Meputso ea Bongoli le Khatello ea Kelello Mekhoa ea ho lemalla (2014)

Psy Psychology. 2014; 5: 79.

E hatisitsoe Inthaneteng 2014 Jul 9. doi:  10.3389 / fpsyt.2014.00079

PMCID: PMC4088186

Sehlooho sena se bile teng e boletsoeng ke lihlooho tse ling ho PMC.

Ho lemalla lithethefatsi le joala ke ts'oaetso e matla ea maemo a mangata ho batho, e nang le litlamorao tse mpe tsa bophelo le lichelete ho motho ka mong le sechaba ka kakaretso. Khatiso e sa tsoa tsoa ea bohlano ea Buka ea ho hlahloba le ea Statistical ea Mathata a kelello (DSM-V) e kopantsitse tlhekefetso e neng e arotsoe pele le ho beha litekanyetso tsa lithethefatsi le litlolo tse seng molaong tsa tlhekefetso ho e etsa mofuta o le mong o bitsoang drug use disorder (SUD). Tlhaloso ena e ncha e kenyelletsa lintlha tsa tlhahlobo tse atamelaneng haholo le litekanyetso tse fetileng (DSM-IV), le mehato e mecha ea tlhahlobo eo lingaka li qosoang ka ho khetholla ho teba ha SUD ea motho ka mong ho latela palo ea mekhoa e fihletsoeng. Haholo-holo, SUD e bonolo e hloka hore ho kopane le matšoao a mabeli ho isa ho a mararo, SUD e itekanetseng e hloka hore ho fihletsoe matšoao a mane ho isa ho a mahlano, 'me SUD e matla e hloka hore ho kopane le matšoao a tšeletseng kapa ho feta. Tlatsetso e 'ngoe e hlokomelehang ea mekhoa ea ho hlahloba lefu lena ke ho lakatsa, ho ka hlalosoang haholo e le takatso e matla kapa ho khothaletsa ho sebelisa lithethefatsi / joala. Lihlopheng tse fapaneng tsa lithethefatsi tse hlekefelitsoeng li ka ba le litlamorao tse fapaneng tsa tlhaho le likotsi tse fapaneng tsa ts'ebeliso ea 'mele, empa li-SUD li hlalositsoe le ho fumanoa ho latela setheo se le seng sa matšoao a boitšoaro a tloaelehileng ho tlhekefetso ea lithethefatsi tsohle. Matšoao ana a boitšoaro a kenyelletsa tšebeliso e mpe ea lithethefatsi, tahlehelo ea taolo ho fokotsa ts'ebeliso ea lithethefatsi, ho hlaha ha boemo bo bobe ba maikutlo maemong a ho ba sieo ha moriana, le tlokotsi e eketsehileng ea ho khutla hape e bakoang ke khatello ea maikutlo kapa likotsi tse amanang le ho fumaneha ha lithethefatsi. E 'ngoe le e' ngoe ea matšoao ana e ka fetoloa ka tekanyo e fapaneng liphoofolong, 'me mehlala ea liphoofolo e na le thuso haholo ho hlahloba ts'ebetso ea ts'ebetso ea SUD le ho tsebahatsa litšepiso tse ncha tsa kalafo tse reretsoeng ho fokotsa tšebeliso e mpe ea lithethefatsi le joala ho batho.

Morero o ka sehloohong oa sehlooho sena sa lipatlisiso ke ho kopanya lintlha le maikutlo a boetapele ke baetapele lefapheng la tlhekefetso le kopang karolo e kopaneng ea meputso ea meputso ea boko le ts'ebeliso ea khatello ea maikutlo maemong a bokhoba. Phetoho ea SUD e matla e hlalosoa ke li-neuroadaptations tse tsamaeang le methapo ea kelello eo, moo ho se nang lithethefatsi, e ikarabellang bakeng sa mekhoa ea boits'oaro le ea 'mele e kenyelletsang maikutlo, maikutlo a mabe le a fosahetseng a maikutlo, nocicept le ho fepa. Ho pepesetsoa hoa lithethefatsi nako e telele nakong ea phetoho ena ho khothaletsa (1) liphetoho tse ka hare ho sistimi liserekising tse hlahisang phello e ntle ea moputso ea lithethefatsi le (2) ho hira bobeli ba li-hypothalamic (neuroendocrine) le tsamaiso ea khatello ea kelello e eketsehileng.

Lits'ebetso tse fapaneng tsa tlhaho le boits'oaro li kenya letsoho ho matla a motho ea ho sebelisa le ho sebelisa lithethefatsi le joala hampe. Mohlala, likhokahano li ntse li hlaha lipakeng tsa profiles tse ikhethang tsa lefutso le liphatlalatso tsa li-SUD. Ntle le moo, ts'ebeliso e mpe ea lithethefatsi le joala e kopane hantle haholo le maemo a mang a kelello (mohlala, mathata a ho tšoenyeha, khatello e kholo ea khatello ea maikutlo, lefu la kelello le mathata a botho) a ka tlang pele kapa a latela nts'etsopele ea mathata a tšebeliso ea lithethefatsi. Ho fapana le lithethefatsi tse fapaneng tsa tlhekefetso, ho na le likarolo tse ngata tse fapaneng tsa boitšoaro le liphetoho tse hlalosang phetoho ea motho ho itšetleha ka ts'ebeliso. Le kahare ho sethethefatsi se le seng sa tlhekefetso, batho ba fapaneng ba sebelisa lithethefatsi ka mabaka a fapaneng; kahare ho motho a le mong, mabaka a tlhekefetso ea lithethefatsi a ka fetoha nakong eohle ea bophelo le nako ea koluoa. Setšoantšo se boetse se thatafatsoa ke taba ea hore hangata batho ba sebelisa lithethefatsi tse fetang e le 'ngoe ka nako e le ngoe.

Sehlooho sena sa Lipatlisiso se qala ka ho hlahlojoa ke Ngaka George Koob, Ph.D., Motsamaisi ea sa tsoa khethoa oa Setsi sa Sechaba sa Ts'ebeliso e Mpe ea Joala le Tahi (NIAAA), se hlalosang bokhoba e le bothata bo kopaneng le phokotso ea pathophysiological mosebetsing oa moputso oa boko le nako. ho lata li-circuits tsa khatello ea kelello (1). Lingoliloeng tse 'maloa tse latelang li theha mohopolo oa ho hira mekhoa ea khatello ea kelello [mohlala, corticotropin-releasing factor (CRF) le glucocorticoids] ho bohlokoa bakeng sa ho khothaletsa tšebeliso e mpe ea lithethefatsi le joala. Karolo e setseng ea Patlisiso ena ke pokello ea lingoloa tse khothatsang le tse hlalosang mosebetsi o reretsoeng ho senola ts'ebetso ea ts'ebeliso ea lithethefatsi lithethefatsing tse fapaneng tsa tlhekefetso, mme e tiisa kamano ea "neurobiology" le lihlooho tse fapaneng tsa hona joale lefapheng la lipatlisiso tsa ho lemalla (2-14).

Lingoloang tsa sehlooho sena sa lipatlisiso li bua ka lintlha tse fapaneng tsa khatello ea hajoale lebaleng la lipatlisiso tsa bokhoba. Karolo e 'ngoe e joalo ke mohopolo oa phapang e fapaneng le motho ka mong: butle-butle ho ntse ho amoheloa hore lithethefatsi le lithethefatsi tsa tlhekefetso ha li tšoane, hore batho ba ka fihla pheletsong e ts'oanang ea tlhahlobo kapa tlhahlobo ka mekhoa e fapaneng ea bophelo le mabaka a fanang ka maikutlo a hore batho ka bomong bonts'a mefuta e fapaneng ea li-co-morbidities (mohlala, bokhoba le bohloko), le hore mekhoa ea phekolo le liteko tsa tleliniking li ka atleha haholoanyane haeba li tsamaisana le litlatsetso tsa tlhabollo ea batho ba bang (ke hore, drugacogenetics). Ntho e 'ngoe e amehang khaolong ena ke taba ea hore methapo ea methapo e ka ba bohlokoa bakeng sa ts'ebeliso e mpe ea tlhekefetso ea lithethefatsi tse fetang e le' ngoe, empa bakeng sa ho sebelisana 'moho le tlhekefetso ea lithethefatsi tse fetang e le' ngoe ho motho a le mong (mohlala, litheko tse phahameng tsa ho tsuba koae le ho batho ba nang le bothata ba tšebeliso ea joala). Karolo e 'ngoe ea likhathatso tse kholo sechabeng se seng se ntse se hapa tlhokomelo e kholo lefapheng la lipatlisiso tsa bokhoba ba maikutlo ke sepheo sa ho utloisisa litlamorao tsa nako e telele tsa tšebeliso ea lithethefatsi tsa bongoana le bokhoba ba joala bokong le boitshwarong. Ho amoheloa ka kakaretso hore ho qaleha ha tšebeliso ea lithethefatsi le joala ho eketsa menyetla ea nts'etsopele ea SUD le maemo a mang a kelello hamorao bophelong, mme sena se ka bakoa ke hore kelello ea mocha, hobane e ntse e hola, e hlaseleha haholo ho litlamorao tsa lintho tsena.

Patlisiso ea pele ho tliliniki e sebelisa mefuta e fapaneng ea liphoofolo le mekhoa e tsoetseng pele ea theknoloji ho hlahloba ts'ebetso ea ts'ebetso ea ts'ebeliso ea lithethefatsi. Lingoloa tse 'maloa ho Sehlooho sena sa Lipatlisiso li hlalosa mefuta e tloaetseng ho sebelisoa ea liphatsa tsa lefutso (mohlala, mefuta e khethiloeng ea ho ikatisa bakeng sa khetho e phahameng ea joala) le meetso e hlahisitsoeng e sa tsoa etsoa (mohlala, nicotine vapor e le mohlala oa koae ea koae le mosi oa matsoho). Mefuta ena e ka kopantsoe le mahlale a macha (mohlala, optogenetics le chemogenetics) ho hlahloba ts'ebetso ea ts'ebeliso ea lithethefatsi ka mekhoa e tsoetseng pele, mohlala, mokhoa oa ho khetholla libaka tsa boko bo le bong o se o nketsoe sebaka ke mekhoa ea potoloho, le phano ea litaba tsa "intra-cranial" Litharollo tsa lithethefatsi tse nang le "li-merafo" tse nyane le tse sa sebetseng li se li nkeloa sebaka ke mekhoa e meng e ka fetolehang e matlafatsang ea litheko le litheko tsa lithethefatsi. Ka kopanelo, lintlha tse hlahisitsoeng mona li fana ka setšoantšo se akaretsang sa boemo ba morao-rao ba liteko le ba liteko lefapheng la lipatlisiso tsa bokhoba.

Tlhōlisano ea Tlhaloso

Sengoli se phatlalatsa hore lipatlisiso li entsoe kamora ho se be le kamano efe kapa efe ea khoebo kapa ea lichelete e ka nkuoang e le khohlano e ka bang teng ea phaello.

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