YBOP Comments: Khopolo ea ho lemalla boitšoaro e baka likhang ho litsebi tse ling le litsebi tsa thobalano. Leha ho le joalo, hoa hlaka ho bafuputsi hore litloaelo tsa boits'oaro li baka liphetoho tsa boko tse bonts'ang ho lemalla lithethefatsi. Sena se tlameha ho ba joalo, joalo ka ha sehlahisoa sohle se ka se etsang e le ho matlafatsa kapa ho thibela mokhoa o tloaelehileng oa mmele. Mekhoa ea ho lemalla lithethefatsi e se e le bokong - tlamo ke mohlala oa bohlokoa. Kahoo hoa utloahala hore boits'oaro bo kenyelletsang tšusumetso e kholo ea mekhoa eo le bona bo na le matla a ho lebisa liphetohong tse amanang le bokhoba.
Background:
Boitšoaro bo 'maloa, ntle le ho kenella ha lithethefatsi, ho hlahisa moputso oa nakoana o ka bakang boits'oaro bo phehellang, leha ho na le tsebo ea litlamorao, ke hore, taolo e fokotsehileng ea boits'oaro. Mathata ana esale a nahanoa ka mekhoa e mengata. Pono e 'ngoe e beha mathata ana e le a ho laoloa ke tšubuhlellano e qobelloang,' me a mang a khetholloa e le mathata a ho laola maikutlo. Khopolo e 'ngoe, empa e sa khethollehe, e nka mathata e le lithethefatsi tse seng tsa lithethefatsi kapa tsa "boits'oaro". Maikemisetso: Tsebisa puisano ka kamano e teng lipakeng tsa lithethefatsi tse kenang kelellong le litloaelo tsa boitšoaro. Mekhoa: Re lekola lintlha tse bonts'ang ho tšoana le phapang lipakeng tsa mathata a taolo ea ts'usumetso kapa litloaelo tsa boits'oaro le lithethefatsi. Sehlooho sena se sebetsa haholoholo bakeng sa tlhophiso e nepahetseng ea mathata ana khatisong e tlang ea bohlano ea American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSMV). Liphetho: Bopaki bo ntseng bo hola bo fana ka maikutlo a hore bokhoba ba boits'oaro bo tšoana le bokhoba ba lithethefatsi literekeng tse ngata, ho kenyelletsa nalane ea tlhaho, phenomenology, mamello, tšehetso, tlatsetso ea liphatsa tsa lefutso, mekhoa ea methapo le karabelo kalafong, ho ts'ehetsa DSM-V Task Force e rerile mofuta o mocha oa Bokhoba ba Tlatsetso le Mathata a amanang le ona. e akaretsa likhathatso tsa tšebeliso ea lithethefatsi le lits'ebeliso tse seng tsa lithethefatsi. Boitsebiso ba hajoale bo fana ka maikutlo a hore sehlopha sena se kopaneng se ka ba se loketseng tšebeliso ea papali ea methapo ea methapo, le lithibelo tse ling tse fokolang tsa boitšoaro tse ithutileng. Hajoale ho na le data e sa lekaneng ho fana ka mabaka a khethollo ea litlatsetso tse ling tsa boitshwaro bo khothalletsoang. Sephetho le Bohlokoa ba Saense: Ho aroloa ka mokhoa o nepahetseng oa litekanyetso tsa boits'oaro kapa mathata a taolo ea tšusumetso ho na le litlamorao tse kholo bakeng sa nts'etsopele ea maano a ntlafalitsoeng a thibelo le kalafo.
Lengolo le fumanehang ho Dr. David A. Gorelick, 251 Bayview Boulevard, Baltimore, MD 21224, USA. Lengolo-tsoibila: [imeile e sirelelitsoe] Mantsoe a bohlokoa a ts'ebeliso ea litloaelo tsa boits'oaro, ho khetholla, ho khetholla, taolo ea tšusumetso, ho hloka taolo ea lithethefatsi
SELELEKELA
Boitšoaro bo 'maloa, ntle le ho kenella ha lithethefatsi, ho hlahisa moputso oa nakoana o ka bakang boits'oaro bo phehellang leha ho na le tsebo ea litlamorao, ke hore, taolo e fokotsehileng ea boits'oaro. Taolo e fokotsehileng ke mohopolo oa mantlha oa ho itšetleha ka lithethefatsi kapa bokhoba ba lithethefatsi. Ho tšoana hona ho hlahisitse mohopolo oa lithethefatso tse seng tsa lithethefatsi kapa tsa "boits'oaro", ke hore, li-syndromes tse ts'oanang le bokhoba ba lithethefatsi, empa ka sepheo sa boits'oaro ntle le ho noa ntho e sebelisang kelello. Mohopolo oa ho lemalla boitšoaro o na le boleng bo itseng ba mahlale le bo bongaka, empa o lula o le likhang. Ho ntse ho ngangisanoa ka litaba tse mabapi le ho lemalla boitšoaro bo bobe molemong oa nts'etsopele ea Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V) (1, 2)
Litekanyetso tse 'maloa tsa boits'oaro li filoe maikutlo a hore li tšoana le bokhoba ba lithethefatsi. Buka ea hajoale ea tlhahlobo ea litheko le ea Statistical, Khatiso ea Bone (DSM-IV-TR) e thathamisitse mekhoa ea tlhahlobo ea mafu bakeng sa a mang a mafu ana (mohlala, papali ea papali ea kelello, kleptomania), e ba khetholla e le mathata a taolo ea tšusumetso, sehlopha se arohaneng le mathata a tšebeliso ea lithethefatsi. Boitšoaro bo bong (kapa mathata a taolo ea tšusumetso) a se a nkuoe hore a kenyellelitsoe ho rekiseng lintho tse matlafatsoang tsa DSM, ho ts'oaroa ha letlalo, ho lemalla thobalano (tšebeliso ea maikutlo a senang paraphilic), ho ts'oara ho feteletseng, papali ea k'homphieutha / ea video le papatso ea inthanete. Ke mekhoa efe ea ho kenyelletsa litlatsetso tsa boitsoaro e ntse e bulehile bakeng sa ngangisano (3). Ha se mathata ohle a taolo ea tšusumetso, kapa mathata a khetholloang ka ho qobelloa, a lokelang ho nkuoa e le bokhoba ba boitšoaro. Leha mathata a mangata a taolo ea ho laola (mohlala, ho becha ha li-pathological, kleptomania) a bonahala a arolelana likarolo tsa mantlha le bokhoba ba lithethefatsi, tse ling, joalo ka ho phatloha ho hoholo ha tse ling, li kanna tsa se be joalo. Ka tšepo ea ho kenya letsoho puisanong ena, sengoloa sena se lekola bopaki ba ho tšoana lipakeng tsa bokhoba ba litekanyetso tsa boitšoaro le mathata a tšebeliso ea lithethefatsi, phapang ea tsona ho pherekano e makatsang, 'me e supa libaka tsa lipatlisiso tse sa tsitsang tsa nakong e tlang. E sebetsa hape e le kenyelletso ea lingoloa tse latelang makasineng ena, tse hlahang boits'oaro bo bobebe ba ho lemalla.
LITLHOHONOLOFATSO TSE BOTSOANG TSA BOPHELO
Karolo ea bohlokoa ea bokhoba ba boitšoaro ke ho sitoa ho hana tšusumetso, ho khanna, kapa teko ea ho etsa ketso e kotsi ho motho kapa ho ba bang (4). Tlatsetso e 'ngoe le e' ngoe ea boitšoaro e khetholloa ke mokhoa o ipheta-phetang oa boits'oaro o nang le tšobotsi ena ea bohlokoa ka har'a domain e itseng. Boitlamo bo pheta-pheto boits'oarong bona bo qetella bo sitisa ho sebetsa libakeng tse ling. Mabapi le sena, litekanyetso tsa boits'oaro li tšoana le mathata a ts'ebeliso ea lithethefatsi. Batho ba lemaletseng lithethefatsi tsa lithethefatsi ba tlaleha mathata a bona khahlanong le takatso ea ho noa kapa ho sebelisa lithethefatsi.
Litloaelo tsa boits'oaro le lithethefatsi li na le ho tšoana ho hongata nalaneng ea tlholeho, liketsahalo tsa tlhaho le litlamorao tse mpe. Ka bobeli li qalile lilemong tsa bocha le bonyaneng ba lilemong tsa bocha le litekanyetso tse phahameng lihlopheng tsena tsa lilemo ho feta tsa batho ba baholo (5). Ka bobeli li na le nalane ea tlhaho e ka bonts'ang mekhoa e sa foleng, e khutlang hape, empa batho ba bangata ba hlaphoheloa ba le bang ntle le kalafo ea semmuso (eo ho thoeng ke "ho ithaopela" ho tlohela) (6).
Bokhoba ba boitšoaro hangata bo etelloa pele ke maikutlo a "tsitsipano kapa ho tsosoa pele o etsa ketso eo" le "monyaka, khotsofalo, kapa phomolo ka nako ea ho e etsa" (4). Sebopeho sa boits'oaro ba boits'oaro bona se ts'oana le boiphihlelo ba boits'oaro ba ts'ebeliso ea lithethefatsi. Sena se fapane le sebopeho sa ho itšoara hampe se bakoang ke ho itšoara hampe le ha ho le joalo, litloaelo tse mpe tsa boitšoaro le litlamorao li ka fokotseha ha nako e ntse e feta, joalo ka ha boits'oaro (ho kenyeletsoa ho nka lithethefatsi) ka bo bona bo fetoha bo sa thabiseng le ho feta tloaelo kapa ho qobelloa (2, 7), kapa ho susumetsoa hanyane ka ho matlafatsoa ke ho matlafatsoa hape ke ho matlafatsoa hampe (mohlala, phomolo ea dysphoria kapa ho hula).
Litloaelo tsa boits'oaro le lithethefatsi li na le ho ts'oana ho ts'oanang. Batho ba bangata ba nang le boitšoaro bo hlephileng ba tlaleha takatso kapa boemo ba takatso pele ba qala boitšoaro, joalo ka batho ba nang le mathata a ts'ebeliso ea lithethefatsi pele ba sebelisa lithethefatsi. Ntle le moo, boits'oaro bona hangata bo fokotsa ho tšoenyeha 'me bo baka maikutlo a matle kapa "bo phahameng" bo ts'oanang le botahoa ba lithethefatsi. Ts'oaetso ea maikutlo e ka tlatsetsa litakatsong tsa mathata a boitšoaro le tšebeliso ea lithethefatsi (8). Batho ba bangata ba nang le papali ea chelete, kleptomania, boitšoaro bo hlephileng ba thobalano, le tlaleho ea ho reka e qobelloang ba fokotseha liphellong tsena tse ntle tsa maikutlo ka boits'oaro bo phetoang kapa tlhoko ea ho eketsa matla a boitšoaro ho fihlela maikutlo a ts'oanang, a ts'oanang le mamello (9-11) . Batho ba bangata ba nang le mekhoa ena ea boits'oaro ba boetse ba tlaleha boemo ba dysphoric ha ba ntse ba qoba boits'oaro, bo ts'oanang le ho khaotsa. Leha ho le joalo, ho fapana le ho tlohela lithethefatsi, ha ho na litlaleho tsa maemo a hlahelletseng a bophelo bo botle ba 'mele kapa a meriana a tebileng a tlohelang lithethefatso tsa boitšoaro.
Papali ea papali ea thuto ea tlhaho, e ithutoang haholo ka lithahasello tsa boitšoaro, e fana ka leseli le eketsehileng mabapi le kamano ea litekanyetso tsa boitšoaro le mathata a ts'ebeliso ea lithethefatsi (bona le Wareham le Potenza, makasine ona). Ho becha ka tsela ea tlhaho hangata ho qala bongoaneng kapa bohlankaneng, ha banna ba rata ho qala ba sa le banyenyane (5, 12), ba bonahatsa mokhoa oa mathata a tšebeliso ea lithethefatsi. Litefiso tse phahameng tsa ho becha ha li-pathological li bonoa ho banna, ka ketsahalo ea telescoping e bonoang ho basali (ke hore, basali ba na le karolo ea morao-rao ea boitšoaro ba bokhoba, empa ba bonts'a nako ea nako ho tloha ho kenelletseng ho keneng bokhobeng) (13). Ketsahalo ea telescoping e ngotsoe ka mokhoa o pharaletseng mekhoeng e mengata ea ts'ebeliso ea lithethefatsi (14).
Joalo ka mathata a ts'ebeliso ea lithethefatsi, mathata a lichelete le a lenyalo a atile mokhoeng oa boits'oaro. Batho ba nang le bokhoba ba boits'oaro, joalo ka batho ba lemaletseng lithethefatsi, ba tla etsa liketso tse seng molaong joalo ka bosholu, ho qhekella, le ho ngola litekolo tse fosahetseng, ho tšehetsa boits'oaro ba bona ba tahi kapa ho sebetsana le litlamorao tsa boits'oaro (15).
botho
Batho ba nang le ts'oaetso ea boits'oaro le ba nang le bothata ba ts'ebeliso ea lithethefatsi ka bobeli ba na le maemo a phahameng a ho itlaleha le ho batla maikutlo mme hangata ba tlase ka mehato ea thibelo e mpe (16-20). Leha ho le joalo, batho ka bomong ba nang le litloaelo tse itseng tsa boitsoaro, tse kang bokhoba ba marang-rang kapa ho becha ka methapo, le bona ba ka tlaleha maemo a phahameng a thibelo ea likotsi (21) (bona le Weinstein le Lejoyeux, makasine ona). Patlisiso e 'ngoe e bontšitse hore likarolo tsa psychoticism, likhohlano tsa batho, le ho itaola li ka bapala karolo ea litheko tsa inthanete (bona Weinstein le Lejoyeux, makasine ona). Ka lehlakoreng le leng, batho ba nang le ts'oaetso e kenelletseng hangata ba ba le maemo a phahameng a ho qoba ho tsoa kotsi le ba tlase ho bohlasoa (17, 21). Batho ba nang le ts'oaetso ea boits'oaro le bona ba na le maemo a mangata a ho qobelloa, empa tsena li ka fokotsoa taolong e senyehileng ea mesebetsi ea kelello le matšoenyeho mabapi le taolo ea taolo ea boitšoaro ba makoloi (22). Tšitiso e senyehileng ea likarabo tsa koloi (ho ts'oaroa) e fumanoe ho batho ba nang le ts'oaetso e potlakileng ea khatello ea kelello le ho ts'oaroa hoa letlalo (tšekamelo ea boitšoaro e nang le khokahano e haufi ea phenomenological le bofokoli bo phehellang), athe bofokoli bo nahanelang (bo nahanoang ho kenya letsoho ho qobelloang) bo ne bo lekantsoe ho ho lemosa feela khatello ea ho qobella (23, 24).
TEBOHO 1. Likhakanyo tsa bophelo bohle tsa lits'ila tsa ts'ebeliso ea lithethefatsi lithahasellong tsa boitšoaro.
Papali ea chelete ea ho becha 35% -63%
Kleptomania 23% -50%
Pathologic letlalo le khetha 38%
Boitšoaro bo matla ba thobalano 64%
Bokhoba ba marang-rang 38%
Ho reka ka matla 21% -46% Mohloli: (102).
Ho itšoara hampe
Leha lithuto tse ngata tsa boemeli ba naha li sa kenyeletse tlhahlobo ea bokhoba ba litekanyetso tsa boitshwaro, datha tse teng tsa seoa tse tšehetsang kamano pakeng tsa papali ea papali ea chelete ea methapo le tšebeliso ea lithethefatsi, ka litekanyetso tse phahameng tsa tšebelisano 'moho ka lehlakoreng le leng le le leng (25, 26). Phuputso ea St. Louis Epidemiologic Catchment Area (ECA) e fumane litheko tse ngata tsa ho kopana ha mathata a tšebeliso ea lithethefatsi (ho kenyeletsoa ho itšetleha ka nicotine) le papali ea chelete ea methapo, ka litekanyetso tse phahameng haholo tse bonoang lipakeng tsa papali ea chelete, mathata a tšebeliso ea joala le bothata ba ho se sebetse hantle bathong ( 25). Tlhahlobo ea mafu a seoa ea Canada e hakanyetse hore menyetla ea ho ba le ts'oaetso ea ts'ebeliso ea joala e eketsehile 3.8-fold ha ho becha ho sa tsubelle ho ne ho le teng (27). Har'a batho ba nang le ts'ebeliso ea lithethefatsi, menyetla ea ho becha ka tsela e leka-lekaneng ho isa ho e phahameng e ne e le linako tsa 2.9 tse phahameng (28). Litekanyo tsa Odds tse qalang ho 3.3 ho isa 23.1 li tlalehiloe pakeng tsa ho becha ha marang-rang le mathata a tšebeliso ea joala lithutong tse thehiloeng ho baahi ba US (25, 29). Ho lemalla marang-rang ho ne ho amana le tšebeliso e mpe ea joala (karo-karolelano ea 1.84) thutong ea baithuti ba koleche ea 2,453, kamora ho laoloa bakeng sa bong, lilemo le khatello ea maikutlo (30).
Mehlala ea Clinical ea litekanyetso tse ling tsa boitšoaro e fana ka maikutlo a hore ho ba teng le mathata a ts'ebeliso ea lithethefatsi ho tloaelehile (Lethathamo la 1). Liphumano tsena li fana ka maikutlo a hore bokhoba ba boitšoaro bo ka arolelana pathophysiology e tloaelehileng le mathata a tšebeliso ea lithethefatsi.
Leha ho le joalo, datha mabapi le ts'ebeliso ea lithethefatsi comorbidity e tlameha ho hlalosoa ka mokhoa o hlokolosi hobane litloaelo life kapa life tsa causal li ka hlaha maemong a boits'oaro (mohlala, tšebeliso ea joala bo hanana le boits'oaro bo sa lokelang, ho kenyelletsa le bo khetholloang e le lemallo) kapa boemong ba syndromal (mohlala, a ts'ebetso ea ts'ebeliso ea lits'ila e qala kamora kalafo ea bokhoba ba tahi, mohlomong e le sebaka sa ho noella). Mathata a batho ba lemaletseng joala khafetsa a na le bothata bo boholo ba ho becha le mathata a kelello a bakoang ke papali ea chelete ho feta a neng a se na litlaleho tsa tšebeliso e mpe ea joala (31), le bacha ba noang joala haholo ba nang le monyetla oa ho becha khafetsa ho feta ba seng (32), ho fana ka maikutlo a kamano lipakeng tsa joala le papali ea chelete. Ho fapana le hoo, ho fumana ho ts'oanang mabapi le ts'ebeliso ea nicotine ho fana ka maikutlo a tšebelisano, joalo ka 'nete ea hore batho ba baholo ba nang le ts'ebeliso ea ho becha ba tsubang bao hona joale ba tsubang ba bile le takatso e matla ea ho becha (33). Barekisi ba mabifi ba sebelisang koae letsatsi le leng le le leng ba na le mathata a ho sebelisa joala le lithethefatsi (34).
Mathata a mang a kelello, a joalo ka khatello e kholo ea khatello ea maikutlo, lefu la ho ferekana kelellong, khatello e matla ea khatello, le tlhaselo ea khatello ea kelello, le tsona li tlalehoa hangata kamanong le bokhoba ba boitšoaro (35, 36) (bona leWeinstein le Lejoyeux, makasine ona). Leha ho le joalo, boholo ba lithuto tsena tsa comorbidity li ne li ipapisitse le mehlala ea kliniki. Boemo boo liphetho tsena li fihlelang ho akaretsa mehlala ea sechaba bo sa tlameha ho tsejoa.
Ho tseba
Litla-morao tsa boitšoaro le mathata a ts'ebeliso ea lithethefatsi li ka ba le likarolo tse tloaelehileng tsa kelello. Ka bobeli basekaseki ba pathological le batho ba nang le bothata ba tšebeliso ea lithethefatsi hangata ba theola moputso kapele (37) mme ba sebetsa hampe ka ho etsa liqeto tsa ho etsa liqeto (38) joalo ka mosebetsi oa ho becha oa Iowa, paradigm e hlahlobang liqeto tsa ho etsa qeto ka menyetla ea kotsi (39). Ho fapana le hoo, phuputso ea batho ba lemaletseng marang-rang e bontšitse hore ha ho na bofokoli bo joalo ha ho etsoa liqeto ho Iowa Papali ea Papali ea Chelete (40). Phuputso e sebelisang betri ea kutlo ea methapo e mengata ho ba betšeli ba methapo ea methapo ea methapo ea methapo ea methapo ea methapo ea methapo ea methapo ea 49, li-48 tse lemalloang ke joala, le taolo ea 49 li fumane hore bashebelli le batho ba lemaletseng joala ka bobeli ba bontšitse ho fokotseha ts'ebetsong litekong tsa thibelo, ho tenyetseha, le mesebetsi ea ho rera, empa ba ne ba sena phapang litekong tsa liteko tšebetso e phahameng (41).
Mekhoa e tloaelehileng ea Neurobiological
'Mele o ntseng o eketseha oa lingoliloeng o kenya ts'ebetsong mekhoa e mengata ea neurotransmitter (mohlala, serotonergic, dopaminergic, noradrenergic, opioidergic) ho pathophysiology ea litekanyetso tsa boits'ebetso le mathata a ts'ebeliso ea lithethefatsi (42). Haholo-holo, serotonin (5-HT), e amehang ka thibelo ea boitšoaro, le dopamine, e kenyellelitsoeng ho ithuteng, khothatso, le boiketlo ba tšusumetso, ho kenyelletsa le meputso, li ka kenya letsoho haholo ho lits'ebetso tsa bobeli tsa mathata (42, 43).
Bopaki ba ho kenya letsoho ha serotonergic lithahasellong tsa boitšoaro le tšebeliso ea lithethefatsi bo tla ka karolo e tsoang lipatlisisong tsa mosebetsi oa platelet monoamine oxidase B (MAO-B), o lumellanang le methapo ea methapo ea methapo ea methapo (CSF) ea 5-hydroxyindole acetic acid (5-HIAA, metabolite of 5-HT) 'me e nkuoa e le letšoao la ts'ebetso ea 5-HT. Maemo a tlase a CSF 5-HIAA a hokahanya maemo a phahameng a ho ts'oaroa le ho ts'oaroa ha maikutlo mme a fumanoe mathateng a ho becha le mathata a tšebeliso ea lithethefatsi (44). Boithuto ba phephetso ea Pharmacologic e lekanyang karabelo ea lihormone kamora ho tsamaisoa ha lithethefatsi tsa serotonergic le tsona li fana ka bopaki ba ho se sebetse hantle ha serotonergic litekong le litlamong tsa tšebeliso ea lithethefatsi (45).
Ts'ebeliso e pheta-phetoang ea lintho kapa ho kenella ts'ebetsong ea temallo ea boitšoaro ka mor'a tšusumetso e ka bonts'a ts'ebetso e kopaneng. Boithuto ba tlhahlobo ea pele le ea bongaka bo fana ka maikutlo a hore mochini o ka sehloohong oa likokoana-hloko tsa mathata a susumetsoang ke tšusumetso o ka kenyelletsa ts'ebetso ea ho kenella ha moputso o kenang ka sebaka sa li-ventral tegmental area / nucleus accumbens / orbital frontal cortex circ (46, 47). Sebaka sa "ventral tegmental" se na le li-neurons tse lokollang dopamine ho li-nucleus accumbens le orbital frontal cortex. Liphetoho tse tseleng ea dopaminergic li hlalositsoe e le sesosa sa ho batla meputso (papali ea chelete, lithethefatsi) tse hlohlelletsang ho lokolloa ha dopamine le ho hlahisa maikutlo a thabo (48).
Bopaki bo lekantsoeng bo tsoang liphuputsong tsa neuroimaging bo ts'ehetsa neurocircuitry e arolelanoang ea litheko tsa boits'oaro le mathata a ts'ebeliso ea lithethefatsi (7). Ts'ebetso e khethiloeng ea "ventral medial pre mapemaal cortex" (vmPFC) e amahantsoe le ho nka liqeto tse sa potlakang litekong tsa meputso ea likotsi le karabelo e fokotsehileng ea likotsi tsa papali ea chelete ea papali ea papali ea papali ea chelete (49). Ka mokhoa o ts'oanang, ts'ebetso e sa tloaelehang ea vmPFC e fumanoe ho batho ba nang le mathata a ts'ebeliso ea lithethefatsi (50). Ts'ebetso e amanang le ts'ebetso ea boko e amanang le papali ea taolo lipapatsong tsa lipapali tsa marang-rang e etsahala likarolong tse tšoanang tsa boko (orbitofrontal, dorsolateral prefrontal, anterior cingulate, nucleus accumbens) joalo ka ts'ebetso ea ts'ebetso e amanang le lithethefatsi ho ts'ebeliso ea lithethefatsi tsa lithethefatsi (51) (bona le Weinstein le Lejoyeux, sena hlahisa).
Patlisiso ea ho nka litšoantšo tsa boko e fana ka maikutlo a hore dopaminergic mesolimbic tsela e tsoang sebakeng sa ventral tegmental ho ea nucleus accumbens e kanna ea kenella mathateng ka bobeli a ts'ebeliso ea lithethefatsi le papali ea chelete. Bafo ba nang le papali ea chelete ea papali ea chelete ba bonts'itse ts'ebetso e nyane ea ventral striatal neuronal ka fMRI ha ba ntse ba etsa papali ea papali ea chelete ho feta lithuto tse laoloang (52), tse ts'oanang le tse bonoang lihloohong tse itšetlehileng ka joala ha li sebetsana le meputso ea chelete (53). Ho fokotseha ha ts'ebetso ea ts'ebetso ea ho tsoaloa ha matla ho boetse ho amehile litakatsong tse amanang le lithethefatsi le boitšoaro bo hlephileng (42). Ho nka karolo mosebetsing oa papali ea chelete ho bonahala ho etsa hore dopamine e lokolloe haholo ho ventral striatum ho batho ba nang le lefu la Parkinson (PD) le papali ea chelete ho feta batho ba nang le PD feela (54), karabo e ts'oanang le e hlahisitsoeng ke lithethefatsi kapa lithethefatsi tse amanang le batho ba lemaletseng lithethefatsi. (55) HO HLOKAHALA
Ho kenya letsoho ha Dopamine litlamong tsa boitšoaro ho boetse ho fanoa ke lithuto tsa bakuli ba PD ba hlalositsoeng (56, 57). Liphuputso tse peli tsa bakuli ba nang le PD li fumane hore ho feta 6% ba bile le ts'oaetso kapa boitšoaro bo sa laoleheng bo qalang (mohlala, papali ea tšebeliso ea kelello, lithethefatsi tsa thobalano), ka litekanyetso tse phahameng haholo har'a ba noang meriana ea dopamine agonist (58, 59). Tekanyetso e phahameng ea levo-dopa e phahameng e ne e amahanngoa le monyetla o moholo oa ho ba le temallo ea boitšoaro (59). Ho fapana le se ka lebelloang ho tsoa ho kenella ho dopamine, bahanyetsi ba dopamine D2 / D3 receptors ba ntlafatsa sepheo se amanang le papali ea chelete le boits'oaro ho batho bao e seng PD ba nang le papali ea papali ea methapo ea methapo (60) mme ba sena ts'ebetso e nepahetseng kalafong ea ho becha ha methapo ea methapo (61, 62) . Patlisiso e 'ngoe e reretsoe ho hlakisa karolo e tobileng ea dopamine papaling ea papali ea chelete le litheko tse ling tsa boitšoaro.
Histori ea Lelapa le Genetics
Boithuto bo fokolang ba nalane ea malapa / genetics ba bokhoba ba boitšoaro bo entsoe le lihlopha tse nepahetseng tsa taolo (7). Lithuto tse nyane tsa malapa tsa li-probands tse nang le ho becha ha methapo ea methapo (63), kleptomania (64), kapa ho reka ka mokhoa o qobelloang (65) e mong le e mong o fumane hore ba leloko la pele la li-probands li na le litekanyetso tse phahameng haholo tsa bophelo ba joala le mathata a mang a tšebeliso ea lithethefatsi, le khatello ea maikutlo le mafu a mang a kelello, ho feta ho laola lihlooho. Lithuto tsena tsa malapa tse laoloang li tšehetsa pono ea hore bokhoba ba boits'oaro bo ka ba le kamano lipakeng tsa mathata a ts'ebeliso ea lithethefatsi.
Melemo ea tikoloho khahlanong le tikoloho le boits'oaro bo itseng e ka hakanyetsoa ka ho bapisa concordance ea bona ka li-twine tse tšoanang (dizygotic). Phuputsong ea mafahla a banna a sebelisang Vietnam Era Twin Registry, 12% ho 20% ea phapang ea liphatsa tsa lefutso e kotsing ea ho becha ha methapo ea methapo le 3% ho 8% ea phapang e sa ts'oaneng ea tikoloho e kotsing ea kotsi ea joala mathata a tšebeliso (66). Likarolo tse peli tsa (64%) tsa tšebelisano e teng lipakeng tsa papali ea papali ea chelete le tšebeliso ea lino tse tahang li bile teng ka lebaka la liphatsa tsa lefutso tse susumetsang likhathatso ka bobeli, ho fana ka maikutlo a ho feta lipakeng tsa maemo ana ka bobeli. Liphumano tsena li tšoana le tse fanang ka maikutlo a tlatsetso ea liphatsa tsa lefutso ho mafu a fapaneng a ts'ebeliso ea lithethefatsi (67).
Ho na le lithuto tse fokolang haholo tsa liphatsa tsa lefutso tsa batho ba lemaletseng boitšoaro. D2A1 allele ea D2 dopamine receptor gene (DRD2) e eketseha khafetsa ho tloha ho batho ba nang le papali ea chelete e seng bothata ho ea ho papali ea methapo ea methapo le ts'ebeliso ea tšebeliso ea methapo ea methapo ea methapo le tšebeliso ea lithethefatsi (68). Mefuta e 'maloa ea DRD2 gene single nucleotide polymorphisms (SNPs) e' nile ea amahanngoa le mehato ea botho ea ho susumetsa le ho leka mehato ea boits'oaro ea boits'ebetso ho baithaopi ba phetseng hantle (69), empa tsena ha li so hlahlojoe ho batho ba nang le boits'oaro ba boitšoaro. Basebelisi ba marang-rang ba nang le marang-rang ba bangata ba ne ba e-na le maqhubu a phahameng a mofuta oa khale oa letsoho (5HTTLPR) ho feta taolo e phetseng hantle, 'me sena se ne se amana le ho qoba kotsi e kholo (70) (bona leWeinstein le Lejoyeux, makasine ona).
Karabelo ea Phekolo
Bokhoba ba boitšoaro le mathata a ts'ebeliso ea lithethefatsi hangata bo arabela hantle liphekeng tse tšoanang, tsa kelello le tsa bongaka. Mekhoa ea ho ithusa ea 12-boits'oaro e atisang ho khothaletsoa, ho khothaletsa matla a susumetsang, le mekhoa ea boits'oaro e tloaetseng ho sebelisetsoa ho phekola mathata a ts'ebeliso ea lithethefatsi e sebelisitsoe ka katleho ho phekola ho becha ha methapo ea methapo, boitšoaro bo qobelloang ba thobalano, kleptomania, ho ts'oaroa ha letlalo la patologic, le ho reka ka potlako (71-74) . Ho kenella hoa kelello le litakatso tsa ts'ebeliso ea lithethefatsi le tlhekefetso ea tšebeliso ea lithethefatsi hangata ho itšetleha ka mokhoa o thibelang boiphetetso o khothalletsang ho ithiba ka ho khetholla mekhoa ea tlhekefetso, ho qoba kapa ho sebetsana le maemo a kotsing e kholo, le ho etsa liphetoho tsa mokhoa o matlafatsang boitšoaro bo botle. Ho fapana le moo, kalafo e atlehileng ea kelello le khatello ea kelello ea mafu a laolehileng e hatella maano a ho hlahisa le ho thibela karabo (2).
Ha ho na meriana e amohetsoeng bakeng sa kalafo ea bokhoba ba boitšoaro, empa lingaka tse ling tse bonts'itseng tšepiso ea ho phekola mathata a ts'ebeliso ea lithethefatsi le tsona li bonts'itse tšepiso ea ho phekola bokhoba ba boitšoaro (75). Naltrexone, mohanyetsi oa li-mu-opioid receptorist ea amohelitsoeng ke US Food and Drug Administration bakeng sa kalafo ea tahi le ts'ebeliso ea opioid, o bonts'itse ts'ebetso e nepahetseng litekong tse laoloang tsa bongaka bakeng sa kalafo ea ts'ebeliso ea ho becha ha li-pathological le kleptomania (76-79), 'me e tšepisa ho sa laoloe lithuto tsa ho reka ka mokhoa o qobelloang (80), boitšoaro bo qobelloang ba thobalano (81), temallo ea inthanete (82), le ho ts'oaroa ha letlalo la patologic (83). Liphumano tsena li fana ka maikutlo a hore li-receptor tsa mu-opioid li bapala karolo e ts'oanang le litekanyetsong tsa boits'ebetso joalo ka ha li etsa litsietsing tsa tšebeliso ea lithethefatsi, mohlomong ka modumo ea tsela ea dopaminergic mesolimbic. Ho fapana le hoo, mo-opioid receptor antagonist le lexone e nkang nako e khuts'oanyane e mpefatsa matšoao a lefu le bonoang ke khatello ea kelello (84).
Mithethefatsi e fetolang ts'ebetso ea glutamatergic e boetse e sebelisoa ho phekola bokhoba ba boits'oaro le ho lemalla lintho tse ling. Topiramate, anticonvulsant e thibelang subPApe ea AMPA ea glutamate receptor (har'a liketso tse ling), e bontšitse tšepiso lithutong tse bulehileng tsa ho becha ha li-pathological, ho reka ka mokhoa o qobelloang, le ho qhekella letlalo ka mokhoa o phehellang (85), hammoho le ho sebetsa hantle ho fokotsa joala (86 ), ts'ebeliso ea koae (87), le koae (88). N-acetyl cysteine, amino acid e khutlisetsang mohopolo oa extracellular glutamate ka har'a li-bokellase tsa nucleus, e fokotse takatso ea papali ea chelete le boitsoaro thutong e le 'ngoe ea li-gambler tsa methapo ea methapo (89), hape e fokotsa ts'ebeliso ea k'hok'heine ea koae (90) le ts'ebeliso ea koae ea koae. Boithuto bona bo fana ka maikutlo a hore ho fetoloa ha glutamatergic molumo oa dopaminergic ho li-bokellase tsa nucleus e ka ba mokhoa o tloaelehileng ho tšebeliso ea litekanyetso tsa boitšoaro le mathata a ts'ebeliso ea lithethefatsi (91).
Mathata a ho hlahloba
Ho lemalla boitšoaro bo le bong feela, papali ea chelete ea ho becha, ke lefu le tsebahalang ho DSM-IV le ICD-10. Mekhoa ea eona ea ho hlahloba e tšoana hantle le ea ts'ebeliso e mpe ea lithethefatsi / ts'ebeliso ea lithethefatsi, ke hore, ho ameha haholo ka boits'oaro, ho fokotsa bokhoni ba ho laola boits'oaro, mamello, ho tlohela le litlamorao tse mpe tsa kelello. DSM-V Task Force e khothalelitse ho tlosa papali ea chelete ho tloha sehlopheng sa eona sa hajoale e le ts'oaetso ea taolo ea maikutlo ho isa sehlopheng se secha se bitsoang "Tlhekefetso le Mathata a Amanang," a ka kenyelletsang mathata a ts'ebeliso ea lithethefatsi le "lithethefatsi tse seng taolong" (www.dsm5. org, e fihletsoe ka la 10 Hlakola, 2010). Phetoho e le 'ngoe feela ea mantlha ea tlhatlhobo ke ho lahla moelelo mabapi le ts'ebetso ea liketso tse seng molaong ho tšehetsa papali ea chelete, e fumanoeng e na le bongata bo tlase ebile bo na le phello e nyane ho fumanoeng.
Litekanyetso tse ling tse 'maloa tsa boits'oaro li hlahisitse mokhoa oa ho hlahloba lefu, ho kenyelletsa ho reka ka mokhoa o qobelloang (93), temallo ea inthanete (94), ts'ebetso ea papali ea video / khomphutha (95), temallo ea thobalano (96), le ho tsuba ho feteletseng (bona Kouroush et al., Makasine ona) . Tsena hangata li ipapisitse le litekanyetso tse teng tsa DSM-IV tsa ts'ebeliso e mpe ea lithethefatsi kapa ho ikemela, mohlala, nako e ngata e sebelisitsoeng ka boits'oaro, liteko tse sa atleheng hangata tsa ho fokotsa kapa ho emisa boitšoaro, ho fokotsa taolo holim'a boits'oaro, mamello, ho se tlose, le maikutlo a mabe a kelello. litlamorao. Sehlopha sa tšebetso se amanang le mathata a amanang le mathata a amanang le mathata a amanang le tlhabollo ea DSM-V se shebile tse 'maloa tsa lintho tseo e seng litheko ho kenyelletsa DSM-V, e bua ka kotloloho ka ts'ebeliso ea ts'ebeliso ea marang-rang (www.dsm5.org; e fihletsoeng ke Feb. 10, 2010). Leha ho le joalo, bakeng sa mathata a mangata, ho na le datha tse nyane kapa tse sa nepahalang bakeng sa litekanyetso tsena tsa tlhahlobo; hajoale li bohlokoa haholo joaloka lisebelisoa tsa tlhahlobo ho hakanya boteng ba bothata.
Potso e 'ngoe ea tlhahlobo e hlahisitsoeng ka har'a lingoliloeng ke moo lithethefatsi tsa ts'ebeliso (le lithethefatsi tsa lithethefatsi) li oelang teng ka sekhahla (97), ke hore, na li joalo ka mathata a taolo ea tšusumetso kapa bohlasoa bo tlamang? Ba bang ba pheha khang ea hore mokhoa ona oa bonngoe bo kopaneng o bonolo haholo, mme ho susumetsoa le ho qobelloa ho emela litekanyetso tsa orthogonal, ho fapana le lipalo tse fapaneng tsa boholo bo le bong (98). Tumellanong le phehisano ea morao-rao ke lintho tse fumanoeng tse kang phapang e kholo litekanyetsong tsa batho ba nang le temallo ea boitšoaro, phapang e ka amanngoeng le karabelo kalafong ea pharmacological (48, 99).
Ho DSM-IV, ho lemalla lithethefatsi (mathata a ts'ebeliso ea lithethefatsi) ke sehlopha se ikemetseng, ha papali ea chelete e nkuoa e le lefu la taolo ea tšusumetso, joalo ka mohlala, pyromania le kleptomania. ICD-10 e khetholla papali ea chelete e le lefu la "tloaelo le tšusumetso", empa e amohela hore "boitšoaro ha bo qobelloe ka tsela ea mahlale," leha ka linako tse ling e bitsoa "ho qobella ho becha."
Taba e amanang le eona ke mokhatlo, kapa ho bokellana, haeba ho le teng, har'a litloaelo tse fapaneng tsa boitšoaro. Tlhatlhobo ea sehlopha ea lipalo tsa palo ea batho le tsa bongaka ho bakuli ba 210 ba nang le bothata ba mantlha ba khatello ea maikutlo bo ile ba supa lihlopha tse peli tse arohaneng tsa bakuli ba lemaletseng boits'oaro (100): bakuli ba nang le papali ea papali ea chelete kapa bokhoba ba thobalano ("bosodoma") ba ne ba na le lilemo tsa pele mme ba ne ba ka khonahala e motona, ha ho bapisoa le bakuli ba mabenkeleng a qobelloang. Patlisiso e ngoe e ea hlokahala ho netefatsa le ho holisa se fumanoeng. Mokhoa o mong oa ho etsa lipatlisiso o ka tlatsetsang haholo tšimong e ka ba tlhahlobo e felletseng ea sehlopha se seholo, se fapaneng, se tsebahalang sa batho ba nang le mekhoa e fapaneng ea boits'oaro le lithethefatsi ho latela likarolo tse fapaneng tsa ho se ts'oenyehe le ho qobelloa ho etsa lintho ka bobeli kelellong (kutloisisong) le boits'oaro ( motor), mohlala, kutloelo-bohloko ea ho putsa moputso (theolelo ea nakoana), ho etsa liqeto tsa moputso oa ho ipeha kotsing, ho ba le maikutlo a thata, ho arabela pele ho nako, ho arabela ka mamello, ho thibela likarabo le ho fetola thuto.
TLHOKOMELISO LE LITLHAKISO
Bopaki bo ntseng bo hola bo supa hore ho lemalla boitšoaro bo ts'oana le ho lemalla lithethefatsi libakeng tse ngata, ho kenyeletsoa nalane ea tlholeho (e sa foleng, e khutlang hape e nang le maemo a phahameng le ho ata ho bacha le ho batho ba baholo), phenomenology (takatso e ikemetseng, botahoa ["phahameng"], le ho tlohela), mamello , comorbidity, tlatsetso ea tlatsetso ea liphatsa tsa lefutso, mekhoa ea methapo ea kutlo (e nang le likarolo tsa `` glutamatergic '' ea boko, opioidergic, serotonergic le dopamine mesolimbic system) le karabelo ea kalafo. Leha ho le joalo, lintlha tse teng li atile haholo bakeng sa papali ea chelete (bona Wareham le Potenza, makasine ona), ka lintlha tse fokolang feela bakeng sa ho reka ka qobello (bona Lejoyeaux le Weinstein, taba ena), bokhoba ba inthanete (bona Weinstein le Lejoyeaux, taba ena), le Bokhoba ba papali ea video / khomphutha (bona Weinstein, makasine ona), 'me ha ho na tlhaiso-leseling bakeng sa litlolo tse ling tsa boits'oaro tse joalo ka bokhoba ba thobalano (bona Garcia le Thibaut, taba ena), lemalla lerato (bona Reynaud, taba ena), ho khetha letlalo (bona Odlaug le Grant, makasine ona), kapa ho qhibiliha ho feteletseng (bona Kouroush et al., Taba ena).
Ho na le bopaki bo lekaneng ba hore ho na le tšebeliso ea ho becha ea pathological e le tšebeliso e mpe ea lithethefatsi kapa boitšoaro; DSM-V Task Force e khothalelitse ho tsamaisa khethollo ea ona ho DSM-V ho tsoa taolong ea taolo e kenang ho ts'ebetsong ho ea ho ts'ebeliso ea lits'ila le tlhekefetso e amanang le eona (sehlopha se secha se kenyelletsang litheko tse tlisoang ke litheko le tseo e seng tsa litheko). Boemong ba hona joale ba tsebo, haholo ha ho se na litekanyetso tse netefalitsoeng tsa tlhahlobo ea mafu le tse ling tse lebelletsoeng, lithuto tsa nako e telele, e ntse e le pele ho nako ho nka litlatsetso tse ling tsa boits'oaro e le mathata a ikemetseng a ikemetseng, ha a ba khetholle kaofela joalo ka lithethefatsi tsa lithethefatsi, ho fapana le joalo ka mathata a ho laola. Patlisiso e tebileng ea bokamoso, ho kenyeletsoa lithuto tsa batho le liphoofolo (101), e hlokahala ho tlisa tsebo ea rona ea litekanyetso tsa boits'oaro maemong a tseo bakeng sa lithethefatsi tsa lithethefatsi, haholoholo maemong a genetics, neurobiology (ho kenyelletsa monahano oa boko), le kalafo.
LINTLHA TSA LITLHAHO
E tšehetsoa ke Lenaneo la Patlisiso la Intramural, Institutes tsa National, Setsi sa Naha sa Tlhekefetso ea Lithethefatsi (DAG); NIH (NIDA) lithuso tsa R01 DA019139 (MNP) le RC1 DA028279 (JEG); le Litsi tsa Minnesota le Yale tsa Botle ho Lipatlisiso tsa Papali ea Chelete, tse tšehetsoang ke Setsi sa Naha sa Lipapali se Ikarabellang le Setsi sa Ts'ebetso sa Lipatlisiso mabapi le Mathata a Papali ea Chelete. Dr. Weinstein o tšehetsoa ke Israel National Institute for Psychobiology. Likateng tsa buka e ngotsoeng ka letsoho ke feela boikarabello ba bangoli 'me ha ho hlile ha li emetse maikutlo a semmuso a Setsi sa Naha sa Lipapatso Tse Ikarabellang kapa Setsi sa Patlisiso mabapi le Mathata a Papali ea Chelete kapa efe kapa efe ea mekhatlo e meng ea lichelete.
Phatlalatso ea Thahasello
Bangoli bohle ba tlaleha ho se lumellane ho teng mabapi le litaba tsa sengoloa sena. Ngaka Grant o amohetse lithuso tsa lipatlisiso ho tsoa NIMH, NIDA, Setsi sa Naha sa Lipapatso Tse Ikarabellang le Setsi sa Tsamaiso se Kopaneng sa Lipatlisiso mabapi le Mathata a Papali ea Chelete, le Lifeme tsa Meru. Ngaka Grant o fumana matšeliso a selemo le selemo ho tsoa ho Springer Publishing bakeng sa ho ba Motsamaisi oa sehlooho oa Buka ea Liphuputso tsa Papali ea Chelete, o entse tlhahlobo ea lithuso bakeng sa NIH le Mokhatlo oa Boloi oa Ontario, o amohetse litheko ho tsoa Oxford University Press, American Psychiatric Publishing, Inc. , Norton Press, le McGraw Hill, ba amohetse honaria ho tsoa Univesithing ea Bongaka ea Indiana University, University of South Florida, Sekolo sa Bongaka sa Mayo, Mokhatlo oa California oa Tlatsetso ea Bongaka, Naha ea Arizona, State ea Massachusetts, Naha ea Oregon, Porofense ya Nova Scotia, le Porofense ya Alberta. Ngaka Grant o amohetse puseletso e le moeletsi bakeng sa liofisi tsa molao litabeng tse amanang le mathata a taolo ea ts'usumetso. Ngaka Potenza o fumane tšehetso ea lichelete kapa matšeliso bakeng sa tse latelang: moeletsi bakeng sa moeletsi le boeletsi ho Boehringer Ingelheim; lithahasello tsa lichelete ho Somaxon; tšeetso ea lipatlisiso e tsoang ho Liofisi tsa Sechaba tsa Bophelo, Lefapha la Litaba tsa Veterans, Mohegan Sun Casino, Setsi sa Naha sa Lipapali Tse Ikarabellang le Setsi sa Tsamaiso se Kopaneng sa Lipatlisiso ka Lits'oaetso tsa Papali ea Chelete, le Laboratories tsa Meru; o nkile karolo lipatlisisong, liposong tsa mangolo kapa lipuisanong tsa mehala tse amanang le tšebeliso ea lithethefatsi, mathata a taolo ea tšusumetso, kapa lihlooho tse ling tsa bophelo bo botle; e buisane le liofisi tsa molao mabapi le litaba tse amanang le tlhekefetso kapa taolo ea tšusumetso; e fanne ka tlhokomelo ea bongaka Lefapheng la Connecticut la Bophelo bo Botle ba kelello le lits'ebeletso tsa tlatsetso ea mathata a lits'ebeletso tsa bongaka; mme e hlahisitse libuka kapa likhaolo tsa buka bakeng sa baphatlalatsi ba mangolo a bophelo bo botle ba kelello. Dr.Weinstein o amohetse lithuso tsa lipatlisiso ho tsoa ho Lekhotla la Ts'ireletso ea Lithethefatsi la Israel, Israel National Institute for Psychobiology, Chief Scientist of Israel Ministry of Health, and Rashi Trust (Paris, France) le litefiso bakeng sa lipuo mabapi le ts'ebeliso ea lithethefatsi ho tsoa ho Lekala la Thuto la Israel. Dr. Gorelick ha a tlalehe hore ha ho chelete ea kantle kapa likhohlano tsa phaello.
LITLHAHISO
1. Potenza MN. Na mathata a lemalloang a lokela ho kenyelletsa maemo a amanang le lintho tse sa amaneng le lithethefatsi? 2006 ea ho lemalla; 101: 142-151. 2. Potenza MN, Koran LM, Pallanti S. Kamano lipakeng tsa mathata a impulsecontrol le ho lemala ho hlokolosi: Kutloisiso ea hajoale le tataiso ea morao-rao ea lipatlisiso. Psychiatry Res 2009; 170: 22-31. 3. Holden C. Qeto ea ho beha litheko tsa boits'oaro ho DSM-V e reriloeng. Mahlale 2010; 327: 935. 4. Mokhatlo oa Maiketsetso oa Amerika. Buka ea ho hlahloba le ea Statistical ea Mathata a kelello. 4th ed., Ntlafatso ea lingoloa (DSM-IV-TR). Washington, DC: American Psychiatric Publishing, Inc., 2000. 5. Chambers RA, Potenza MN. Neurodevelopment, impulsivity, le papali ea bohlankana. J Gambl Stud 2003; 19: 53-84. 6. SlutskeWS. Pholoso ea tlhaho le ho batla kalafo ho papali ea methapo ea methapo: Liphetho tsa US tse peli lipatlisiso tsa naha. Ke J Psychiatry 2006; 163: 297-302. 7. Brewer JA, Potenza MN. Neurobiology le genetics ea mathata a laoloang ke tšusumetso: likamano le bokhoba ba lithethefatsi. Biochem Pharmacol 2008; 75: 63-75. 8. de Castro V, Fong T, Rosenthal RJ, Tavares H. Papiso ea litakatso tsa maikutlo le maikutlo a maikutlo lipakeng tsa papali ea papali ea papali ea chelete le botahoa. Adict Behav 2007; 32: 1555-1564. 9. Blanco C, Moreyra P, Nunes EV, S'aiz-Ruiz J, Ib'aanes A. Ho becha ka tsela ea tlhaho: ho lemalla kapa ho qobella? Semin Clin Neuropsychiatry 2001; 6: 167-176. Ke J D lithethefatsi tse tahiloeng tsa joala tse jarolotsoeng ho tsoa ho informahealthcare.com ke Lekala la Mafu a Tsamaeang le Tai ho 06 / 21 / 10 Bakeng sa ts'ebeliso ea botho feela. LITLHAKISO TSA BOPHELO 7 10. Grant JE, Brewer JA, Potenza MN. The neurobiology ea lithethefatsi le litloaelo tsa boits'oaro. CNS Spectr 2006; 11: 924-930. 11. Grant JE, Potenza MN. Phapang e amanang le bong ho batho ba batlang kalafo bakeng sa kleptomania. CNS Spectr 2008; 13: 235-245. 12. Grant JE, Kim SW. Lipalo tsa batho ba bangata le ba bongaka ba 131 ea ba bechang. J Clin Psychiatry 2001; 62: 957-962. 13. Potenza MN, Steinberg MA, McLaughlin SD, Wu R, Rounsaville BJ, O'Malley SS. Phapang e amanang le botona le botšehali litšobotsing tsa ba bechang ka bothata ba sebelisa thuso ea papali ea chelete. Ke J Psychiatry 2001; 158: 1500-1505. 14. Brady KT, Randall CL. Phapang pakeng tsa botona le botšehali litabeng tsa tšebeliso ea lithethefatsi. Psychiatr Clin Leboea Am 1999; 22: 241-252. 15. Ledgerwood DM, Weinstock J, Morasco BJ, Petry NM. Litšobotsi tsa kliniking le nalane ea kalafo ea bakuli ba mothating oa ho tsuba le ntle le boitšoaro bo seng molaong bo amanang le papali ea chelete. J Am Acad Psychiatry Molao 2007; 35: 294-301. 16. Lejoyeux M, Tassain V, Solomon J, Ad`es J. Ho ithuta ka ho qobella ho reka ho bakuli ba tepelletseng maikutlo. J Clin Psychiatry 1997; 58: 169-173. 17. Kim SW, Grant JE. Bophahamo ba botho bothateng ba papali ea ho becha le ho sheba lintho habonolo. Psychiatry Res 2001; 104: 205-212. 18. Grant JE, Kim SW. Litšusumetso tsa mocheso le tikoloho ea tikoloho ho kleptomania. Compr Psychiatry 2002; 43: 223-228. 19. Raymond NC, Coleman E, Miner MH. Psorchiatric comorbidity le mekhoa e qobelloang / e susumetsang e ts'oereng takatso ea thobalano. Compr Psychiatry 2003; 44: 370-380. 20. Kelly TH, Robbins G, Martin CA, Fillmore MT, Lane SD, Harrington NG, Rush CR. Phapang e fapaneng ea motho ea kotsing ea ho sebelisa lithethefatsi hampe: d-Amphetamine le boemo ba ho batla maikutlo. Psychopharmacology (Berl) 2006; 189: 17-25. 21. Tavares H, Gentil V. Ho becha ka tsela ea tlhaho le bokuli bo potelletseng: Ho isa pheletsong ea likhathatso tsa boithati. Rev Bras Psiquiatr 2007; 29: 107-117. 22. Blanco C, Potenza MN, Kim SW, Ib'aanez A, Zaninelli R, Saiz-Ruiz J, Grant JE. Boithuto ba sefofane ba ho ts'oenyeha le ho qobelloa ho ts'oasa papali ea methapo ea methapo. Psychiatry Res 2009; 167: 161-168. 23. Chamberlain SR, Fineberg NA, Blackwell AD, Robbins TW, Sahakian BJ. Inhibition ea likoloi le ho fetoha habonolo hoa kelello ho ramatiki e bonang lintho habonolo le lefu le tšoaetsang "trichotillomania". Ke J Psychiatry 2006; 163: 1282-1284. 24. Odlaug BL, Grant JE, Chamberlain SR. Inhibition ea motor le ho tenyetseha habonolo ha ho lata letlalo. Prog Neuropharm Biol Psych 2010; 34: 208-211 .. 25. Cunningham-Williams RM, Cottler LB, Compton WM 3rd, Spitznagel EL. Ho nka menyetla: bothata ba ho becha le mathata a bophelo bo botle ba kelello-Liphetho tse tsoang ho St. Thuto ea Sebaka sa Catchment ea Louis Epidemiologic. Ke J J Health Health 1998; 88: 1093-1096. 26. Petry NM, Stinson FS, Grant BF. Comorbidity ea DSM-IV ho becha ha methapo ea methapo le mafu a mang a kelello: liphetho tse tsoang ho National Epidemiologic Survey on Alcohol and maemong a amanang le ona. J Clin Psychiatry 2005; 66: 564-574. 27. Bland RC, Newman SC, Orn H, Stebelsky G. Epidemiology ea maloetse a marang-rang a Edmonton. Na J Psychiatry 1993; 38: 108-112. 28. el-Guebaly N, Patten SB, Currie S, Williams JV, Beck CA, Maxwell CJ, Wang JL. Mekhatlo ea Epidemiological lipakeng tsa boitšoaro ba papali ea chelete, ts'ebeliso ea lithethefatsi le maikutlo le matšoenyeho. J Gambl Stud 2006; 22: 275-287. 29. Welte JW, Barnes GM, Tidwell MC, Hoffman JH. Ho ata ha papali ea chelete papaling ea chelete US bacha le bacha ba baholo: Liphetho tse tsoang lipatlisisong tsa naha. J Gambl Stud 2008; 24: 119-133. 30. Yen JY, Ko CH, Yen CF, Chen CS, Chen CC. Kamano pakeng tsa tšebeliso e mpe ea joala le bokhoba ba marang-rang har'a liithuti tsa koleche: Papiso ea botho. Kliniki ea Psychiatry Neurosci 2009; 63: 218-224. 31. Stinchfield R, KushnerMG, Winters KC. Tšebeliso e mpe ea tahi le kalafo ea tlhekefetso ea lithethefatsi malebana le bothata ba papali ea chelete ea ho becha le sephetho sa kalafo ea papali ea chelete. J Gambl Stud 2005; 21: 273-297. 32. Duhig AM, Maciejewski PK, Desai RA, Krishnan-Sarin S, Potenza MN. Litšobotsi tsa batho ba lilemong tsa bocha ba bechang le bao e seng ba papali ea papali ea chelete mabapi le joala. Adict Behav 2007; 32: 80-89. 33. Grant JE, Potenza MN. Ts'ebeliso ea koae le papali ea chelete. 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. Litšobotsi tsa bothata ba ho becoc ba ho becha ba bitsang mohala oa thuso ea papali ea chelete. Ke J Adict 2004; 13: 471-493. 35. Presta S, Marazziti D, Dell'Osso L, Pfanner C, Pallanti S, Cassano GB. Kleptomania: Litšobotsi tsa kliniki le ho hlonepha ka sampole ea Italy. Compr 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, Janiri L. Litlhahiso tsa boitšoaro ho bakuli ba lefu la ho ferekana kelellong: Karolo ea ho potlaka le boholo ba botho. J Afimate Disord 2010; [ePub pele ho khatiso ea Doi: 10.1016 / j.jad.2009.12.016]. 37. Petry NM, Casarella T. Phokotso e kholo ea meputso e liehang ho batho ba sebelisang lithethefatsi hampe ka mathata a papali ea chelete. Phokotso ea Lithethefatsi 1999: 56-25. 38. Bechara A. Khoebo e kotsi: maikutlo, ho etsa liqeto le ho lemalla. J Gambl Stud 2003; 19: 23-51. 39. Cavedini P, Riboldi G, Keller R, D'Annucci A, Bellodi, L. Frontal lobe dysfunction ho bakuli ba ts'ebetso ea papali ea papali ea chelete. Biol Psychiatry 2002; 51: 334-341. 40. Ko CH, Hsiao S, Liu GC, Yen JU, Yang MJ, Yen CF. Litšobotsi tsa ho etsa liqeto, monyetla oa ho nka likotsi, le botho ba liithuti tsa koleche tse lemaletseng inthanete. Psychiatry Res 2010; 175: 121-125. 41. Goudriaan AE, Oosterlaan J, de Beurs E, Van Den Brink W. Mesebetsi ea Neococitive ea ho becha ha methapo ea methapo: papiso le ts'ebeliso ea lino tse tahang, lefu la Tourette le taolo e tloaelehileng. 2006 ea ho lemalla; 101: 534-547. 42. Potenza MN. Tlhahlobo. The neurobiology ea ts'ebetso ea papali ea ho becha le ho lemalla lithethefatsi: Tlhatlhobo le liphetho tse ncha. 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. Ho batla boits'oaro bo qobellang ebile bo sa susumetse, ho tloha mehlaleng ea liphoofolo ho ea ho endophenotypes: Tlhahlobo e phetoang. Neuropsychopharmacology 2010; 35: 591-604. 44. Blanco C, Orensanz-Mu˜noz L, Blanco-Jerez C, Saiz-Ruiz J. Mosebetsi oa ho becha oa thuto ea tlhaho le liplatele tsa MAO: thuto ea kelello le kelello. Ke J Psychiatry 1996; 153: 119-121. 45. Hollander E, Kwon J, Weiller F, Cohen L, Stein DJ, DeCaria C, Liebowitz M, Simeon D. Ts'ebetso ea Serotonergic ho phobia ea sechaba: ho bapisoa le lithuto tse tloaelehileng tsa taolo le likhatello tse lemalloang. Psychiatry Res 1998; 79: 213-217. 46. Dagher A, Robbins TW. Botho, ho lemalla, dopamine: Lintlha tse tsoang ho lefu la Parkinson. Neuron 2009; 61: 502-510. 47. O'Sullivan SS, Evans AH, Lees AJ. Dopamine dysregulation syndrome: kakaretso ea lefu la seoa sa eona, mekhoa ea eona le tsamaiso ea eona. Lithethefatsi tsa CNS 2009; 23: 157-170. 48. Zack M, Poulos CX. Likarolo tse tšoanang tsa dopamine ho papali ea papali ea methapo ea mali le ho lemalla taeo ea kelello. Ts'ebeliso e Mpe ea Ts'ebeliso e Mpe ea Lithethefatsi Rev 2009; 2: 11-25. 49. Potenza MN, Leung HC, Blumberg HP, Peterson BS, Fulbright RK, Lacadie CM, Skudlarski P, Gore JC. Tlhahlobo ea mosebetsi oa FMRI Stroop ea ts'ebetso ea methapo ea methapo ea methapo ho tsa bataki. Ke J Psychiatry 2003; 160: 1990-1994. 50. London ED, Ernst M, Grant S, Bonson K, Weinstein A. Orbitof Pambal cortex le tlhekefetso ea lithethefatsi tsa batho: ts'ebetso ea ho nahana. Cereb Cortex 2000; 10: 334-342. 51. Ko CH, Liu GC, Hsiao S, Yen JY, Yang MJ, Lin WC, Yen CF, Chen CS. Liketsahalo tsa bono tse amanang le ho bapala lipapali tsa ho bapala lipapaling tsa Inthanete. J Psychiatr Res 2009; 43: 739-747. 52. Reuter J, Raedler T, Rose M, Hand I, Gl¨ascher J, B¨uchel C. Ho becha ha pathological ho hokahanngoa le ts'ebetso e fokolitsoeng ea sisteme ea moputso oa mesolimbic. Nat Neurosci 2005; 8: 147-148. Ke J D lithethefatsi tse tahiloeng tsa joala tse jarolotsoeng ho tsoa ho informahealthcare.com ke Lekala la Mafu a Tsamaeang le Tai ho 06 / 21 / 10 Bakeng sa ts'ebeliso ea botho feela. 8 J. E. TANTELISO ET AL. 53. Ngola J, Schlagenhauf F, Kienast T, W¨ustenberg T, Bermpohl F, Kahnt T, Beck A, Str¨ohle A, Juckel G, Knutson B, Heinz A. Ho se sebetse hantle hoa ts'ebeliso ea meputso e tsamaellanang le litakatso tsa joala ho batho ba lemaletseng joala. Neuroimage 2007; 35: 787-794. 54. SteevesTD, Miyasaki J, Zurowski M, Lang AE, Pellecchia G, VanEimeren T, Rusjan P, Houle S, Strafella AP. Ho eketsa tlhahiso ea dopamine e tsoang ho bakuli ba Parkinsonia ka ho becha ha methapo: Phuputso ea [11C] ea raclopride PET. Brain 2009; 132: 1376-1385. 55. Bradberry CW. Tlhokomeliso ea cocoaine le phetisetso ea dopamine ea litlamorao ho litoeba, litšoene le batho: Libaka tsa tumellano, ho se lumellane le litlatsetso tsa ho lemalla. Psychopharmacology (Berl) 2007; 191: 705-717. 56. Weintraub D, Potenza MN. Mathata a ho laola tšusumetso ea lefu la Parkinson. Curr Neurol Neurosci Rep 2006; 6: 302-306. 57. Voon V, Fernagut PO, Wickens J, Baunez C, Rodriguez M, Pavon N, Juncos JL, Obeso JA, Bezard E. E sa foleng ea dopaminergic stimulaton lefung la Parkinson: Ho tloha ho dyskinesias ho ea ho mathata a ho laola maikutlo. Lancet Neurol 2009; 8: 1140-1149. 58. Voon V, Hassan K, Zurowski M, de Souza M, Thomsen T, Fox S, Lang AE, Miyasaki J. Bokapele ba mekhoa e pheta-phetoang le e batlang meputso ho lefu la Parkinson. Neurology 2006; 67: 1254-1257. 59. Weintraub D, Siderowf AD, Potenza MN, Goveas J, Morales KH, Duda JE, Moberg PJ, Stern MB. Mokhatlo oa tšebeliso ea dopamine agonist o nang le mathata a ho laola litšusumetso ho lefu la Parkinson. Arch Neurol 2006; 63: 969-973. 60. Zack M, Poulos CX. Mohanyetsi oa D2 o ntlafatsa litlamorao le moputso oa ketsahalo ea papali ea papali ea chelete ea papali ea papali ea chelete. Neuropsychopharmacology 2007; 32: 1678-1686. 61. Fong T, Kalechstein A, Bernhard B, Rosenthal R, Rugle L. Teko e laoloang habeli, e laoloang ke placebo ea olanzapine bakeng sa kalafo ea ba becang ka video ea poker. Pharmacol Biochem Behav 2008; 89: 298-303. 62. McElroy SL, Nelson EB, Welge JA, Kaehler L, Keck PE Jr. Olanzapine kalafong ea papali ea ho becha ha methapo ea methapo: Teko e seng molaong e sa sebetseng ea sebaka seo. J Clin Psychiatry 2008; 69: 433-440. 63. DW e ntšo, Monahan PO, Temkit M, Shaw M. Thutong ea lelapa ea papali ea chelete ea ho becha. Psychiatry Res 2006; 141: 295-303. 64. Grant JE. Nalane ea lelapa le ho hlaseloa ke kelello comorbidity ho batho ba nang le kleptomania. Compr Psychiatry 2003; 44: 437-441. 65. DW e ntšo, Repertinger S, Gaffney GR, Gabel J. Nalane ea lelapa le maikutlo a kelello ho batho ba rekang ka thata: Lintho tse fumanoeng pele li fumanoa. Ke J Psychiatry 1998; 155: 960-963. 66. Slutske WS, Eisen S, WR ea 'nete, Lyons MJ, Goldberg J, Tsuang M. Kotsi e tloaelehileng ea lefutso bakeng sa papali ea papali ea chelete ea ho becha le ho itlopa joala ho banna. 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, E tloha L. Ketsahalo e kopanetsoeng ea tlhekefetso ea lithethefatsi tse fapaneng ho banna: Karolo ea tlhekefetso e boletsoeng lithethefatsi le ho arolelanoa ka tsela e tšoanang. Arch Gen Psychiatry 1998; 55: 967-972. 68. Metsotso DE. Hobaneng ha ho hlokahala melao e fapaneng bakeng sa lefa la polygenic: Lithuto ho tsoa lipatlisisong tsa mofuta oa DRD2. Joala 1998; 16: 61-70. 69. Hamidovic A, Dlugos A, Skol A, Palmer AA, de Wit H. Tlhahlobo ea phapang ea liphatsa tsa lefutso ho dopamine receptor D2 mabapi le boitšoaro bo thibelang le ho tsitsipana / maikutlo a ho batla: Phuputso e entsoeng le d-amphetamine ho barupeluoa ba phetseng hantle. Exp Clin Psychopharmacol 2009; 17: 374-383. 70. Lee Y, Han D, Yang K, Daniels M, Na C, Kee B, Renshaw P. Litšobotsi tse kang khatello ea maikutlo tsa 5HTTLPR polymorphism le bohale ho basebelisi ba fetelletseng ba marang-rang. Tlaleho ea Lits'oaetso tse Amehileng 2009; 109: 165-169. 71. Petry NM, Ammerman Y, Bohl J, Doersch A, Gay H, Kadden R, Molina C, Steinberg K. Phekolo ea kelello-boits'oaro bakeng sa ba bechang. J Consult Clin Psychol 2006; 74: 555-567. 72. Teng EJ, WoodsDW, TwohigMP. Tloaelo ea morao-rao joalo ka kalafo bakeng sa ho ts'oaroa ha letlalo le sa foleng: lipatlisiso tsa sefofane. Behav Modif 2006; 30: 411-422. 73. Mitchell JE, Burgard M, Faber R, Crosby RD, de Zwaan M. Phekolo ea boits'oaro ea kelello bakeng sa bokuli bo qobelloang ke ho reka. Behav Res Ther 2006; 44: 1859-1865. 74. Toneatto T, Dragonetti R. Katleho ea kalafo e thehiloeng sechabeng bakeng sa papali ea bothata: Teko e lekantsoeng ea tlhahlobo ea kelello kalafo ea mehato e leshome le metso e 'meli. Ke J Adict 2008; 17: 298-303. 75. Dannon PN, Lowengrub K, Musin E, Gonopolsky Y, Kotler M. Phuputso ea morao-rao ea khoeli ea 12 ea kalafo ea lithethefatsi ho ba tsubang ka methapo: Phuputso ea mantlha. J Clin Psychopharmacol 2007; 27: 620-624. 76. Kim SW, Grant JE, Adson DE, Shin YC. Boithuto ba naltrexone bo sa boneng mahlo le boithuto ba placebo kalafong ea papali ea papali ea chelete. Biol Psychiatry 2001; 49: 914-921. 77. Fana ka JE, Potenza MN, Hollander E, Cunningham-Williams R, Nurminen T, Smits G, Kallio A. Phuputso e ngata ea molumo oa antio oa antio ea phekolo ea kalafo ea kalafo ea papali ea methapo. Ke J Psychiatry 2006; 163: 303-312. 78. Fana ka JE, Kim SW, Hartman BK. Phuputso e laoloang habeli, e laoloang ke placebo ea opiate antagonist naltrexone kalafong ea litabatabelo tsa methapo ea kutlo. J Clin Psychiatry 2008; 69: 783-789. 79. Grant JE, Kim SW, Odlaug BL. Teko e laoloang habeli, e laoloang ke placebo ea mohanyetsi oa opioid, naltrexone, kalafong ea kleptomania. Biol Psychiatry 2009; 65: 600-606. 80. Grant JE. Nyeoe tse tharo tsa theko e qobelloang li phekoloa ka naltrexone. Int J Psychiatr Clin Exercise 2003; 7: 223-225. 81. Raymond NC, Grant JE, Kim SW, Coleman E. Litlhahlobo Phekolo ea boitšoaro bo qobelloang ba thobalano le naltrexone le serotonin reuptake inhibitors: Lithuto tse peli tsa linyeoe. Int Clin Psychopharmacol 2002; 17: 201-205. 82. Bostwick JM, Bucci JA. Litlhare tsa thobalano tsa marang-rang li tšoaroa ka naltrexone Mayo Clin Proc 2008; 83: 226-230. 83. Arnold LM, Auchenbach MB, McElroy SL. Psychogenic excavation. Likarolo tsa bongaka, litekanyetso tsa tlhahlobo ea lefu la mafu, lefu la mafu le mekhoa ea kalafo. Lithethefatsi tsa CNS 2001; 15: 351-359. 84. Insel TR, Pickar D. Tsamaiso ea Naloxone bothateng bo hlokisang botsitso: tlaleho ea linyeoe tse peli. Ke J Psychiatry 1983; 140: 1219-1220. 85. Roncero C, Rodriguez-Urrutia A, Grau-Lopez L, Casas M. Ho hlakile. Lithethefatsi tsa antiepilectic taolong ea mathata a ts'usumetso. 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 bakeng sa ho phekola ts'ebeliso ea joala: teko e laoloang e sa reroang. JAMA 2007; 298: 1641-1651. 87. Johnson BA, Swift RM, Addolorato G, Ciraulo DA, Myrick H. Ho hlokahala. Tšireletseho le katleho ea meriana ea GABAergic bakeng sa ho phekola bokhoba ba tahi. Alin Clin Exp Res 2005; 29: 248-254. 88. Kampman KM, Pettinati H, Lynch KG, Dackis C, Sparkman T, Weigley C, O'Brien, CP. Teko ea sefofane sa topiramate bakeng sa kalafo ea ts'ebeliso ea koae. Phokotso ea Lithethefatsi 2004: 75-233. 89. Fana ka JE, Kim SW, OdlaugBL. N-acetyl cysteine, moemeli oa phetoho ea glutamate, kalafong ea papali ea papali ea methapo: Phuputso ea sefofane. Biol Psychiatry 2007; 62: 652-657. 90. SD ea LaRowe, Myrick H, Hedden S, Mardikian P, Saladin M, McRae A, Brady K, Kalivas PW, Malcolm R. Na takatso ea koae e fokotsoe ke Nacetylcysteine? Ke J Psychiatry 2007; 164: 1115-1117. 91. Mardikian PN, LaRowe SD, Hedden S, Kalivas PW, Malcolm RJ. Teko e bulehileng ea N-acetylcysteine bakeng sa kalafo ea ho itšepa koae: Phuputso ea sefofane. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31: 389-394. 92. Kalivas PW, Hu XT. Lintho tse thabisang tse ka u lematsang moeeng. Mekhoa ea Neurosci 2006; 29: 610-616. 93. DW e ntšo. Ho reka ka tieo: Tlhahlobo. J Clin Psychiatry 1996; 57: 50-54. 94. Ko CH, Yen JY, Chen SH, Yang MJ, Lin HC, Yen CF. Mekhoa e reriloeng ea tlhahlobo ea mali le sesebelisoa sa tlhahlobo le tlhaiso sa tlhekefetso ea inthanete ho baithuti ba koleche. Compr Psychiatry 2009; 50: 378-384. Ke J D lithethefatsi tse tahiloeng tsa joala tse jarolotsoeng ho tsoa ho informahealthcare.com ke Lekala la Mafu a Tsamaeang le Tai ho 06 / 21 / 10 Bakeng sa ts'ebeliso ea botho feela. LITLHAKISO TSA BOPHELO 9 95. Porter G, Starcevic V, Berle D, Fenech P. Ho lemoha ts'ebeliso ea papali ea bothata ba video. Aust NZJ Psychiatry 2010; 44: 120-128. 96. Molemo oa Goodman A. Boqhekanyetsi ba thobalano: Boqapi le kalafo. J Thobalano tsa Marato Ther 1992; 18: 303-314. 97. Hollander E, Wong CM. Bofokoli ba 'mele bo bakoang ke ho hlaseloa ke' mele, ho becha ka methapo le ho qobelloa ho etsa thobalano. J Clin Psychiatry 1995; 56: 7-12. 98. Lochner C, Stein DJ. Na ho sebetsa mathateng a pono a bonoang a nang le tšusumetso e matla ho tlatsetsa ho utloisiseng heterogeneity ea obsessivecompulsive disorder? Prog Neuropsychopharmacol Biol Psychiatry 2006; 30: 353-361. 99. Grant JE. Lipheo tsa nalane ea nalane ea nalane. E hlahisoa ho Symposium mabapi le Lithuto tsa Translational of Pathological Gossip ho Koleche ea Amerika ea Neuropsychopharmacology, Kopano ea Selemo le Selemo ea 48th, Hollywood, FL, 2009. 100. LochnerC, Hemmings SM, Kinnear CJ, NiehausDJ, Nel DG, CorfieldVA, Moolman-Smook JC, Seedat S, Stein DJ. Tlhahlobo ea sehlopheng ea mathata a ho bona lintho ka bongata ka sebahaleng ho bakuli ba nang le bothata ba ho bona lintho ka tsela e potellehang: litlhahlobo tsa bongaka le tsa liphatsa tsa lefutso. Compr Psychiatry 2005; 46: 14-19. 101. Potenza MN. Bohlokoa ba mefuta ea liphoofolo ea ho etsa liqeto, ho becha, le boits'oaro bo amanang le ona: litlamorao ho lipatlisiso tsa phetolelo ho tlatsetso. Neuropsychopharmacology 2009; 34: 2623-2624. 102. Grant JE. Mathata a Taolo ea Khatello: Tataiso ea Tleliniki ea Kutloisiso le Phekolo ea Lithethefatsi. New York, NY: Norton Press, 2008.
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