Bothata ba papali ea chelete: ho lemalla boitšoaro (2016)

Ho becha ka tsela ea tlhaho, eo hape ho thoeng ke pherekano ea papali ea chelete, e fetohile tšebeliso ea pele ea tlhekefetso e sa amaneng le litloaelo ho DSM ‐ 5. Tlalehong ena, mathata a 'maloa a sehlopha sa henogenible DSM ‐ IV a Ts'oaetso ea Ts'usumetso ea Ts'usumetso e seng Ntle le Hoo li Khethiloeng li ile tsa hlakisoa hape ho latela data e bokelletsoeng nakong ea DSM ‐ IV. Leha ho le joalo, karohano ea DSM ‐ 5 e hlahisitse likhohlano, 'me maikutlo a mang a thuto a le mothating oa ho tlohela papali ea chelete ea kelello ho khaolo ea mathata a taolo ea tšusumetso (bona, ka mohlala, Grant et al1 koranteng ena).

Mona re fana ka kakaretso ea mabaka a tšehetsang karohano ea papali ea papali ea chelete ea ho becha e le bothata ba ho lemalla (mabaka a "pro") mme re sebetsana le mabaka ana a hlahisoang ke basebetsi mmoho ba ratang tumello e fapaneng ea nalos ("con"). Ka lehlakoreng la "pro", ho ka totobatsoa liphapang tse ngata lipakeng tsa papali ea papali ea chelete ea methapo le mathata a tšebeliso ea lithethefatsi. Har'a lintho tsena tse tloaelehileng ke liphofu tsa tsona tse tšoanang tsa ts'ebetso ea boko le likarolo tsa kelello2. Li kenyelletsa ho ts'oana ho likarolo tsa ts'ebetso ea moputso pakeng tsa papali ea chelete ea ho becha le mathata a tšebeliso ea lithethefatsi tse fapaneng le mathata a taolo ea ts'usumetso. Le ha mathata ana a morao a na le likarolo tse khotsofatsang bakeng sa motho ka mong1, moputso ona o thehiloe ho matlafatso e mpe: batho ba na le maikutlo a ho phomola kamora ketso. Ka lehlakoreng le leng, lithethefatsi tse khothalletsoang ke lithethefatsi le papali ea chelete li fana ka matlafatso, bonyane methating ea pele ea ts'oaetso ea lefu lena.2, ha batho ba tlaleha “kick” kapa boemo ba “phallo”. Ke maemong a kamora moo, likarolo tse qobelloang le ho matlafatsa pelehi e mpe. Ntle le moo, ts'ebetso e kholo ea ts'usumetso e hokahaneng le boits'oaro bo nang le mathata ke karolo ea mantlha e arolelanoang ke ho becha ha methapo ea kutlo le mathata a tšebeliso ea lithethefatsi. Maemong ana ka bobeli, tebello ea moputso ke ho se sebetse ntle le mofuta oa moputso. Bopaki bo fana ka maikutlo a hore batho ba nang le bothata ba ho becha kapa ba ts'ebeliso ea lithethefatsi ba bonts'a phallo e ntle ea moputso. Liphetho tsena li ts'ehetsa maikutlo a hore dopaminergic dysfunction e etsa karolo e tloaelehileng ea lithahasello tsa litheko le litekanyetso tsa boitšoaro, leha ho ntse ho etsoa lipatlisiso tse ling.2.

Ho feta moo, mathata a ts'ebeliso ea methapo ea kutlo le ts'ebeliso ea lithethefatsi li na le litšobotsi tse ts'oanang tsa tlhahlobo, mme litheko tsa comorbidity li phahameng2. Ho na le ho hongata ho phekoloeng ha meriana le litabeng tsa boitšoaro. Ho ba le bofokoli ba liphatsa tsa lefutso pakeng tsa papali ea chelete ea ho becha le mathata a tšebeliso ea lithethefatsi li teng3, le kopanyo e akaretsang ea papali ea papali ea chelete ea ho becha le tšebeliso ea lithethefatsi maemong a pele a batho ba nang le papali ea papali ea chelete ha ba bapisoa le ba malapa a taolo.4.

Ho pheha khang mabapi le karohano ea papali ea papali ea methapo ea methapo e le bothata ba ho lemalla, joalo ka mohlala o hlalositsoe ke Grant et al1, e ka phetoa ntle le tlhokahalo ea ho khetholla papali ea methapo ea methapo e le bothata ba taolo ea tšusumetso. E 'ngoe ea mabaka a behiloeng pele ke hore ke pele ho nako ho nka papali ea chelete ea marang-rang e le tšibollo ea ho fumana lintlha tse ka bang teng liphatseng tsa lefutso lipakeng tsa papali ea papali ea chelete le khatello ea maikutlo. Re nahana hore boteng ba lintho tsena tse arolelanoang li ka hlalosoa ka mokhoa o fapaneng, ha ho nahanoa hore mathata a ho feto-fetoha ha maikutlo ke bothata ba bobeli bo tloaelehileng bo hlahang ho papali ea methapo ea methapo, kamora ts'ebeliso ea ts'ebeliso ea lithethefatsi. Ntle le moo, mokoloto o arolelanoeng oa liphatsa tsa lefutso o boetse o teng lipakeng tsa ho itšetleha ka lintho (mohlala, nicotine5, cocaine6) le khatello ea maikutlo.

Khang e 'ngoe e ile ea etelloa pele1 ke hore ha ho na ts'ebeliso ea bongaka e hlakileng bakeng sa ho khetholla ho becha ha methapo ea methapo joaloka tšibollo hobane phekolo e atamelana le tse ling ntle le tse sebelisoang kalafo ea mathata a ts'ebeliso ea lithethefatsi e ka ba molemo bakeng sa boemo boo. Mehlala e thathamisitsoeng ke litlhare tsa kalafo ea lithium le tlhaiso. Leha ho le joalo, lithium e na le monyetla oa ho fokotsa ho becha ho feteletseng ka hohle kamoo ho ka khonehang ka lebaka la ts'ebetso ea eona ea ho phekola matšoao a phefumolohang a comorbid ho e-na le ho becha ka methapo. ka bobeli 7. Rea lumela hore litlhare tse pepesang li ka thusa ho fokotsa litakatso tsa papali ea chelete ea ho becha. Leha ho le joalo, mokhoa ona oa kalafo o sebelisitsoe ka katleho mathateng a ts'ebeliso ea lithethefatsi 'me o sebetsa ho fokotsa litakatso tse amanang le lithethefatsi.8.

Kamora nako, ha re nahana ka thibelo, tlhahlobo ea papali ea methapo ea methapo e ka ba le tšusumetso e kholo. Le ha ts'ibollo le litekanyetso li ka susumetsoa haholo ke mehato ea thibelo9, sena ha sea bontšoa bakeng sa mathata a taolo ea tšusumetso.

Ka kakaretso, mabaka a behiloe pele ke Grant et al1 ha ea lekana ho loants'a karohano ea ho becha ha methapo ea methapo e le bothata ba ho lemalla ho DSM ‐ 5 le ho fana ka mabaka a khethollo e fapaneng ho ICD ‐ 11. Ho fapana le moo, se fapaneng ke 'nete. Ho becha ka tsela ea tlhaho ho ka utloisisoa hofeta hantle e le temallo ea "boitšoaro", eo ho eona motho e mong a sa lemalloang ke sehlahisoa se nang le matla sa khemikhale empa boits'oaro bo mo khotsofatsang.

Karl Mann1, Mira Fauth ‐ Bühler1, Susumu Higuchi2, Marc N. Potenza3, John B. Saunders4 1Department of Addictive Behavior and Addiction Medicine, Setsi se Bohareng sa Bophelo ba Kelello, Setsi sa Bongaka sa Mannheim / Heidelberg University, Mannheim, Jeremane; 2National Hospital Organisation Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japane; Likarolo tsa 3D tsa Psychiatry, Neurobiology le Setsi sa Boithuto sa Bana le CASAColumbia, Yale University School of Medicine, New Haven, CT, USA; 4Centre ea Lipatlisiso tsa Tlhekefetso ea Lithethefatsi tsa Bacha, Univesithi ea Queensland, Brisbane, Australia; Taeo ea Psychiatry le Addiction Medicine, Faculty of Medicine, Univesithi ea Sydney, Sidney, Australia

K. Mann le JB Saunders ke litho tsa ICD ‐ 11 Working Group on Substance ‐ Lits'oaetso tse Amanang le ho Tlatsetsa. Maikutlo a hlahisitsoeng lengolong lena ha a emele maikutlo a sehlopha seo se sebetsang. K. Mann le M. Fauth ‐ Bühler le bona ba kentse letsoho ka mokhoa o tšoanang ntlheng ena.

References

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