Vanhu vose vanobatana navo 'zvinyorwa zve ICD-11 zvitsauko zvine chokuita nehutano hwepfungwa uye zvepabonde (2019)

YBOP inoti: Pepa rine chikamu chinokurukura zvakataurwa pamusoro pe "Compulsive sex behaviour disorder" kuongororwa. Muchikamu chakashinga vanyori vari kutsanangura Nicole Prause uyo akataura kwete ka14 asi kanopfuura ka20. Mazhinji ezvaakataura aisanganisira kurwiswa kwake, kutaura kwenhema, kumiririra zvisirizvo kwetsvagiridzo, kunhonga cherry uye kusvibisa zita.

Kuita zvepabonde zvekuita zvepabonde kwakagamuchira nhamba yepamusoro yehutano hwehutano hwepfungwa (N = 47), asi kazhinji kubva kuvanhu vakafanana (N = 14). Kutanga kwechikwata chekuongorora ichi chave chichikwikwidzana3 uye zvinyorwa pamusoro peCII-11 tsanangudzo yakadzokorora kuenderera mberi kwechirevo mumunda. Zvinyorwa zvinyorwa zvinosanganisira kupikisana kwevatsanangudzo, sekupomerwa kwekupesana kwechido kana kusakwanisa (48%; κ = 0.78) kana kutaura kuti mamwe masangano kana vanhu vaizobatsirwa nekuisa kana kubviswa mu ICD-11 (43%; κ = 0.82). Rimwe boka rakaratidza rutsigiro (20%; κ = 0.66) uye rakafunga kuti pane humbowo hwakakwana (20%; κ = 0.76) yekubatanidzwa, nepo imwe ichirwisa zvine mutsindo kuiswa (28%; κ = 0.69), ichimanikidza kufunga kwakaipa (33 %; κ = 0.61), humbowo husina kukwana (28%; κ = 0.62), uye zvinokanganisa mhedzisiro (22%; κ = 0.86). Mapoka ese ari maviri akataura neuroscientific proof (35%; κ = 0.74) kutsigira nharo dzavo. Vashoma vatauri vakaronga shanduko chaidzo kududziro (4%; κ = 1). Pane kudaro, mativi ese ari maviri akakurukura mibvunzo yesological senge kufungidzira kwechiitiko sekushushikana, kumanikidza, hunhu kupindwa muropa kana kuratidzwa kwehunhu hunhu (65%; κ = 0.62). I WHO inobvuma kuti kuiswa kwechikamu chitsva ichi chakakosha kune vagari vepachipatara vemuzvipatara kuti vawane rubatsiro4. Kunetseka pamusoro pekupedza zvakagadziriswa kunotaridzirwa muCDDG, asi hutungamiri hahuoneki mune tsanangudzo pfupi iripo kune beta platform commenters.

Kana iwe uchida kuverenga mazwi evanhu pamusoro peCI-11 CSBD zvikamu (zvinosanganisira hostile / defamatory / disparaging ivo) shandisa zvibatanidza izvi:

• 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

Iwe unoda kuumba zita rekushandisa kuti uverenge mazwi.

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

World Psychiatry 18, no. 2 (2019): 233-235.

Simba rakasiyana-siyana rekusimudzirwa kweHIV Healthcare Organization (WHO) yeCHD-11 kusarudzwa kwehutano hwepfungwa, hutsika uye neurodevelopmental kwave kuri kuita zvinoitwa kubva kune vakawanda vanobatanidza pasi rose.

Zvinyorwa zvinyorwa zve ICD-11 yeMorbidity and Mortality Statistics (MMS), kusanganisira tsanangudzo shoma, dzave dziripo paIndaneti-11 beta platform (https://icd.who.int/dev11/l‐m/en) kuongororwa kwevanhu uye kupindura kwemakore akawanda akapfuura1. Zvinyorwa zvakaongororwa neW WHO nokuda kwekuvandudzwa kweMMS version yeCD-11 uye shanduro yekushandiswa kwekliniki nevanodzidza nezvehutano hwepfungwa, Clinical Descriptions uye Diagnostic Guidelines (CDDG)1. Pano, tinopfupikisa zvinyorwa zvinowanikwa zvezvikamu zvezvikamu izvo zvakaunza mhinduro huru.

Zvose zvataurwa uye zvinyorwa zvakaongororwa zvezvikamu zvinowanzogadzirwa muchitsauko pamusoro pekusawirirana kwepfungwa uye maitiro muCII-10, kunyange zvazvo dzimwe dzei dzakagadziriswa uye dzakatamirwa kune zvitsva zve ICD-11 pamusoro pekurara kwekurara uye mamiriro ehutano hwepabonde2.

Pakati paNdira 1, 2012 naDecember 31, 2017, 402 makomendi nezvikumbiro zana nemakumi mapfumbamwe nezviviri zvakatumirwa kumatambudziko epfungwa, maitiro uye neurodevelopmental, kurara kwekumuka, uye mamiriro ane hukama nehutano hwepabonde. Nhamba yakakura kwazvo yekutumira inoenderana nepfungwa, maitiro uye neurodevelopmental kusagadzikana kwakanangana nekumanikidzika kwehutano hwepabonde (N = 162), yakaoma mushure mekutambudzika kwekushushikana kwepfungwa (N = 47), kushushikana kwemuviri kushushikana (N = 26), autism spectrum disorder ( N = 23), uye kusagadzikana kwemitambo (N = 17). Kuendesa pamamiriro ane chekuita nezvehutano hwepabonde kunonyanya kugadzirisa kusagadzikana kwevakadzi pakuyaruka uye kuva munhu mukuru (N = 11) uye kusagadzikana kwevakadzi paudiki (N = 151). Zvishoma zvirevo zvaive zvine chekuita nezvekurara-kumutsa kusagadzikana (N = 39).

Isu takaita zvehunhu zvemukati kuongorora kuti titarise misoro mikuru yekutumira inoenderana nezvikamu zvaive nematanho gumi nemashanu. Nekudaro, 15% yemashoko ese uye 59% yezvese zvirevo zvakanyorwa. Kutumira kwaive kwakazvimiririra kuyerwa nevaviri vaongorori. Akawanda zvemukati macode anogona kunyorera pane yega kutumira. Kuvimbika kwepakati pakatarwa kwakaverengerwa kushandisa kape yaCohen; macodings chete ane akanaka epakati-akavimbika akavimbika (κ≥⃒29) anotariswa pano (0.6%).

Kuita zvepabonde zvekuita zvepabonde kwakagamuchira nhamba yepamusoro yehutano hwehutano hwepfungwa (N = 47), asi kazhinji kubva kuvanhu vakafanana (N = 14). Kutanga kwechikwata chekuongorora ichi chave chichikwikwidzana3 uye zvirevo pane iyo ICD-11 tsananguro yakadzokororazve kuenderera mberi kwekuparadzanisa mumunda. Kutumira kwaisanganisira kupokana kunopikisa pakati pevatauri, senge kupomedzerwa kwekukakavara kwekufarira kana kusakwanisa (48%; κ = 0.78) kana kutaura kuti mamwe masangano kana vanhu vangabatsirike nekubatanidzwa kana kubviswa muICD-11 (43%; κ = 0.82) . Rimwe boka rakaratidza rutsigiro (20%; κ = 0.66) uye rakafunga kuti pane humbowo hwakakwana (20%; κ = 0.76) yekubatanidzwa, nepo imwe ichirwisa zvine mutsindo kuiswa (28%; κ = 0.69), ichimanikidza kufunga kwakaipa (33 %; κ = 0.61), humbowo husina kukwana (28%; κ = 0.62), uye zvinokanganisa mhedzisiro (22%; κ = 0.86). Mapoka ese ari maviri akataura neuroscientific proof (35%; κ = 0.74) kutsigira nharo dzavo. Vashoma vatauri vakaronga shanduko chaidzo kududziro (4%; κ = 1). Pane kudaro, mativi ese ari maviri akakurukura mibvunzo yesological senge kufungidzira kwechiitiko sekushushikana, kumanikidza, hunhu kupindwa muropa kana kuratidzwa kwehunhu hunhu (65%; κ = 0.62). IWHO inotenda kuti kuiswa kweichi chikamu chitsva kwakakosha kune yepamutemo kiriniki yevanhu kuti vagamuchire masevhisi4. Kunetseka pamusoro pekupedza zvakagadziriswa kunotaridzirwa muCDDG, asi hutungamiri hahuoneki mune tsanangudzo pfupi iripo kune beta platform commenters.

Zvimwe zvikamu zvakabatana nehutano hwekugadziriswa kwehutano hwepfungwa zvinotsigira kuiswa kwayo mu ICD-11 (16%; κ = 0.62), pasina munhu anonyatsopopotedzana nezvekubatanidzwa (κ = 1). Zvisinei, maverengi akawanda anotsanangura kuchinja kune tsanangudzo (36%; κ = 1), yakatumira mashoko anotsanangurwa (24%; κ = 0.60) (semuenzaniso, maererano nekodzero), kana kuti akakurukura chirairo chekuongorora (20%; κ = 1) . Mitsara yakawanda (20%; κ = 0.71) yakasimbisa kuti kuonekwa kwechiitiko ichi sehutano hwepfungwa kunogona kukurudzira tsvakurudzo uye kuita kuti kuongororwa uye kurapwa.

Ruzhinji rwemashoko pamusoro pechirwere chekurwadziwa kwepfungwa rwakakosha, asi dzaiwanzoitwa nevanhu vakafanana (N = 8). Kururamisa kunonyanya kufunga nezvekufunga (48%; κ = 0.64) uye zita rechirwere (43%; κ = 0.91). Kushandiswa kweshoko rekutsvaga rinonyatsobatanidzwa neyo zvakasiyana-siyana yakagadziriswa mumuviri dambudziko syndrome5 yakaonekwa sechinetso. Imwe kutsoropodza ndeyokuti tsanangudzo iyi inonyanya kunyanya kugadziriswa kwechirongwa chemakiriniki iyo varwere vanocherechedza kune zviratidzo zvemuviri ndeye "kunyanyisa". Nhamba yezvinyorwa (17%; κ = 0.62) yakaratidza kunetseka kuti izvi zvaizoita kuti varwere vaite sevanorwara mupfungwa uye kuvadzivisa kubva pakugamuchira zvakakodzera kuchengetedzwa kwehupenyu. Vamwe vapeji vakapa zvirevo zvekuchinja kune tsanangudzo (30%; κ = 0.89). Vamwe vanopesana nekubatanidzwa kwechirwere zvachose (26%; κ = 0.88), asi pasina kuiswa (κ = 1) vakaratidza kutsigira kwekuiswa. WHO yakasarudza kuchengetedza muviri kushungurudzika chirwere sechikwata chekuongorora6 uye vakataurirana nezvekunyanya kudikanwa nekutsvaga muCDDG kuvapo kwezvimwe zvikamu, zvakadai sekukosha kwehutano hunoita.

Zvinyorwa zvine chokuita nemamiriro ezvinhu ane chokuita nehutano hwepabonde zvakaratidza kutsigirwa kwakasimba kwekubviswa kwezvinetso zvepabonde uye kuongororwa kwepabonde kubva muchitsauko chepfungwa uye kuumbwa kwechitsauko chakasiyana (35%; κ = 0.88)7. Mhinduro dzakawanda (25%; κ = 0.97) dzinoshandisa mharidzo ye template inopiwa neWorld Association for Sexual Health. Mitsva yakawanda yakaratidza kuti kuchengetedza hutano hwepabonde muhutano hwechirwere hunogona kukuvadza nekunyadzisa vanhu vevanhu vanonzi transgender (14%; κ = 0.80), vakarondedzerwa kushandiswa kwakasiyana kwetsanangudzo (18%; κ = 0.71) kana imwe tsamba yekuongorora (23%; κ = 0.62). WHO yakashandura tsanangudzo muchikamu zvichienderana nemhinduro dzakagamuchirwa7.

Sezvineiwo, boka hombe rekutumira pane yakatsanangurwa ICD-11 tsananguro yevakadzi kusagadzikana kwehucheche yakaratidza kupokana neazvino zviyero zvekutarisirwa nekuramba zvakajeka kushanduka kwenzanga uye kusimbisa kwevakadzi - kurapwa kwevana (46%; κ = 0.72), zvinhu izvo , kunyange hazvo ichikosha uye ichiita gakava, zvine chekuita nekurapwa kwete pane kupatsanura. Tsananguro yakatsoropodzwa yakashoropodzwa kana kupikiswa mu31% yekutumira (κ = 0.62), nevamwe vachishandisa template yakapihwa neWorld Association yeHIV Health kukurudzira kudzokorodza kunoenderana nekubvunzana kubva munharaunda (15%; κ = 0.93). Vamwe vakapokana nehutachiona vachiratidza kutya kurapa kusiyanisa kwevanhurume nekusiyana kwevakadzi (15%; κ = 0.93) uye vachiti hazvina basa nekuti panenge pasisina kushushikana (11%; κ = 0.80) kana kudiwa kwevanhurume - vanotsigira hutano (28% ; κ = 0.65) muvana. Vamwewo vakapokana kuti kuongororwa hakuna kudikanwa pakutsvagisa, vachiratidza kuti ongororo nezvechingochani yakabudirira kubva payakabviswa kubva kuICD (9%; κ = 0.745). Ichiri kubvuma makakatanwa akakomberedza kurapwa, iyo WHO yakachengetedza chikamu ichi kuti chibatsire kuona mukana wekuchengetwa kwakakodzera kweclinic ichitarisana nekunyadziswa kuburikidza nekuiswa kwayo muchitsauko chitsva chemamiriro ane chekuita nezvehutano hwepabonde pamwe nekuwedzera ruzivo muCDDG.7.

Mukududzira zvinyorwa izvi, zvakajeka kuti zvizhinji zvekutumirwa kwave zvichiitwa kubva pakuona kwekutaura, zvinowanzotarisa pane imwe nzvimbo. Zvakakodzera kuti nyanzvi dzezvesayenzi dziongorore mazano avo muchiedza chechiitiko chevarwere nemhinduro. IWHO yakashandisa zvinyorwa uye zvido zvepuratifomu ye beta pamwe chete nemamwe magwaro ehuwandu, kunyanya zvidzidzo zvemunda8, 9, sechikonzero chekugadzirisa muMMS neCDDG.