Stein, DJ, Billieux, J., Bowden-Jones, H., Grant, JE, Fineberg, N., Higuchi, S., Hao, W., Mann, K., Matsunaga, H., Potenza, MN, Rumpf , HM, Veale, D., Ray, R., Saunders, JB, Reed, GM kanye noPoznyak, V. (2018),
I-World Psychiatry, i-17: 363-364. doi:10.1002 / wps.20570
Umqondo wezinqubo zokuziphatha eziphuthumayo (okungezona-amakhemikhali) wenziwa cishe eminyakeni engamashumi amathathu eyedlule, futhi umzimba okhulayo wezincwadi uye wavela kamuva kulezi zakhiwo ezihlobene1, 2. Ngesikhathi esifanayo, abanye abalobi baye baphawula ukuthi ukuhlukaniswa kwezidakamizwa zokuziphatha kudinga umzamo owengeziwe3, 4. Lapha sinikeza ukubuyekezwa kule ndawo, sigcizelele umsebenzi wamuva owenziwe ngesikhathi kuthuthukiswa i-ICD-11, futhi sibheka umbuzo wokuthi kungasiza yini ukuba nengxenye ehlukene ngezifo ngenxa yokuziphatha okuluthayo kulezi zigaba.
Kokubili izinhlelo ze-DSM ne-ICD ziye zagwema isikhathi esithi "ukulutha umlutha" ngokuqondene nokwakhiwa "kokuxhomeka kwemithwalo". Kodwa-ke, i-DSM-5 ihlanganisa ukungezwani kokugembula esahlukweni sayo mayelana nokuphazamiseka kwezidakamizwa nezidakamizwa, futhi inikezela indlela yokudlala ye-intanethi, ngokuyibheka njengenkampani edinga ukufundwa okuqhubekayo, nokugqamisa ukufana kwayo nokuphazamiseka kokusetshenziswa kwezidakamizwa5-7. Ku-ICD-11 ehleliwe, i-World Health Organization iye yaveza umqondo wokuthi "ukuphazamiseka ngenxa yokuziphatha okuluthayo" kufaka ukuphazamiseka kokugembula nokudlala2, 8. Lokhu kuphazamiseka kubonakala ngokulawulwa okungafanelekile kokuzibandakanya ekuziphatheni okuluthayo, indlela yokuziphatha ebambe iqhaza elikhulu empilweni yomuntu, nokuqhubeka nokuzibandakanya ekuziphatheni ngaphandle kwemiphumela emibi, nokucindezeleka okuhambisana nakho noma ukukhubazeka okukhulu komuntu siqu, umndeni, ezenhlalo, nokunye izindawo ezibalulekile zokusebenza2, 8.
Ukugxila okubalulekile ngesikhathi kuthuthukiswa i-DSM-5 kwakuyi-validators yokuqinisekisa. Ngokuqinisekile, kunobunye ubufakazi bokungenelela phakathi kokuphazamiseka kokusetshenziswa kwezidakamizwa kanye nokuphazamiseka ngenxa yokuziphatha okuluthayo, njengokungcakaza kokugembula, kwi-validator esebenzayo, okubandakanya ukuguga, izindlela zokuphila, nokusabela kokwelashwa5-7. Ngokwemidlalo yokudlala, kunolwazi olukhulayo emitholampilo nasezintweni ze-neurobiological. Ukuze uthole ezinye izidakamizwa zokuziphatha ezihlukahlukene, ubufakazi obuncane bukhona. Ngaphezu kwalokho, eziningana zalezi zimo zingase zibonise ukuguqulwa kwezifo zokulawula ukucindezeleka (ku-DSM-IV ne-ICD-10), kufaka phakathi ukuguquka, izindlela eziphilayo, nokuphendula ukwelashwa9.
Amaqembu asebenza ku-ICD-11 ayaqaphela ukubaluleka kweziqinisekisi zokuphazamiseka kwengqondo nokuziphatha, njengoba kunikezwe ukuthi uhlelo lokuhlukanisa olunokuqinisekiswa okukhulu kokuxilonga lungaholela emiphumeleni yokwelashwa ethuthukisiwe. Ngesikhathi esifanayo, amaqembu e-ICD-11 agxile ikakhulukazi ekusetshenzisweni kwemitholampilo kanye nokucatshangelwa kwezempilo yomphakathi ekubhekaneni kwabo, ngokugxila okucacile ekuthuthukiseni ukunakekelwa okuyisisekelo kuzilungiselelo ezingezona ezobuchwepheshe, ngokuhambisana nokugcizelelwa kwe-ICD-11 empilweni yengqondo yomhlaba wonke. Ukwahlukaniswa okuhle okuhle kokuphazamiseka kanye nama-subtypes wokuphazamiseka, noma ngabe kusekelwa ngumsebenzi wobuciko ekuqinisekisweni kokuxilongwa, ngokungangabazeki akusizi ezimeni lapho onjiniyela abangahlinzeki ngokunakekelwa. Kodwa-ke, ukukhubazeka nokukhubazeka okuhambisanayo yizinkinga ezibalulekile kulo mbono, ezisekela ukufakwa kwezinkinga zokugembula nezokudlala ku-ICD-112, 8.
Kunezizathu eziningi zokuthi kungani ukuqaphela ukuphazamiseka ngenxa yokuziphatha okuluthayo nokufakwa kwabo kwi-nosology kanye nokuphazamiseka kokusetshenziswa kwezidakamizwa kungasiza ekuthuthukiseni impilo yomphakathi. Okubaluleke kakhulu, uhlaka lwezempilo lomphakathi lokuvimbela nokuphathwa kwezinkinga zokusebenzisa izidakamizwa lungase lusebenze ekubhejeni kwegeyimu, ukungahlelwa kwemidlalo, futhi mhlawumbe nezinye izifo ezibangelwa ukuziphatha okuluthayo (nakuba i-ICD-11 ehleliwe isikisela ukuthi kungakapheli ukufaka phakathi ukuhlukaniswa nanoma yisiphi esinye isifo ngenxa yokuziphatha okulutha ngaphandle kokugembula kanye nokuphazamiseka kwezemidlalo).
Uhlaka lwezempilo lomphakathi lokubhekisisa izinkinga ngenxa yokuziphatha okuluthayo kunamathuba amaningi athile. Ngokuyinhloko, libeka ukunakekelwa okufanelekile: a) i-spectrum ekuziphatheni okuhlobene nokuzilibazisa ngaphandle kokulimaza empilweni ngokuziphatha okuhambisana nokukhubazeka okuphawulekayo; b) isidingo sokuhlola okuphezulu kwezindleko nezindleko zalezi zimo nokukhathazeka, futhi c) nokusetshenziswa komgomo wokwenza umgomo wokwehlisa ubufakazi.
Nakuba abanye bengase bakhathazeke ngokusebenzisa ukwelashwa kokuphila okujwayelekile nokuphila, ukwakhiwa okunjalo kuqaphela ukuthi ezinye izindlela zokuziphatha eziluthayo akuzona neze futhi zingeke zibe yinkinga yomtholampilo, futhi igcizelela ukuthi ukuvinjelwa nokunciphisa umthwalo wezempilo nomphakathi okuhambisana kanye nokuphazamiseka ngenxa yokuziphatha okuluthayo kungafinyelelwa ngezindlela ezinengqondo ngokungenelela ngaphandle kwemboni yezempilo.
Ezinye izigxeko zokwakhiwa kwezinkinga zokuziphatha noma izinkinga ngenxa yokuziphatha okuluthayo zingase ziphakanyiswe ukuze zixoxwe. Sikhulume ngaphambili kulo magazini ukuthi umsebenzi owengeziwe udingekayo ukuze wenze izicelo ezinamandla mayelana nokuqinisekisa ukuxilongwa9, futhi i-ICD-11 ehleliwe okwamanje ibuye ibhale ukubheja nokugembula kwezemidlalo kusigaba esithi "ukucindezeleka kokulawula umfutho". Okuhlobene, kunokukhathazeka okunengqondo ukuthi imingcele yalesi sigaba ingahle isetshenziswe ngendlela engafanele ngaphandle kwezokugembula kanye ne-disorder disorder yokufaka ezinye izinhlobo eziningi zomsebenzi womuntu. Ezinye zalezi zingxabano zihambisana nalabo abakugcizelela izingozi zendlela yokunciphisa yezokwelapha zokuphazamiseka kokusetshenziswa kwezidakamizwa.
Ngenkathi siqaphela ukubaluleka kwalezi zinkinga, umbono wethu wukuthi umthwalo omkhulu wezifo ngenxa yezidakamizwa zokuziphatha kudinga impendulo ehambisanayo, nokuthi uhlaka oluhle luyimpilo yomphakathi.
Lapha siye sichaza izizathu zokuthi kungani uhlaka lwezempilo lomphakathi olusizo ekusetshenzisweni kokusetshenziswa kwezidakamizwa lungase lusetshenziswe ngendlela efanele ekubhejeni kokugembula, ukukhubazeka kwemidlalo futhi, mhlawumbe, nezinye izimo zezempilo ngenxa yokuziphatha okuluthayo. Le mpikiswano inikeza usizo lokufaka izidakamizwa zokusetshenziswa kwezidakamizwa, ukungazitholi ukugembula kanye nesifo sokudlala emkhakheni owodwa wesahluko ngokuphazamiseka kwengqondo, ukuziphatha noma kwe-neurodevelopmental ku-ICD-11.
Abalobi bodwa banomthwalo wemibono evezwe kule ncwadi futhi akusho neze izinqumo, inqubomgomo noma imibono ye-World Health Organization. Le ncwadi isekelwe emsebenzini ovela ku-Action CA16207 "Inethiwekhi YaseYurophu Yokusetshenziswa Kwezinkinga ze-Intanethi", exhaswe yi-European Cooperation ku-Science and Technology (COST).
Okubhekwayo
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