Amazwana: Nalu olunye ucwaningo lwamacala olubonisa ukuthi isidakamizwa iNaltrexone sisiza abayimilutha yezocansi ukulawula ukusetshenziswa kwabo kocansi (njengendlela yokugcina). Ukuze uthole ingxoxo ephelele, futhi ekhanyayo, yeNaltrexone nokulutha kwezocansi ubone lokhu cwaningo lwangaphambilini.
Xhumanisa ne-Research Gate PDF lephepha eligcwele
UShane W. Kraus, PhD a, b * Sarah Meshberg-Cohen, PhD a, b Steve Martino, PhD a, b Lantie J. Quinones, MD c Marc N. Potenza, MD, PhD b
i-VISN 1 Mental Illness Research Education kanye neZikhungo Zemitholampilo, Uhlelo lwe-VA Connecticut Healthcare System, eWest Haven, e-CT USA
b Yale University School of Medicine, eNew Haven, eC.C. USA
c Isibhedlela iMcLean, iHarvard Medical School, uMnyango Wezengqondo, Belmont, MA USA
* Umbhali ohambisanayo: UShane W. Kraus, Ph.D., VISN 1 MIRECC, VA Connecticut Healthcare System, 950 Campbell Avenue 151D, West Haven, Connecticut 06515, United States. Ucingo: 203-932-5711, Ext: 7907; I-imeyili: [i-imeyili ivikelwe]
UKUHLAZIYA:
Phakathi kwe-30-50% yamadoda ase-US abukela izithombe zocansi njalo, futhi yidlanzana nje lababukeli elithuthukisa ukusetshenziswa okuphoqelelayo. Ukusetshenziswa kocansi okuphoqayo kubonakaliswa ngokulangazelela, ukufakwa kokuziphatha, ukuphazamiseka kwezenhlalo / emsebenzini, kanye namanani aphakeme we-psychor ye-comorbidity yezifo zengqondo (1). Uma sicabanga ngamacala amabili asanda kushicilelwa (i-2, i-3) ephakamisa i-naltrexone, umphikisi we-opioid-receptor, anganciphisa ukuqina kwezifiso zocansi nokuziphatha okuhambisana nokungaziphathi okuphathelene nocansi okucindezelayo, sibika ngecala le-naltrexone njengesijobelelo se-psychotherapy ku- Owesilisa oshadile, oqashiwe, onobungqingili kowesilisa ongafani naye kuma-30 wakhe obefuna ukwelashwa ngokubuka i-Internet. Ukusebenza kahle kukaNaltrexone ekunciphiseni isifiso sobulili sokushaya indlwabu kuzithombe zocansi akunakwa kakhulu.
UMnu D. waqala ukusebenzisa izithombe zobulili ezingcolile njalo eneminyaka engu-13. Ngesikhathi sokuxoxisana nokudla, wabika ukushaya indlwabu okucindezelayo iminyaka engu-10 edlule yize imizamo eminingi yokuhluleka ukuyeka; wayebuka izithombe zocansi ze-Intanethi cishe nsuku zonke cishe imizuzu ye-30. Ubike ukuthi kutholakale isifo esidala esidabukisayo futhi engenawo umlando wokusebenzisa kabi izidakamizwa, ukuzibandakanya ocansini nobungozi, izinkinga ezinkulu zezokwelapha futhi akazange aphuze nemithi ebekiwe.
UMnu D waqala ukuya masonto onke ngokwelashwa komuntu okuboniswa ngudokotela osezingeni eliphezulu kwengqondo. Emavikini e-18, uqedele ama-worksheets wokuzihlola nsuku zonke ezinxenxa ukubuka izithombe zocansi ze-Intanethi (i-1.0 = Ayikho i-Urge, i-7.0 = i-Intense Urge) nokuthi ngabe wayebuke futhi wahlukumeza yini ezocansi. Phezu kokunciphisa ukusetshenziswa kwakhe kocansi okuyisisekelo cishe yi-70%, uMnu. D uyaqhubeka nokubika izifiso zocansi ezivamisile zokushaya indlwabu kwi-Interneto pornogubuqili. Ngakho-ke, ngesonto leshumi lokwelashwa, wanikezwa i-naltrexone (50 mg / d).
Engakapheli amasonto amabili eqala umuthi, wabika ukwehla kwesifiso sakhe sokushaya indlwabu kwezocansi. Njengoba kukhonjisiwe kuMfanekiso 1, emasontweni ayisishiyagalolunye athatha i-naltrexone, ubukhulu bezinkanuko zakhe zocansi bancipha kakhulu (MAmaviki we-1-9 = 3.71, SD= 1.28 vs. MAmaviki we-10-18 = 2.37, SD= .80), t(124) = 6.93, p<.0001, Cohen's d = 1.25). Wabuye wabheka izithombe zobulili ezingcolile kaningi (izinsuku ezinhlanu emavikini 5-10; izinsuku eziyi-18 kumaviki 17-1), χ9 (2, N= 125) = 7.04, p<.01 (NOMA = .25, 95% CI = 0.09-0.73). Ngaphezu kwalokho, waphinda futhi walala nomuntu onenkosikazi yakhe.
Ukuthola kwethu kusikisela ukuthi i-naltrexone ingaba ukwelashwa okuhlanganisiwe kweziguli ezibika ubunzima bokuphatha ukuziphatha kocansi njengokubuka ngokweqile kwezithombe zocansi ze-Intanethi. Ukukhawulelwa okuphawuleka kombiko wamanje wamacala ukuthi asisebenzisanga ukwakhiwa okuguqukayo (Aba) noMnu D. Ngokwengeziwe, ukuvivinya okuthe xaxa kuhlolo olucishe luphindwe kabili, olulawulwa ngokungahleliwe, nolulawulwa indawo. noma ngaphandle) kwengqondo ekwelashweni kokubuka okuyizinkinga kokubuka izithombe zobulili ezingcolile kanye nezinye izindlela zokuziphatha zocansi eziphoqelekile kuyadingeka.
IZINDAWO ZOLWAZI
I-1. Kraus SW, Potenza MN, Martino S, Grant JE. Ukuhlola izakhiwo ze-psychometric ze-Yale-Brown Obsessive-Compulsive Scale kusampula yabasebenzisi bezithombe zobulili ezingcolile. I-Compr Psychiatry. I-2015.
I-2. I-Bostwick JM, iBucci JA: Umlutha wezocansi we-Intanethi ophathwa nge-naltrexone. e-Mayo Clinic Proceedings, e-Elsevier; I-2008. I-pp. 226-230.
I-3. URaymond NC, uGrant JE, uColeman E. Augmentation nge-naltrexone ukuphatha ukuziphatha kocansi okuphoqayo: Uchungechunge lwamacala. I-Ann Clin Psychiatry. I-2010; 22: 55-62. I-5
Inani Lamasonto Umfanekiso 1. Kusho Izilinganiso Eziningi Zokulangazelela Izithombe Zobulili Ezingcolile Nenani Lezinsuku Ezibukelwe Izithombe Zobulili Ezingcolile Isonto ngalinye Pre / Post Naltrexone (50mg / d) Scraving Score (1.0 - No Urge, 7.0 - Intense Urge) Inani lezinsuku ezisetshenziswa izithombe zobulili ezingcolile ngesonto
I-Naltrexone 50mg / d
Izimali
Leli cala kubikwa ukuthi lalisekelwa i-Veterans Affairs Administration, VISN 1 Mental Illness Research Education kanye neZikhungo Zemitholampilo, i-CASAColumbia kanye neNational Center for Responseible Gaming. Okuqukethwe kombhalo wesandla kukhombisa imibono yababhali hhayi ama-ejensi okuxhasa ngemali. Ama-ejensi wokuxhasa ngezimali awazange afake kokuqukethwe kombhalo wesandla.
wokudalula
Ababhali babika ukuthi abanazo izingqinamba zezimali zenzalo maqondana nokuqukethwe yilo mbhalo wesandla. UDkt Potenza uthole ukwesekwa ngokwezezimali noma isinxephezelo ngokulandelayo: UDkt Potenza uthintane nokweluleka iLundbeck, Ironwood, Shire, INSYS kanye ne-RiverMend Health; uthole ukwesekwa kokucwaninga (kuYale) kwaNational Institutes of Health, Mohegan Sun Casino, Isikhungo Sikazwelonke Sokubhekelela Ukudlala Imidlalo, ne-Pfizer pharmaceuticals; ubambe iqhaza ocwaningweni, ekubhaleni ngeposi noma ngokuxhumana ngocingo okuhlobene nokuluthwa yizidakamizwa, ukuphazamiseka kokulawula okungathinti noma ezinye izihloko zezempilo; uthintane nezokugembula nezinhlangano ezingokomthetho ezindabeni ezihlobene nokulawulwa okungathandeki; ihlinzeka ukunakekelwa kwemitholampilo eMnyangweni Wezinsizakalo Zokugembula Wezinsizakalo Nokulutheka; wenze ukubuyekezwa kwemali yesibonelelo yamaZiko Kazwelonke Wezempilo nezinye izinhlaka; ukuhlelile noma ukuhlelwa kwamajenali noma izihloko zamaphephabhuku; unikeze izinkulumo zezifundo emjikelezweni omuhle, imicimbi ye-CME nakwezinye izindawo zokwelapha noma zesayensi; futhi ukhiqize izincwadi noma izahluko zencwadi zabashicileli bemibhalo yezempilo yengqondo.
;