmaceuticals. Dr. Grant akubwezeredwa chaka chilichonse kuchokera ku Springer Publishing kuti achite monga Editor-Chief of Journal of Gambling Studies, apanga ndemanga zopereka thandizo kwa NIH ndi Ontario Gambling Association, walandira ndalama kuchokera ku Oxford University Press, American Psychiatric Publishing, Inc. , Norton Press, ndi McGraw Hill, walandira ulemuaria kuchokera ku Indiana University Medical School, University of South Florida, Sukulu ya Zamankhwala ya Mayo, California Society of Addiction Medicine, State of Arizona, State of Massachusetts, State of Oregon, Province of Nova Scotia, ndi Province of Alberta. Dr. Grant walandira malipiro monga wothandizira maofesi a malamulo pa nkhani zokhudzana ndi kusokoneza maganizo. Dr. Potenza walandira thandizo la ndalama kapena malipiro a zotsatirazi: aphunzitsi ndi aphungu a Boehringer Ingelheim; ndalama za Somaxon; thandizo la kafukufuku wochokera ku National Institutes of Health, Dipatimenti ya Veterans Affairs, Mohegan Sun Casino, National Center for Gaming Resping ndi bungwe la Institute for Research on Gambling Disorders, ndi Forest Laboratories; watenga nawo mbali mufukufuku, mauthenga kapena ma telefoni okhudzana ndi mankhwala osokoneza bongo, matenda osokoneza maganizo, kapena nkhani zina zaumoyo; adafunsira maofesi a malamulo pa nkhani zowonongeka kapena mavuto oletsa kupanikizika; wapereka chithandizo kuchipatala ku Connecticut Department of Health mentally and Addiction Services Problem Gambling Services Program; ndipo wapanga mabuku kapena magawo a mabukhu kwa ofalitsa a matenda a maganizo. Dr.Weinstein walandira thandizo lofufuzira ku Israeli Anti-Drug Authority, Israeli National Institute for Psychobiology, Scientist Wamkulu wa Ministry of Health ku Israel, ndi Rashi Trust (Paris, France) ndi malipiro a zokambirana za mankhwala osokoneza bongo kuchokera ku Utumiki Wophunzitsa wa Israeli. Dr. Gorelick sakunena zapadera kapena zopikisano kunja.
ZOKHUDZA
1. Potenza MN. Kodi mavuto ozunguza bongo ayenera kukhala osagwirizana ndi mankhwala? 2006; 101: 142-151. 2. Potenza MN, Koran LM, Pallanti S. Mgwirizano pakati pa matenda a impulsecontrol ndi matenda osokoneza maganizo: Kumvetsetsa kwamakono komanso kafukufuku wamtsogolo. Psychiatry Res 2009; 170: 22-31. 3. Holden C. Zizoloŵezi za makhalidwe oyamba mu DSM-V. Sayansi 2010; 327: 935. 4. Association of Psychiatric Association. Kufufuza ndi Kuwerenga Buku la Mavuto a Mitsempha. 4th ed., Malemba (DSM-IV-TR). Washington, DC: American Psychiatric Publishing, Inc., 2000. 5. Chambers RA, Potenza MN. Neurodevelopment, kutengeka, ndi kutchova juga. J Jambulani Stud 2003; 19: 53-84. 6. SlutskeWS. Kukhalanso kwachilengedwe ndi kufunafuna chithandizo mu kutchova njuga: Zotsatira za awiri a US kafukufuku wa dziko lonse. Am J Psychiatry 2006; 163: 297-302. 7. Brewer JA, Potenza MN. Nthenda ya ubongo ndi chibadwa cha matenda osokoneza maganizo: kugwirizana ndi mankhwala osokoneza bongo. Zakudya Zamadzimadzi 2008; 75: 63-75. 8. de Castro V, Fong T, Rosenthal RJ, Tavares H. Kuyerekezera chilakolako ndi maganizo pakati pa anthu otchova njuga ndi zidakwa. Kusokoneza Behav 2007; 32: 1555-1564. 9. Blanco C, Moreyra P, Nunes EV, S'aiz-Ruiz J, Ib'ainnez A. Kutchova njuga kumatenda: kuledzera kapena kukakamizidwa? Semin Clin Neuropsychiatry 2001; 6: 167-176. Am J Mankhwala Osokoneza Bongo Kusokonezedwa Kuchokera ku informahealthcare.com ndi Digestive Matenda a Nthambi pa 06 / 21 / 10 Pogwiritsa ntchito paokha. ZOCHITA ZOKHUDZA 7 10. Perekani JE, Brewer JA, Potenza MN. Mankhwala opatsirana pogwiritsa ntchito mankhwala osokoneza bongo. CNS Wopenya 2006; 11: 924-930. 11. Perekani JE, Potenza MN. Kusiyana kwa kugonana kwa anthu omwe akufuna chithandizo cha kleptomania. CNS Wopenya 2008; 13: 235-245. 12. Grant JE, Kim SW. Ziwerengero ndi zochitika zamakono a 131 akuluakulu otchova njuga akuluakulu. J Clin Psychiatry 2001; 62: 957-962. 13. Potenza MN, Steinberg MA, McLaughlin SD, Wu R, Rounsaville BJ, O'Malley SS. Kusiyanasiyana kwa amuna ndi akazi omwe ali ndi vuto la juga pogwiritsa ntchito njuga yopezera njuga. Am J Psychiatry 2001; 158: 1500-1505. 14. Brady KT, Randall CL. Kusiyana kwa kusiyana pakati pa kugwiritsira ntchito mankhwala. Chipatala cha Psychiatr North Am 1999; 22: 241-252. 15. Ledgerwood DM, Weinstock J, Morasco BJ, Petry NM. Zochitika zachipatala komanso chithandizo cha mankhwala omwe ali ndi vuto la kutchova njuga komanso popanda khalidwe lachigawenga laposachedwa. J Am Acad Psychiatry Law 2007; 35: 294-301. 16. Lejoyeux M, Tassain V, Solomon J, Adjes J. Phunziro la kugula mokakamiza odwala opanikizika. J Clin Psychiatry 1997; 58: 169-173. 17. Kim SW, Grant JE. Zochitika za umunthu mu vuto lakutchova njuga ndi matenda osokoneza bongo. Psychiatry Res 2001; 104: 205-212. 18. Grant JE, Kim SW. Chilengedwe ndi zotsatira zoyambirira zachilengedwe mu kleptomania. Khalani Psychiatry 2002; 43: 223-228. 19. Raymond NC, Coleman E, Miner MH. Kusokonezeka maganizo ndi zipsyinjo zofuna kugonana. Khalani Psychiatry 2003; 44: 370-380. 20. Kelly TH, Robbins G, Martin CA, Fillmore MT, Lane SD, Harrington NG, Rush CR. Kusiyanitsa kwa munthu pazogwiritsira ntchito mankhwala osokoneza bongo: d-Amphetamine ndi malo ofunafuna zilakolako. Psychopharmacology (Berl) 2006; 189: 17-25. 21. Tavares H, Gentil V. Matenda a njuga ndi matenda osokoneza bongo: Kulimbana ndi mavuto ambiri. Rev Bras Psiquiatr 2007; 29: 107-117. 22. Blanco C, Potenza MN, Kim SW, Ibane A, Zaninelli R, Saiz-Ruiz J, Grant JE. Kuphunzira kwa woyendetsa zamatsenga ndi kukakamizika kutchova njuga. Psychiatry Res 2009; 167: 161-168. 23. Chamberlain SR, Fineberg NA, Blackwell AD, Robbins TW, Sahakian BJ. Kusokoneza magalimoto ndi kusokonezeka kwa chidziwitso mu matenda osokoneza bongo komanso trichotillomania. Am J Psychiatry 2006; 163: 1282-1284. 24. Odlaug BL, Grant JE, Chamberlain SR. Kusokoneza magalimoto ndi kusamvetsetsana kwachitsulo kumatenda akutupa. Prog Neuropharm Biol Psych 2010; 34: 208-211 .. 25. Cunningham-Williams RM, Cottler LB, Compton WM 3rd, Spitznagel EL. Kupeza mwayi: vuto la juga ndi matenda a matenda a m'maganizo-Zotsatira za St. Pulogalamu ya Louis Epidemiologic Catchment Area Study. Am J Public Health 1998; 88: 1093-1096. 26. Petry NM, Stinson FS, Grant BF. Kugonjetsedwa ndi kutchova njuga kwa DSM-IV ndi matenda ena a maganizo: zotsatira za National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2005; 66: 564-574. 27. Bland RC, Newman SC, Orn H, Stebelsky G. Epidemiology ya kutchova njuga ku Edmonton. Kodi J Psychiatry 1993; 38: 108-112. 28. el-Guebaly N, Patten SB, Currie S, Williams JV, Beck CA, Maxwell CJ, Wang JL. Mgwirizano wama Epidemiological pakati pamachitidwe otchova juga, kugwiritsa ntchito mankhwala osokoneza bongo & kusokonezeka kwa nkhawa. J Jambulani Stud 2006; 22: 275-287. 29. Welte JW, Barnes GM, Tidwell MC, Hoffman JH. Kukula kwa njuga pakati pa US Achinyamata ndi achinyamata: Zotsatira kuchokera ku kafukufuku wapadziko lonse. J Jambulani Stud 2008; 24: 119-133. 30. Yen JY, Ko CH, Yen CF, Chen CS, Chen CC. Kusonkhana pakati pa mankhwala osokoneza bongo ndi intaneti pakati pa ophunzira a koleji: Kuyerekezera umunthu. Kliniki ya Psychiatry Neurosci 2009; 63: 218-224. 31. Stinchfield R, KushnerMG, Winters KC. Mowa umagwiritsira ntchito mankhwala osokoneza bongo komanso kumwa mankhwala osokoneza bongo poyendetsa vuto lakutchova njuga komanso kutchova njuga zotsatira zake. J Jambulani Stud 2005; 21: 273-297. 32. Duhig AM, Maciejewski PK, Desai RA, Krishnan-Sarin S, Potenza MN. Zizindikiro za achinyamata omwe ali ndi zaka zapakati pachitchova njuga komanso osakhala achitchova chifukwa cha zakumwa za mowa. Kusokoneza Behav 2007; 32: 80-89. 33. Perekani JE, Potenza MN. Kusuta fodya komanso kutchova njuga. Ann Clin Psychiatry 2005; 17: 237-241. 34. Potenza MN, Steinberg MA, McLaughlin SD, Wu R, Rounsaville BJ, Krishnan-Sarin S, George TP, O'Malley SS. Makhalidwe a anthu ochepetsera juga otchova njuga akutcha njuga. Am J Addict 2004; 13: 471-493. 35. Presta S, Marazziti D, Dell'Osso L, Pfanner C, Pallanti S, Cassano GB. Kleptomania: Zochitika zachipatala ndi zovuta mu chitsanzo cha ku Italy. Khalani Psychiatry 2002; 43: 7-12. 36. Di Nicola M, Tedeschi D, Mazza M, Martinotti G, Harnic D, Catalano V, Bruschi A, Pozzi G, Bria P, Janid L. Zizoloŵezi za chizoloŵezi cha odwala matenda a maganizo ochititsa munthu kusinthasintha zolaula: Udindo wa kusaganizira ndi umunthu. J Zimakhudza Kusokonezeka 2010; [ePub patsogolo pa print doi: 10.1016 / j.jad.2009.12.016]. 37. Petry NM, Casarella T. Kuchulukitsira kwakukulu kwa madalitso omwe amachedwa kuchepetsa anthu ozunza ndi mavuto a juga. Mankhwala Osokoneza Bongo Amadalira 1999; 56: 25-32. 38. Bechara A. Bungwe loopsa: maganizo, kupanga chisankho, ndi kuledzera. J Jambulani Stud 2003; 19: 23-51. 39. (Adasankhidwa) Cavedini P, Riboldi G, Keller R, D'Annucci A, Bellodi L. Kulephera kwapachilombo koyambitsa njuga kwa odwala. Msambo Wosamalidwa Pachaphala 2002; 51: 334-341. 40. Ko CH, Hsiao S, Liu GC, Yen JU, Yang MJ, Yen CF. Makhalidwe apangidwe ka zisankho, zokhoza kutenga zoopsa, ndi umunthu wa ophunzira a ku koleji ndi chizolowezi cha intaneti. Psychiatry Res 2010; 175: 121-125. 41. Goudriaan AE, Oosterlaan J, de Beurs E, Van Den Brink W. Ntchito zokhudzana ndi vuto la kutchova njuga: kuyerekezera ndi kumwa mowa, matenda a Tourette ndi machitidwe abwino. 2006; 101: 534-547. 42. Potenza MN. Onaninso. Nthenda ya ubongo yokhudzana ndi kutchova njuga ndi kusuta mankhwala: Zowonongeka ndi zotsatira zatsopano. Philos Trans R Soc Lond B Biol Sci 2008; 363: 3181-3189. 43. Fineberg NA, Potenza MN, Chamberlain SR, Berlin HA, Menzies L, BecharaA, Sahakian BJ, Robbins TW, Bullmore ET, Hollander E. Kufufuza makhalidwe okhwima ndi osaganizira ena, kuchokera ku zinyama kupita ku mapeto: Kufotokozera ndemanga. Neuropsychopharmacology 2010; 35: 591-604. 44. Blanco C, Orensanz-Mu~noz L, Blanco-Jerez C, Saiz-Ruiz J. Matenda a njuga ndi mapepala MAO ntchito: phunziro la psychobiological. Am J Psychiatry 1996; 153: 119-121. 45. Hollander E, Kwon J, A Filler, Cohen L, A Stein DJ, DeCaria C, A Liebowitz M, A Simeon D. Serotonergic imagwira ntchito m'magulu a anthu ena: kuyerekezera ndi njira zowonongeka komanso zovuta kwambiri. Psychiatry Res 1998; 79: 213-217. 46. Dagher A, Robbins TW. Umunthu, chizolowezi, dopamine: Kuzindikira kuchokera ku matenda a Parkinson. Neuron 2009; 61: 502-510. 47. O'Sullivan SS, Evans AH, Lees AJ. Dopamine dysregulation syndrome: mwachidule za matenda ake, njira zake ndi kasamalidwe kake. CNS Mankhwala 2009; 23: 157-170. 48. Zack M, Poulos CX. Udindo wofanana wa dopamine mu kutchova njuga ndi psychostimulant mowa. Kugwiritsa Ntchito Mankhwala Osokoneza Bongo Rev 2009; 2: 11-25. 49. Potenza MN, Leung HC, Blumberg HP, Peterson BS, Fulbright RK, Lacadie CM, Skudlarski P, Gore JC. Pulogalamu ya FMRI Stroop yophunzira za ventromedial prefrontal cortical ikugwira ntchito mwa anthu otchova njuga. Am J Psychiatry 2003; 160: 1990-1994. 50. London ED, Ernst M, Grant S, Bonson K, Weinstein A. Kugwiritsira ntchito mankhwala osokoneza bongo komanso kugwiritsa ntchito mankhwala osokoneza bongo: kujambula kwabwino. Cereb Cortex 2000; 10: 334-342. 51. Ko CH, Liu GC, Hsiao S, Yen JY, Yang MJ, Lin WC, Yen CF, Chen CS. Zochita za ubongo zogwirizana ndi masewera olimbitsa machitidwe ozunguza masewera a pa Intaneti. J Psychiatr Res 2009; 43: 739-747. 52. Reuter J, Raedler T, Rose M, Hand I, Gl¨ascher J, B¨uchel C. Pathological njuga ikugwirizana ndi kuchepetsa kutsegula kwa masolimbic mphoto dongosolo. Nat Neurosci 2005; 8: 147-148. Am J Mankhwala Osokoneza Bongo Kusokonezedwa Kuchokera ku informahealthcare.com ndi Digestive Matenda a Nthambi pa 06 / 21 / 10 Pogwiritsa ntchito paokha. 8 J. E. GRANT ET AL. 53. Wrase J, Schlagenhauf F, Kienast T, W¨ustenberg T, Bermpohl F, Kahnt T, Beck A, Str¨ohle A, Juckel G, Knutson B, Heinz A. Kulephera kwa mphoto yokonza correlates ndi chilakolako cha mowa mu zakumwa zoledzeretsa. Neuroimage 2007; 35: 787-794. 54. SteevesTD, Miyasaki J, Zurowski M, Lang AE, Pellecchia G, VanEimeren T, Rusjan P, Houle S, Strafella AP. Kuwonjezereka kwa dopamine kumatulutsa anthu odwala Parkinsonian omwe ali ndi njuga: Phunziro la PET la raclopride la [11C]. Ubongo 2009; 132: 1376-1385. 55. Bradberry CW. Kuwonetsetsa kwa Cocaine ndi dopamine kuyanjanitsa zowonongeka mu makoswe, abulu, ndi anthu: Malo ogwirizana, osagwirizana, ndi omwe amatanthawuza kuledzera. Psychopharmacology (Berl) 2007; 191: 705-717. 56. Weintraub D, Potenza MN. Zovuta zowongolera zovuta mu matenda a Parkinson. Curr Neurol Neurosci Rep 2006; 6: 302-306. 57. Von V, Fernagut PO, Wickens J, Baunez C, Rodriguez M, Pavon N, Juncos JL, Obeso JA, Bezard E. Matenda opatsirana a dopaminergic mu matenda a Parkinson: Kuchokera ku dyskinesias kupita kuzovuta zoyendetsa. Lancet Neurol 2009; 8: 1140-1149. 58. Von V, Hassan K, Zurowski M, de Souza M, Thomsen T, Fox S, Lang AE, J. Miyasaki Kuwonjezeka kwa kubwerezabwereza komanso kufunafuna mphotho ku Parkinson matenda. Neurology 2006; 67: 1254-1257. 59. Weintraub D, Siderowf AD, Potenza MN, Goveas J, Morales KH, Duda JE, Moberg PJ, Stern MB. Mgwirizanowu wa dopamine agonist umagwiritsa ntchito matenda osokoneza bongo ku Parkinson matenda. Arch Neurol 2006; 63: 969-973. 60. Zack M, Poulos CX. Wotsutsana ndi D2 amachulukitsa zotsatira zopindulitsa komanso zopindulitsa za kutchova njuga m'zochitika za anthu otchova njuga. Neuropsychopharmacology 2007; 32: 1678-1686. 61. Fong T, Kalechstein A, Bernhard B, Rosenthal R, Rugle L. Kuyesedwa kwa doubleblind, komwe kumaloledwa ndi placebo kwa olanzapine pofuna kuchiza juga ya poker pathological njuga. Pharmacol Biochem Behav 2008; 89: 298-303. 62. McElroy SL, Nelson EB, Welge JA, Kaehler L, Keck PE Jr. Olanzapine pakuthandizira kutchova njuga: Mlandu wosasinthika wa placebo woyendetsa. J Clin Psychiatry 2008; 69: 433-440. 63. Black DW, Monahan PO, Temkit M, Shaw M. Phunziro la banja la kutchova njuga. Psychiatry Res 2006; 141: 295-303. 64. Perekani JE. Mbiri ya banja ndi matenda okhudza matenda omwe ali ndi kleptomania. Khalani Psychiatry 2003; 44: 437-441. 65. Black DW, Repertinger S, Gaffney GR, Gabel J. Mbiri ya banja komanso matenda okhudza maganizo a anthu omwe ali ndi kugula mokakamiza: Zotsatira zoyambirira. Am J Psychiatry 1998; 155: 960-963. 66. Slutske WS, Eisen S, Woona WR, Lyons MJ, Goldberg J, Tsuang M. Kawirikawiri majini amatha kuika njuga ndi kudalira mowa mwa amuna. Arch Gen Psychiatry 2000; 57: 666-673. 67. Tsuang MT, Lyons MJ, Meyer JM, Doyle T, Eisen SA, Goldberg J, True W, Lin N, Toomey R, Eaves L. Kuwonetseratu kwa nkhanza za mankhwala osiyana pakati pa amuna: Udindo wokhudzana ndi mankhwala osokoneza bongo komanso ogawana nawo. Arch Gen Psychiatry 1998; 55: 967-972. 68. Kubwera DE. Chifukwa chiyani malamulo osiyana amafunika kwa cholowa cha polygen: Zophunzira kuchokera ku maphunziro a jini DRD2. Mowa 1998; 16: 61-70. 69. Hamidovic A, Dlugos A, Skol A, Palmer AA, a Wit H. Kufufuza kwa mitundu yosiyanasiyana ya dopamine receptor D2 poyerekeza ndi khalidwe loletsa khalidwe ndi kutengeka mtima / kufunafuna: Kuphunzira ndikufufuza ndi d-amphetamine mwa anthu omwe ali ndi thanzi labwino. Exp Clin Psychopharmacol 2009; 17: 374-383. 70. Lee Y, Han D, Yang K, Daniels M, Na C, Kee B, Renshaw P. Zizindikiro zofanana ndi maganizo a 5HTTLPR yopanga mafilimu ndi chikhalidwe cha ogwiritsa ntchito kwambiri pa intaneti. Journal of Affective Disorders 2009; 109: 165-169. 71. Petry NM, Amerman Y, Bohl J, Doersch A, Gay H, Kadden R, Molina C, Steinberg K. Njira yodziwa zamaganizo kwa anthu otchova njuga. J Consult Kliniki Psychol 2006; 74: 555-567. 72. Teng EJ, WoodsDW, TwohigMP. Kusintha kwa chizolowezi monga chithandizo cha kukonzekera khungu kosatha: kufufuza kwa woyendetsa. Behav Modif 2006; 30: 411-422. 73. Mitchell JE, Burgard M, Faber R, Crosby RD, de Zwaan M. Matenda osadziwika a khalidwe lachisokonezo cha kugula. Behav Res Ther 2006; 44: 1859-1865. 74. Toneatto T, Dragonetti R. Kugwiritsa ntchito chithandizo chamagulu kwa kutchova njuga: Kufufuza koyesa kafukufuku wotsutsana ndi chidziwitso. mankhwala khumi ndi awiri. Am J Addict 2008; 17: 298-303. 75. Dannon PN, Lowengrub K, Musin E, Gonopolsky Y, Kotler M. Mwezi wa 12 wophunzira mozama za mankhwala osokoneza bongo kwa anthu otchova njuga: Chotsatira chachikulu chophunzira. J Clin Psychopharmacol 2007; 27: 620-624. 76. Kim SW, Grant JE, Adson DE, Shin YC. Kuphatikizika kwapadera ndi kuwerengera kwa placebo pakuchiza njuga. Msambo Wosamalidwa Pachaphala 2001; 49: 914-921. 77. Grant JE, Potenza MN, Hollander E, Cunningham-Williams R, Nurminen T, Smits G, Kallio A. Kafukufuku wochuluka wa wotsutsa opioid amene amachitika pochiza njuga. Am J Psychiatry 2006; 163: 303-312. 78. Perekani JE, Kim SW, Hartman BK. Kafukufuku wopangidwa ndi awiri omwe ali osopa, omwe amachititsa malo omwe amatsutsana ndi opiate anttreist naltrexone pochiza matenda ochova njuga. J Clin Psychiatry 2008; 69: 783-789. 79. Grant JE, Kim SW, Odlaug BL. Chiyeso chodzidzimutsa chachiwiri, chopanda malobo cha wotsutsa opioid, naltrexone, pochiza kleptomania. Msambo Wosamalidwa Pachaphala 2009; 65: 600-606. 80. Perekani JE. Milandu itatu yokakamiza kugula ndi treated naltrexone. Int J Psychiatr Clin Practice 2003; 7: 223-225. 81. Raymond NC, Grant JE, Kim SW, Coleman E. Kuchiza kwa chizolowezi chogonana ndi naltrexone ndi serotonin reuptake inhibitors: Zochitika ziwiri. Int Clin Psychopharmacol 2002; 17: 201-205. 82. Bostwick JM, Bucci JA. Kugonana kwa pa Intaneti kumagwiritsidwa ntchito ndi naltrexone. Mayo Clin Pro 2008; 83: 226-230. 83. Arnold LM, Auchenbach MB, McElroy SL. Zosangalatsa zamaganizo. Zochitika zachipatala, zoyenera kugwiritsidwa ntchito, matenda opatsirana komanso njira zochiritsira. CNS Mankhwala 2001; 15: 351-359. 84. Insel TR, Pickar D. Ulamuliro wa Naloxone mu matenda osokoneza bongo: lipoti la milandu iwiri. Am J Psychiatry 1983; 140: 1219-1220. 85. Roncero C, Rodriguez-Urrutia A, Grau-Lopez L, Casas M. Mankhwala a antiepilectic akuyendetsa matenda osokoneza maganizo. Actas Esp Psiquiatr 2009; 37: 205-212. 86. Johnson BA, Rosenthal N, Capece JA, Wiegand F, Mao L, Beyers K, McKay A, Ait-Daoud N, Anton RF, Ciraulo DA, Kranzler HR, Mann K, O'Malley SS, Swift RM. Topiramate pochiza mowa mwauchidakwa: kuyesedwa kosasinthika. JAMA 2007; 298: 1641-1651. 87. Johnson BA, Swift RM, Addolato G, Ciraulo DA, Myrick H. Chitetezo ndi chithandizo cha mankhwala a GABAergic pofuna kuthetsa uchidakwa. Kampani ya Mowa Imapereka 2005; 29: 248-254. 88. Kampman KM, Pettinati H, Lynch KG, Dackis C, Sparkman T, Weigley C, O'Brien, CP. Mlandu woyendetsa ndege wa topiramate kuti azitsatira kudalira kocaine. Mankhwala Osokoneza Bongo Amadalira 2004; 75: 233-240. 89. Grant JE, Kim SW, OdlaugBL. N-acetyl cysteine, wothandizira kuteteza njuga: Kuphunzira woyendetsa ndege. Msambo Wosamalidwa Pachaphala 2007; 62: 652-657. 90. LaRowe SD, Myrick H, Hedden S, Mardikian P, Saladin M, McRae A, Brady K, Kalivas PW, Malcolm R. Kodi chikhumbo cha cocaine chinachepetsedwa ndi Nacetylcysteine? Am J Psychiatry 2007; 164: 1115-1117. 91. PND ya Mardikian, LaRowe SD, Hedden S, Kalivas PW, Malcolm RJ. Mayesero otseguka a N-acetylcysteine pochiza matenda a cocaine: Kuphunzira woyendetsa ndege. Prog Neuropsychopharmacol Nthenda ya Psychiatry 2007; 31: 389-394. 92. Kalivas PW, Hu XT. Kuletsedwa kosangalatsa mu psychostimulant oledzera. Zojambula Neurosci 2006; 29: 610-616. 93. DW yakuda. Kugulira mokakamiza: Ndemanga. J Clin Psychiatry 1996; 57: 50-54. 94. Ko CH, Yen JY, Chen SH, Yang MJ, Lin HC, Yen CF. Zomwe zimapangidwira ndikuyezetsa ndi kugwiritsira ntchito chida cha intaneti pa ophunzira a koleji. Khalani Psychiatry 2009; 50: 378-384. Am J Mankhwala Osokoneza Bongo Kusokonezedwa Kuchokera ku informahealthcare.com ndi Digestive Matenda a Nthambi pa 06 / 21 / 10 Pogwiritsa ntchito paokha. ZOCHITA ZOKHUDZA 9 95. Porter G, Starcevic V, Berle D, Fenech P. Kuzindikira masewera a masewera a kanema. Aust NZJ Psychiatry 2010; 44: 120-128. 96. Goodman A. Kugonana ndi kugonana: Kusankhidwa ndi chithandizo. J Zogonana za Ther 1992; 18: 303-314. 97. Hollander E, CM Wong. Matenda a thupi, kutchova njuga, komanso kugonana. J Clin Psychiatry 1995; 56: 7-12. 98. Lochner C, Stein DJ. Kodi kumayambitsa matenda osokoneza bongo kumathandiza kumvetsa kusagwirizana kwa matenda osokoneza bongo? Prog Neuropsychopharmacol Nthenda ya Psychiatry 2006; 30: 353-361. 99. Perekani JE. Zolinga zamakono zokhudzana ndi zakumwa za mphotho zotsutsana ndi kutchova njuga. Osonyezedwa pa Symposium pa Masinthidwe Otembenuza Maphunziro a Kutchova Juga ku American College of Neuropsychopharmacology, Msonkhano Wapachaka wa 48th, Hollywood, FL, 2009. 100. LochnerC, Hemmings SM, Kinnear CJ, NiehausDJ, Nel DG, CorfieldVA, Moolman-Smook JC, Seedat S, Stein DJ. Kusanthula kwa magulu a matenda osokoneza bongo omwe ali ndi vuto lodzimvera kwambiri: odwala ndi odwala omwe ali ndi matenda. Khalani Psychiatry 2005; 46: 14-19. 101. Potenza MN. Kufunika kwa zitsanzo za zinyama pakupanga zisankho, njuga, ndi machitidwe ena ofanana. Neuropsychopharmacology 2009; 34: 2623-2624. 102. Perekani JE. Zovuta Zowongolera: Chitsogozo cha Wachipatala Chakuzindikira ndi Kuchiza Zizolowezi Zoyipa. New York, NY: Norton Press, 2008.
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