Ukungaqiniseki kokuxilongwa kunye nokunyuka kwegalelo kukufaka isandla kwiiphene
Ngokomphando ovela kwiZiko leSizwe leMpilo yengqondo (i-NIMH), abantu abadala abayi-5.7 abachaphazelekayo yi- bipolar disorder e-US ngamnye ngonyaka. Phakathi kwezi, iiphesenti ezingama-82,9 zihlelwa njengezifo ezinzima. Phakathi kwabantwana kunye nentsha, kukholelwa ukuba abaninzi abangama-750,000 bangafanelana neendlela zokuba ne- bipolar I okanye i- bipolar II disorder.
Unyaka ngonyaka, ezo manani zibonakala ziphakama. Ukususela ngo-1994 ukuya ku-2003, inani labantu abadala abanokuxilongwa nge-bipolar disorder e-US kabini xa iziganeko phakathi kwabantwana kunye nentsha zandisiwe ngokuphindwe ngama-40.
Nangona ukunyuka kubangelwa yinto yolwazi olubanzi phakathi koluntu kunye nokuphathwa koluntu, abaye bachaze kuphela ukuba kutheni abaninzi abantu baseMerika bafumaneka ukuba bipolar kuneyona ndawo nayiphi na indawo emhlabeni.
I-Bipolar Disorder e-United States
I-bipolar disorder ibonakala ngebhayisikili engaqhelekanga yeemvakalelo ezihamba ngaphaya kwezinto eziqhelekileyo kunye nokuhla komntu onokukwazi ukuhlangabezana nobomi bemihla ngemihla. Yimeko ephosakeleyo, ebonakaliswa ngamaxesha okuphakama komntu kunye nokunyamezela , okwenza kube nzima kwabanye kwaye kungenakwenzeka kwabanye.
Ngenxa yoko, isifo sengqondo se-bipolar namhlanje sinoxanduva lweminyaka emininzi elahlekelwe ukukhubazeka kunokuba zonke izifo zomhlaza okanye nayiphi na isifo esibangelwa yi-neurologic, kuquka nokuhluthwa kunye ne-Alzheimer's.
Ngokungafani nale miqathango, izifo ezibangelwa yi-bipolar zivame ukuvela ngaphaya kwangoko ebomini kwaye ziyakwazi ukuqhubeka kwixesha lokuphila ngamaqondo ahlukeneyo.
Ingxaki ye-bipolar ihambelana namazinga aphezulu ekungabikho kwemisebenzi kunye nobunzima obuhlobene nomsebenzi, nokuba phakathi kwabantu abaneekholeji. Nangona iifomathi zifani, bekholelwa ukuba izinga lokungaqeshwa kwabasebenzi abaneengxaki ze-bipolar liyakwazi ukuhamba naphakathi kwama-40 ukuya kuma-60 ekhulwini.
Ukuhlalutya kwedatha ye-epidemiological ukususela ngo-1991 ukuya ku-2009 kugqiba ukuba iindleko zonyaka zokunyamekela abantu abaphila ne-bipolar disorder e-US zingaphezulu kwama-dollar ayi-150 yezigidi. Ezinye ziqikelele zenze iindleko ezingekho ngqo (ezibandakanya phakathi kwezinye izinto, ukulahleka kwemveliso, ukungasebenzi, kunye nokukhubazeka) njengamaxesha amane loo mali.
Isifundo sibonisa i-US Inomlinganiselo ophezulu kakhulu we-Bipolar Disorder
Ngokunyuka okuqhubekayo kwimiba yokuhlola, i-US ibonakala ikhupha onke amanye amazwe kwipesenti yabantu abahlala okanye abahlala nesifo.
Ngokwe-11-uphando lwentlanga olwenziwa yi-NIMH, iUnited States inezinga eliphezulu kakhulu lokuphila kwentsholongwane ye-bipolar kuma-4.4 ekhulwini xa kuthelekiswa nomyinge wamazwe ngama-2.6 ekhulwini. Ukongezelela, ama-US amanqanaba angaphezulu kwezixhenxe ezisibhozo ezahlukeneyo ze-bipolar. (IBrazil yabika i-10.4 yepesenti yezinga lokudakumba okukhulu kunye nama-8.3 ekhulwini.)
Xa besabela kwiziphumo, abaphandi ba-NIMH abazange bakwazi ukudibanisa nayiphi na into ekhethekileyo kulezi zinto ezingafaniyo ngaphandle kokubonisa ukuba i- genetics , inkcubeko, imvelo, kunye neziseko zonyango ziyakudlala inxalenye.
Oko babenako ukugqamisa kwakukho ukungaphumeleli kwindlela abaphathi bezempilo abachazela ngayo izifundo kunye nesiphumo sokuphazamiseka kwe-bipolar.
Ezi nkcazo zisentliziyweni yendlela esichengisisa ngayo isifo se-bipolar. Naluphi na ukuhluka kunokubangela ukungahambi kakuhle okanye, njengokuba ezinye iingcali ziqala ukubonisa, ukukhula okuphezulu kweso sifo.
Ukugqithisa kwe-Bipolar Disorder kwi-Adult and Children
E-US, ukuxilongwa kweengxaki ze-bipolar kusekelwe kwimiqathango yemigaqo ekufuneka umntu adibana ngayo ukuze acinge ukuba yi-bipolar.
I-Bipolar I disorder, umzekelo, ichazwa ngokubakho ubuncinane kweso siqhelo somntu , ngokuqhelekileyo ngokubambisana nesinye seziqephu zokudandatheka . Izikhokelo ezifanayo zibonisa ukuba esinye isiqhelo se-mania ngaphandle kokudandatheka singanele ngokwaneleyo ukuxilonga ngokukhawuleza ukuba akukho zizathu zonyango (kuquka ukusetyenziswa kakubi kwezidakamizwa, izifo zesistim, ukuphazamiseka kwegazi, okanye ezinye izifo zengqondo).
Ngaloo ndlela, ukuxilongwa kwentsholongwane ye-bipolar yinto enye yokubandakanywa (oku kuthetha ukuba umntu kufuneka ahlangabezane neendlela ezithile) kunye nokukhutshwa okunye (intsingiselo kufuneka siyikhuphe zonke ezinye izizathu ngaphambi kokuba sifumane ukuxilongwa ngokucacileyo). Ngokwezinye iindawo zonyango, oogqirha basengozini yokunyuka kwezi zigaba zombini.
Izinto eziba negalelo kwi-Overnagnosis
Ngo-2013, abaphandi kwi-University of Texas yeZiko lezeNzululwazi yezeMpilo e-Houston baqhube uphononongo olubucayi lwezifundo ezi-7 eziphambili zophando malunga neengxaki zokugqithisa i-bipolar disorders, ngokukodwa kubantu abaphulukileyo.
Nangona iirhafu zihluka ukusuka kwisifundo esinye ukuya kwesinye-kunye nabanye abaphantsi kangange-4.8 ekhulwini kunye nabanye abaphakamileyo njengama-67 e-five themes amakhulu ekugqibeleni banxulumanisa nganye yezifundo:
- Ukungabikho kwamathuba ekliniki ekuphatheni i-bipolar disorder kwahlanganiswa namazinga aphezulu okuxilongwa okukhoyo.
- Abaxhasi bamaziko okusetyenziswa gwenxa kweziyobisi basebenza ngokukhawuleza ukufumanisa ingxaki ye-bipolar kubaxhasi babo.
- Ingxaki ye-bipolar yayifumene ngokugqithiseleyo kubantwana ababenemibonakalo embalwa yezifo zesifo (ukuguquka kwemizwelo, ukuxhamla, ukuxhatshazwa kwezesondo, iindiza zeengcinga, ukunciphisa isidingo sokulala) okanye imbali yentsapho eqinile.
- Iziphazamiso zaphawulwa kwisikhokelo sokuxilonga esikhutshwe nguMbutho wezeMpilo waseMelika (APA) apho ezininzi zeendlela ezisetyenziselwa ukubonisa imania kunye ne- hypomania azichazwanga kwaye zivulekele ukutolika ngokubanzi. Ngokufanayo, ukufakwa kwabakwa-APA ngabantu abanexinzelelo kodwa akukho mlando we-mania (inkcazo ekhutshwe ngokukhawuleza ukukhusela i-underdiagnosis) igxekwa njengento engaphantsi.
- Ukuqaliswa kwe-"bipolar spectrum," into eyaziwayo ngokugqithiseleyo kwiminyaka yamuva, ivumela ukuba kubekho ukulungelelanisa ngakumbi ukuxilongwa . Kucinga, phakathi kwezinye izinto, ukuba abantu abanesifo sokuphazamiseka kwengqondo bafumane "iintlobo" zesifo ukuba abahambelani nemigangatho yemveli yokufakwa.
Iingxaki zeNgcaciso kwiZiko eziBantu kunye nabantwana
Ngokutsho kophando lweYunivesithi yaseTexas, umphumo wokungazi kakuhle kweekliniki, kunye nokuchazwa ngokubanzi kwezikhokelo ze-APA, kuye kwabangela amazinga aphezulu okugqithisa i-overpoagnosis kubantu abacinga ukuba bipolar. Uphononongo olulodwa olubandakanywe kuhlalutyo luchaze ukuba ama-37 eepesenti abaqeqeshi bempilo yengqondo abangenawo amava ekuphazamiseni ukukhupha i-diagnostic.
Nangona bekuya kuba lula ukutyhola i-blame kuphela kwi-inexperience, inyaniso elula kukuba impawu zokuxilonga ezisetyenziswa ngabagqirha zivame ukuzithoba kwaye zilungele ukuchazwa kakuhle.
Oku kuyinyani ngokukhethekileyo kubantwana (kunye nabantwana basenkulanga) abaye bahlengahlengiswa kwiphilisi ye-bipolar. Abaninzi bathi i-criteria yokukhuphazekayo ayichazwa kakuhle kwizingane kwaye, ngokungafani nokuphazamiseka komntu ongenamkhawulo , kukho ubungqina obuncinane bokuxhasa iingxelo zokuthi zizingcambu zabo ebuntwaneni. Uninzi, enyanisweni, lithetha ukuba lincinci kakhulu kubantwana.
Nangona kunjalo, utshintsho olutshanje kwingcaciso ye-mania kubantwana ngoku luvumela ukuxilongwa kwe-bipolar xa, ngexesha elidlulileyo, indlela yokuziphatha yayingabonwa ngokuba yi-ADHD , ingxaki yokufunda, okanye nokuba nomoya womntwana.
Abanye baye bacetyiswa ukuba akuyona nje ingxaki yokungahambi kakuhle. Kwezinye iimeko, abazali, ootitshala kunye noogqirha baya kufumana ukuxilongwa kwe-bipolar njengengcaciso ekhangelekayo yokuziphatha kwengxaki yomntwana. Ngale ndlela, nayiphi na imiba okanye imiba yokuziphatha ibonwa ukuba nayo imvelaphi yezofuzo okanye i-neurologic apho kukho unyango oluchanekileyo olunokumiselwa.
(Kwakungumzekelo obonakaliswe kukugqithisa kweRitalin kubantwana abaxilongwa nge-ADHD ekuqaleni kwawo-2000.)
I-Bipolar Spectrum Ikhupha ingxabano, ingxabano
Izinkolelo ezifanayo zinokuqhuba ukuxilongwa ngokugqithiseleyo kokuphazamiseka kwabantu abadala. Ngokuqinisekileyo siye sabona oku kuhlonywa kwe- bipolar spectrum classification, esenza sikwazi ukubeka iziphazamiso zokulawula ukuphazamiseka, ukuphazamiseka komntu, ukuphazamiseka kwezixhala kunye nezinye iindlela zokusetyenziswa kakubi kweziyobisi phantsi kwe-bipolar umbrella efanayo.
Abagxeki bahlulo bathi:
- I-bipolar i-spectrum ayinalo ukucaciswa ngokubanzi kwenkcazelo yokuphazamiseka kwengqondo.
- Le ngcamango iyangqamanisa imigca phakathi kweendlela ezahlukeneyo zezifo ezifunyaniswayo, ezikhokelela ekuncinci kunokuba kukhulu ukuxilongwa.
- Ukuthandwa kwengqondo kunokukhokelela ekubeni "ukuxilonga," igama elisetyenziselwa ukuchaza imeko apho oogqirha baqala ukubona ukuphazamiseka kuyo yonke indawo.
- Ukuxilongwa kwe-bipolar spray diagnostic kungakhokelela izigulane kunye noogqirha ukuba bafune unyango olongezelelekileyo kwiimpawu ezinokuthi zingabandakanywa nezifo ezibangelwa yi-bipolar.
Abaxhasi, okwangoku, baxela ukuba le ngongoma inikezela isakhelo esichazamisayo ukuqhuba amandla ezifo ezahlukahlukeneyo umntu angakwazi ukuzenza ngaphandle kokugxila kwelinye okanye ukuhlukana ngamnye njengengxaki yokuphathwa ngabanye.
Ukungaphumeleli ukuKhuphela ezinye izizathu
Esinye seziganeko zesifo sokuxilongwa kwe-bipolar ukukhutshwa kwazo zonke ezinye izizathu zokuziphatha komntu okanye ukucindezeleka. Oku kuthetha ukulawula naluphi na umqathango onokuthi ufanane nesimo sengxaki yokuphazamiseka kwengqondo, kuquka:
- Ukuphazamiseka kwengqondo, kubandakanya ukugula komzimba, ukuhluthwa, i-encephalitis, i-tumor cerebral, okanye i-brain hemorrhage
- Amachiza afana ne-corticosteroids, i-stimulants ekhethiweyo kunye ne-levodopa (esetyenziswe kwisifo sika-Parkinson) kunokubangela iimpawu zomntu .
- Izifo ezinokwenziwa kwemetaboli ezifana nesifo sikaCushing, i-hyperthyroidism, ukusilela kwe-vitamin B12 kunye ne-dialysis enokubangela ukuziphatha komntu
- I-Schizophrenia , enokufana ne-bipolar mania kwizigaba ezinzima
- Ukusetyenziswa kakubi kweziyobisi, ngokukodwa i-cocaine, i- ecstasy , okanye i-amphetamines ezinokuba neempawu ezinjenge-mania
Ukungabandakanyi kwezi zizathu, ngokukodwa kubantu abaneempawu ezintsha kunye nezigulane, oogqirha babeza kwenza ibhetri yeemvavanyo ngaphambi kokuba banike ukuxilongwa. Basenokuquka isikrini seziyobisi, iimvavanyo zokucinga (i-CT scan, i-ultrasound), i-electroencephalogram (i-EEG), kunye nokuhlolwa kwegazi.
Ngokudabukisayo, kwiimeko ezininzi, ezi zinto zenziwe, nakwiindawo apho umngcipheko we-diagnosticosis uphezulu. Olunye lwezifundo oluhlolisiswe ngabaphandi beYunivesithi yaseTexas lubonise ukuba malunga nesiqingatha (42.9 ekhulwini) zabantu abafuna unyango kumaziko okusetyenziswa gwenxa kweziyobisi basebenzakala ngokungenakulungile ukuba baneengxaki ze-bipolar.
Nangona kuyi nyaniso ukuba kukho izinga eliphezulu lokusetyenziswa gwenxa kweziyobisi kubantu abane-disorder bipolar, ukuxilongwa ngokuqhelekileyo kwenziwa kuphela emva kokuba iimpawu zezilwelisi ziye zatshatyalaliswa ngokupheleleyo (ezinokuthi zithathe naphi na iintsuku ezisixhenxe ukuya kwezi-14, okanye ngaphezulu. Ngokuqhelekileyo, unyango lwe-bipolar luqalisiwe ngaphambi koko.
Ngaphandle kokuvavanya ukuxhomekeka, ukuxhamla nokuxhatshazwa kakubi kuphezulu. Uphononongo olhululwe ngo-2010 lubonise ukuba, abantu abangama-528 abafumana ukukhubazeka koLuntu kwi-Bipolar disorder, kuphela i-47.6 pesenti idibene neendlela zokuxilonga.
> Imithombo:
> Dilsaver, S. "Uqikelelo lomthwalo ubuncinane wezomnotho weengxaki ze-bipolar I and II e-United States: 2009." Umbhalo weengxaki ezichaphazelekayo. 2011; 129 (1-3): 79-83.
> Ghouse, A .; IiSanches, M .; Zunta-Soares, G; okqhubekayo. "Ukuxilongwa kwe-Bipolar Disorder: Uhlalutyo olubalulekileyo lweencwadi." IScientific World Journal. 2013 (2013); I-ID yeSiqendu 297087.
> Merikangas, K .; Jin, R .; Yena, JP .; okqhubekayo. "Ukuxhaphaka kunye neCorrelates ye-Bipolar Spectrum Disorder kwi-Initiative Survey Health Initiative . " I- Archives of General Psychiatry. 2011; 68 (3): 241-251.
> Miller, S .; Dell'Osso, B; kunye neKetter, T. "Ubuninzi kunye nomthwalo wokudandatheka kwengqondo." Umbhalo weengxaki ezichaphazelekayo. 2014; 169 (S1): S3-S11.
> Parens, E. kunye noJohnston, H. "Impikiswano malunga nokuxilongwa kunye nokunyangwa kwengxaki yokugula kwengqondo kubantwana." I-Adolesc ye-Child Adolesc Psychiatry. 2010; 4: 4-9.