Comments: Heino imwe nyaya yekuongorora inoratidza kuti chinodhaka Naltrexone inobatsira vanodhakwa kudzora kushandisa kwavo zvinonyadzisira (senzira yekupedzisira). Kuti uwane zvakakwana, uye kupenya, kukurukurirana kweNaltrexone uye kupindwa muropa nezvinonyadzisira uone izvi nyaya yekutanga.
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Shane W. Kraus, PhD a, b * Sarah Meshberg-Cohen, PhD a, b Steve Martino, PhD a, b Lantie J. Quinones, MD c Marc N. Potenza, MD, PhD b
a VISN 1 Mental Illness Tsvaga Yekudzidza Dzidzo uye Clinical Centers, VA Connecticut Healthcare System, West Haven, CT USA
b Yale University Chikoro cheMishonga, New Haven, CT USA
c McLean Chipatara, Harvard Medical School, Dhipatimendi rePsychiatry, Belmont, MA USA
* Munyori anoenderana: Shane W. Kraus, Ph.D., VISN 1 MIRECC, VA Connecticut Healthcare System, 950 Campbell Avenue 151D, West Haven, Connecticut 06515, United States. Runhare: 203-932-5711, Ext: 7907; Email: [email inodzivirirwa]
KUSVIRA KUSVIRA:
Pakati pe30-50% yevarume veUS vanoona zvinonyadzisira nguva dzose, uye chikamu chidiki chidiki chevataridzi vanogadzira kushandiswa kunomanikidza. Kushandiswa kwezvinonyadzisira kushandiswa kunoratidzwa nekuchiva, maitiro ekumanikidza, kushamwaridzana / kushaya basa, uye yakakwirira mibairo yehutano hwepfungwa comorbidity (1). Tichifunga nezve mbiri dzichangoburwa nyaya idzi (2, 3) ichidudzira naltrexone, opioid-receptor antagonist, inogona kudzikisira kukura kwehukombwe hwepfungwa uye maitiro ane hukama neasina kupesana anomanikidza kuita zvepabonde, isu tinoshuma nenyaya ye naltrexone sechibvumirano chezvepfungwa mune murume akaroora, anoshanda, anoita zvechirume murume ari mu30 yake aitsvaga kurapwa kwekuona dambudziko reInternet zvinonyadzisira. Kubudirira kwaNaltrexone mukuderedza zvishuwo zvepabonde kuita bonhora nezvekuona zvinonyadzisira hakuenzaniswi.
Mr. D. akatanga kushandisa zvinonyadzisira nguva dzose pazera 13. Munguva yekubvunzurudza kwekudya, akataura zvekumanikidza kubata bonhora kuona zvinonyadzisira kwemakore ekupedzisira 10 kunyangwe akawanda akundikana kuedza; iye aiona Internet zvinonyadzisira anenge zuva nezuva kwemaminetsi e30. Akarondedzera kuongororwa kwekutanga kwekushungurudzika kwakakura, uye asina nhoroondo yekushandisa zvisina kunaka zvinodhaka, zvine hutano hwepabonde, matambudziko akakosha ekurapa, kana kutora mishonga yakatemwa.
Mr. D akatanga kuenda kumavhiki kwega kwega hwekuziva-maitiro ekurapa anotumirwa nachiremba-chikamu chikiriniki psychologist. Kwemavhiki e18, akapedzisa zuva nezuva kuzviongorora mapepa ebasa achiedza kukurudzira kuona Internet zvinonyadzisira (1.0 = Hapana Urge, 7.0 = Intense Urge) uye kana anga akatarisa ndokuita bonhora nezvekuona zvinonyadzisira. Kunyangwe achideredza mashandisiro ake ekushandiswa kwezvinonyadzisira nechero 70%, Mr. D akaenderera achienderera nekurondedzera kurara kwepabonde kuridza bonhora kuita Internet pornography. Naizvozvo, pavhiki yegumi yekurapwa, akagadzwa naltrexone (50 mg / d).
Mukati memavhiki maviri ekutanga mushonga, akataura subjential kuderera kwake kukurudzira kuita bonhora kuona zvinonyadzisira. Sezvinoratidzwa mumufananidzo 1, mumavhiki mapfumbamwe aakatora naltrexone, kukura kwechido chake chebonde kwakadzikira zvakanyanya (M1-9 mavhiki = 3.71, SD= 1.28 vs. M10-18 mavhiki = 2.37, SD= .80), t(124) = 6.93, p<.0001, Cohen's d = 1.25). Akaonawo zvinonyadzisira zvishoma (mazuva mashanu mumavhiki 5-10; Mazuva gumi nemashanu mumasvondo 18-17), χ1 (9, N= 125) = 7.04, p<.01 (OR = .25, 95% CI = 0.09-0.73). Mukuwedzera, akatangazve kugara, kugutsikana kurara nemukadzi wake.
Zvatinowana zvinoratidza kuti naltrexone inogona kuve inobatsira kurapwa kwekurapa kune varwere vanotaurira kuomesa maitiro ehupombwe sekuwandisa kwekuona kweInternet zvinonyadzisira. Mhedzisiro inokwenenzverwa yenyaya yazvino yemishumo yenyaya ndeyekuti hatina kushandisa dhizaini (WA) dhizaini na Mr. D. Kuwedzeredza, kuedzwazve muyedzo mune yakapetwa-bofu, isina tarisiro, nzvimbo inodzorwa-inoongororwa kuongorora kugona uye kusimba kwe naltrexone na kana pasina) psychotherapy yekurapa kwekutambudzika kwekuona zvinonyadzisira uye humwe hunhu hwekumanikidza hwepabonde hunodiwa.
References
1. Kraus SW, Potenza MN, Martino S, Grant JE. Kuongorora iyo psychometric zvinhu zveYale-Brown Obsessive-Inomanikidza Scale mune muyenzaniso yevashandisi vanoita zvinonyadzisira. Compr Psychiatry. 2015.
2. Bostwick JM, Bucci JA: Kupindwa muropa kwepabonde kweInternet kwakabatwa naltrexone. muMayo Clinic Processings, Elsevier; 2008. pp. 226-230.
3. Raymond NC, Grant JE, Coleman E. Augmentation ine naltrexone kubata unomanikidza kuita zvepabonde maitiro: A nyaya nhete. Ann Clin Psychiatry. 2010; 22: 55-62. 5
Nhamba Yemavhiki Mufananidzo 1. Zvinoreva Zvizhinji Zvekuda Zvinonyadzisira uye Nhamba Yemazuva Akaonekwa Zvinonyadzisira Svondo rega rega Pre / Post Naltrexone (50mg / d) Kushuva Chikamu (1.0 - Hapana Kukurudzira, 7.0 - Yakanyanya Kukurudzira) Nhamba yemazuva akashandiswa zvinonyadzisira pavhiki
Naltrexone 50mg / d
Mari
Mhosva iyi inonzi yakatsigirwa neVeterans Affairs Administration, VISN 1 Mental Illness Research Education uye Clinical Centers, CASAColumbia neNational Center for Responsible Gaming. Zvemukati memanyoro zvinoratidza maonero evanyori uye kwete kunyanya iwo masangano emari. Masangano anobatsira mari haana kuwana zvaakawana mune zvakanyorwa.
Disclosures
Vanyori vacho vanoti havana mhirizhonga yezvemari yekufarira zvine chekuita nezviri mune uyu manyoro. Dr. Potenza akagamuchira rutsigiro rwemari kana kubhadharirwa zvinotevera: Dr. Potenza akabvunza uye ndokupa zano Lundbeck, Ironwood, Shire, INSYS uye RiverMend Health; akagamuchira rutsigiro rwekutsvagisa (kuna Yale) kubva kuNational Institutes of Health, Mohegan Sun Casino, National Center for Responsible Gaming, uye Pfizer mishonga yemishonga; yatora chikamu muongororo, kutumira mameseji kana kubvunzana nerunhare zvine chekuita nekudhakwa kwezvinodhaka, kusimbisa kudzora kusagadzikana kana mimwe misoro yehutano; yakabvunza kubhejera uye epamutemo masangano pazvinhu zvine chekuita nekumanikidza kudzora; inopa kurapwa kwehutano muDhipatimendi reConsticut Routano hwepfungwa uye Dhijidhiti Dambudziko Rokubhejera Services Chirongwa; yaita ratidziro yemapiro eNational Institutes of Health nemamwe masangano; yakagadzirisa kana yakashongedza-yakarongedzerwa majenhau kana zvikamu zvemagazini; yakapa hurukuro dzezvidzidzo mumakwikwi makuru, zviitiko zveCME uye dzimwe nzvimbo dzekiriniki kana dzesainzi; uye yakagadzira mabhuku kana zvitsauko zvebhuku revaparidzi vezvinyorwa zvehutano hwepfungwa.
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