Litlhaloso tsa batho ba amehang ka likhaolo tsa ICD-11 li amana le bophelo bo botle ba kelello le ba thobalano (2019)

Litlhaloso tsa YBOP: Pampiri e na le karolo e buang ka maikutlo mabapi le "tlhahlobo e mpe ea boits'oaro ba thobalano" e ncha. Karolong e sebete ea ho becha bangoli ba hlalosa Nicole Prause ea sa kang a fana ka maikutlo makhetlo a 14 empa makhetlo a fetang 20. Boholo ba litlhaloso tsa hae bo ne bo kenyelletsa litlhaselo tsa botho, lipolelo tsa bohata, moelelo o fosahetseng oa lipatlisiso, ho khetha li-cherry le ho senya lebitso.

Mathata a boitšoaro bo bobe a ho kopanela liphate a ile a fumana palo e phahameng ka ho fetisisa ea litlhaselo tsa kelello (N = 47), empa hangata ho tsoa ho batho ba tšoanang (N = 14). Ho kenyelletsoa ha sehlopheng sena sa ho hlahloba ho bile le phehisano e matla3 mme litlhaloso tsa tlhaloso ea ICD-11 li khutliselitsoe polarization e ntseng e tsoela pele tšimong. Litlhahiso li ne li kenyelletsa maikutlo a khahlanong le batho ba hlalosang maikutlo, joalo ka liqoso tsa tlhōlisano ea thahasello kapa ho se sebetse (48%; κ = 0.78) kapa ho bolela hore mekhatlo e itseng kapa batho ba tla rua molemo ka ho kenngoa kapa ho khelosoa ICD-11 (43%; κ = 0.82). Sehlopha se seng se bontšitse ts'ehetso (20%; κ = 0.66) mme sa nka hore ho na le bopaki bo lekaneng (20%; κ = 0.76) bakeng sa ho kenyeletsoa, ​​athe e 'ngoe e hanana ka matla le kenyelletso (28%; κ = 0.69), e hatella mohopolo o fosahetseng (33%) %; κ = 0.61), bopaki bo sa lekaneng (28%; κ = 0.62), le sephetho se kotsi (22%; κ = 0.86). Lihlopha tsena ka bobeli li ne li qotsitse bopaki ba methapo ea kutlo (35%; κ = 0.74) ho ts'ehetsa mabaka a bona. Ke bahlalosi ba fokolang ba hlahisitseng liphetoho tsa 'nete ho tlhaloso (4%; κ = 1). Sebakeng seo, mahlakore ka bobeli a ile a tšohla lipotso tsa maikutlo tse kang ho nahana ka boemo bona e le ho se ts'oenyehe, ho qobelloa, ho lemalla boitšoaro kapa ho hlahisa boitšoaro bo tloaelehileng (65%; κ = 0.62). WHO e lumela hore ho kenngoa ha sehlopha sena se secha ke habohlokoa bakeng sa baahi ba bophelo bo botle ba ho fumana litšebeletso4. Ho tšoenyeha ka ho fetela ka ho feteletseng ho lebisitsoe ho CDDG, empa tataiso ena ha e hlahe litlhaloso tse khutšoanyane tse fumanehang ho bahlalosi ba sethaleng sa beta.

Haeba u batla ho bala litlhaloso tsa sechaba ka likarolo tsa ICD-11 CSBD (ho akarelletsa le mahlatsipa / a silafatsang / a ferekanyang) sebelisa li-link tsena:

  • 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

O tla hloka ho bopa lebitso la hau ho bala litlhaloso.


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

World Psychiatry 18, che. 2 (2019): 233-235.

Matla a ikhethileng a nts'etsopele ea tlhophiso ea ICD-11 ea Lefatše la Bophelo (WHO) ea mafu a kelello, a boitšoaro le a neurodevelopmental e bile boipheliso bo sebetsang bo tsoang ho batho ba bangata ba amehang lefatšeng lohle.

Mantsoe a liphetolelo tsa ICD-11 bakeng sa Lipalo-palo tsa Morbidity le Mortality (MMS), ho kenyelletsa le tlhaloso e khutšoanyane, li fumaneha sethaleng sa beta ea ICD-11 (https://icd.who.int/dev11/l‐m/en) bakeng sa tlhahlobo ea sechaba le litlhaloso tsa lilemo tse 'maloa tse fetileng1. Litlhahiso li ile tsa hlahlojoa ke WHO bakeng sa ntshetsopele ea phetolelo ea MMS ea ICD-11 le phetolelo ea tšebeliso ea meriana ea litsebi tsa bophelo bo botle ba kelello, Tlhaloso ea Mantsoe a Bophelo le Litsela tsa Ts'oaetso (CDDG)1. Mona, re akaretsa lihlooho tse tloaelehileng tsa litlhahiso tsa likarolo tse hlahisitseng karabo e kholo ka ho fetisisa.

Litlhaloso tsohle le litlhahiso li ile tsa hlahlojoa bakeng sa likarolo tse hlalositsoeng khaolong ea litsebo tsa kelello le tsa boitšoaro ICD-10, le hoja tse ling tsa tsona li amoheloe hape 'me li isoa likarolong tse ncha tsa ICD-11 mabapi le mathata a ho robala le maemo a amanang le bophelo bo botle ba botona le botšehali2.

Pakeng tsa la 1 Pherekhong 2012 le la 31 Tšitoe 2017, litlatsetso tse 402 le litlhahiso tse 162 li ile tsa tlisoa ka mathata a kelello, boits'oaro le methapo ea kutlo, mathata a ho robala le maemo a amanang le bophelo bo botle ba thobalano. Palo e kholo ka ho fetisisa ea litlhahiso tse amanang le mathata a kelello, boits'oaro le neurodevelopmental a shebaneng le khatello ea maikutlo ea ho kopanela liphate (N = 47), lefu le rarahaneng la khatello ea maikutlo (N = 26), lefu la khatello ea mmele (N = 23), lefu la autism spectrum ( N = 17), le bothata ba papali (N = 11). Litlhahiso mabapi le maemo a amanang le bophelo bo botle ba thobalano li ne li sebetsana haholo le boits'oaro ba bong ba bohlankana le botsofali (N = 151) le boits'oaro ba bong ba bongoana (N = 39). Litlhahiso tse fokolang li ne li amana le mathata a ho robala (N = 18).

Re sebelisitse tlhahlobo ea boleng ba boleng ho supa meralo ea mantlha ea litlhahiso tse amanang le mekhahlelo eo bonyane ho nang le litlhaloso tse 15 ho eona. Kahoo, 59% ea litlhaloso tsohle le 29% ea litlhahiso tsohle li ile tsa ngolisoa ka likhoutu. Litlhahiso li ne li lekantsoe ka boikemelo ke bahlahlobi ba babeli. Likhoutu tse ngata tsa litaba li ka sebetsa tlhahiso e ngoe le e ngoe. Ho tšepahala ha li-inter-rater ho baliloe ho sebelisoa kappa ea Cohen; ke li-codings feela tse nang le ts'epahalo e ntle ea li-inter-rater (κ≥⃒0.6) tse nkoang mona (82.5%).

Mathata a boitšoaro bo bobe a ho kopanela liphate a ile a fumana palo e phahameng ka ho fetisisa ea litlhaselo tsa kelello (N = 47), empa hangata ho tsoa ho batho ba tšoanang (N = 14). Ho kenyelletsoa ha sehlopheng sena sa ho hlahloba ho bile le phehisano e matla3 le litlhaloso ka tlhaloso ea ICD-11 li pheta-pheta polarization e tsoelang pele lebaleng. Litlhahiso li kenyelletsa maikutlo a hanyetsanang har'a bahlalosi, joalo ka liqoso tsa khohlano ea lithahasello kapa ho se sebetse (48%; κ = 0.78) kapa tse reng mekhatlo kapa batho ba itseng ba tla una molemo ka ho kenyelletsoa kapa ho qheleloa ka thoko ho ICD-11 (43%; κ = 0.82) . Sehlopha se seng se bontšitse ts'ehetso (20%; κ = 0.66) mme sa nka hore ho na le bopaki bo lekaneng (20%; κ = 0.76) bakeng sa ho kenyeletsoa, ​​athe e 'ngoe e hanana ka matla le kenyelletso (28%; κ = 0.69), e hatella mohopolo o fosahetseng (33%) %; κ = 0.61), bopaki bo sa lekaneng (28%; κ = 0.62), le sephetho se kotsi (22%; κ = 0.86). Lihlopha tsena ka bobeli li ne li qotsitse bopaki ba methapo ea kutlo (35%; κ = 0.74) ho ts'ehetsa mabaka a bona. Ke bahlalosi ba fokolang ba hlahisitseng liphetoho tsa 'nete ho tlhaloso (4%; κ = 1). Ho e-na le hoo, mahlakore ka bobeli a ile a tšohla lipotso tsa maikutlo tse kang ho nahana ka boemo bona e le ho se ts'oenyehe, ho qobelloa, ho lemalla boitšoaro kapa ho bontša boits'oaro bo tloaelehileng (65%; κ = 0.62). WHO e lumela hore ho kenyelletsoa ha sehlopha sena se secha ho bohlokoa hore baahi ba kliniki ba molaong ba fumane litšebeletso4. Ho tšoenyeha ka ho fetela ka ho feteletseng ho lebisitsoe ho CDDG, empa tataiso ena ha e hlahe litlhaloso tse khutšoanyane tse fumanehang ho bahlalosi ba sethaleng sa beta.

Litlhahiso tse 'maloa tse amanang le bothata bo tebileng ba lefu la khatello ea maikutlo bo tšehetsang ho kenngoa ho ICD-11 (16%; κ = 0.62), ha ho na letho le hlakileng khahlanong le kenyelletso (κ = 1). Leha ho le joalo, litlhahiso tse 'maloa li fana ka tlhahiso ea phetoho ho tlhaloso (36%; κ = 1), e fane ka litlhaloso tsa bohlokoa (24%; κ = 0.60) (mohlala, mabapi le khopolo ea maikutlo), kapa e tšohla lebokose la ho hlahloba (20%; κ = 1) . Litlhaloso tse 'maloa (20%; κ = 0.71) li ile tsa hatisa hore ho hlokomela boemo bona e le lefu la kelello ho tla etsa hore lipatlisiso li be teng le ho thusa ho hlahloba le ho phekoloa.

Boholo ba litlhahiso mabapi le bothata ba 'mele bo tsielehileng, empa bo ne bo atisa ho etsoa ke batho ba tšoanang (N = 8). Ho nyatsuoa ho ne ho lebisitsoe tlhokomelo ea conceptualization (48%; κ = 0.64) le lebitso la bothata (43%; κ = 0.91). Tšebeliso ea lentsoe la ho hlahloba le amanang haufi-ufi le maikutlo a fapaneng a 'mele a tšoeroeng ke lefu la matšoenyeho5 e ne e nkoa e le mathata. Tlhaloso e 'ngoe e ne e le hore tlhaloso e itšetlehile haholo ka qeto ea kliniki e ikemetseng eo bakuli ba e lebisang holima matšoao a' mele ke "ho feteletseng". Litlhaloso tse 'maloa (17%; κ = 0.62) li bontšitse ho tšoenyeha ka hore sena se tla lebisa ho bakuli hore ba khethoe kelellong' me ba ba thibele ho fumana tlhokomelo e loketseng ea liphatsa tsa lefutso. Bafani ba bang ba rometse tlhahiso ea liphetoho ho tlhaloso (30%; κ = 0.89). Ba bang ba hanyetsa ho kenngoa ha lefu lena ka ho feletseng (26%; κ = 0.88), athe ha ho na tlhahiso (κ = 1) e bontšitseng tšehetso ea ho kenngoa. WHO e ile ea etsa qeto ea ho boloka bothata ba 'mele bo tsielehileng e le sehlopha sa ho hlahloba6 mme a buisana le mathata ka ho hloka hore CDDG e be teng ka likarolo tse eketsehileng, tse kang boima ba ts'ebetso bo sebetsang.

Litlhaloso mabapi le maemo a amanang le bophelo bo botle ba botona le botšehali li bontšitse ts'ehetso e kholo ea ho tlosoa ha lits'oaetso tsa thobalano le ho hlahlojoa ha bong bo botle khaolong le ho theha khaolo e fapaneng (35%; κ = 0.88)7. Litlhahiso tse ngata (25%; κ = 0.97) li sebelisa molaetsa oa tempele o fanoeng ke Mokhatlo oa Lefatše oa Bophelo bo Botle ba Botona le Botšehali. Liphuputso tse 'maloa li phehile ka hore ho boloka botona ba botona le botšehali boemong ba lefu bo tla ntša kotsi le ho nyatsa batho ba litlamorao (14%; κ = 0.80), ho hlahisoa tlhaloso e fapaneng ea tlhaloso (18%; κ = 0.71) kapa lebokose le fapaneng la ho hlahloba (23%; κ = 0.62). WHO e fetotse litlhaloso ka karolo ho latela litlhaloso tse fumanoeng7.

Ho khahlisang ke hore sehlopha se seholo sa litlatsetso mabapi le tlhaloso e reriloeng ea ICD-11 ea boits'oaro ba bong ba bongoana e bontšitse khanyetso ho litekanyetso tsa hajoale tsa tlhokomelo ka ho hana ka kotloloho phetoho ea sechaba le kalafo e netefatsang bong (46%; κ = 0.72), litaba tseo , leha e le ea bohlokoa ebile e le tsekisano, e amana le kalafo ho fapana le tlhophiso. Tlhaloso e reriloeng e ile ea nyatsoa kapa ea hanyetsoa ho 31% ea litlatsetso (κ = 0.62), ha ba bang ba sebelisa template e fanoeng ke Mokhatlo oa Lefatše oa Bophelo bo Botle ba Botona le Botšehali ho khothaletsa ntlafatso e ipapisitseng le lipuisano tse tsoang sechabeng (15%; κ = 0.93). Ba bang ba hanana le ts'oaetso e bonts'ang tšabo ea ho khetholla phapang ea bong ba bongoana (15%; κ = 0.93) mme ba re ha e hlokahale hobane ho ke ke ha ba le khatello ea maikutlo (11%; κ = 0.80) kapa tlhoko ea tlhokomelo ea bophelo e netefatsang bong (28%) ; κ = 0.65) ho bana. Ba bang ba boetse ba pheha khang ea hore tlhahlobo ha e hlokahale molemong oa lipatlisiso, ba supa hore lipatlisiso mabapi le bosodoma li atlehile ho tloha ha li tlosoa ICD (9%; κ = 0.745). Ha e ntse e amohela litsekisano tse mabapi le kalafo, WHO e ile ea boloka karolo ena ho thusa ho netefatsa phihlello ea tlhokomelo e nepahetseng ea bongaka ha e ntse e sebetsana le sekhobo ka ho beoa ha eona khaolong e ncha ea maemo a amanang le bophelo bo botle ba thobalano le ka tlhaiso-leseling e tlatselletsang ho CDDG7.

Ha ho hlalosoa litlhaloso tsena, ho hlakile hore litlhahiso tse ngata li entsoe ka pono ea bobuelli, hangata e tsepamisitsoe sehlopheng se itseng. Ho loketse hore litsebi tsa saense li hlahlobe litlhoko tsa bona ka lebaka la phihlelo ea mokuli le maikutlo. WHO e sebelisitse litlhaloso le litlhahiso ho sethaleng sa beta hammoho le mehloli e meng ea tlhahisoleseding, haholo-holo lithuto tsa tšimo8, 9, e le motheo oa ho etsa liphetoho MMS le CDDG.

References