Tatizo la kiakili linalotokana na kiwewe

Tatizo la kiakili linalotokana na kiwewe (kwa Kiingereza: post-traumatic stress disorder; kifupi : PTSD) ni tatizo la akili linaloweza kukua baada ya mtu kupatwa na tukio la kiwewe, kama vile unyanyasaji wa kijinsia, vita, ajali barabarani, au tishio jingine kwa maisha yake.[1]

Dalili zinaweza kuwa: mawazo ya wasiwasi, mhemuko, au ndoto zinazohusiana na matukio hayo, huzuni, jaribio la kuepa ishara zinazohusiana na kiwewe, mabadiliko ya jinsi mtu hufikiria na huhisi, na kuongezeka kwa kupamba na-au-kutoroka majibu.[1][2] Dalili hizo hukaa kwa zaidi ya mwezi baada ya tukio.[1] Watoto wadogo wana uwezekano mdogo wa kuonyesha huzuni, lakini badala yake wanaweza kuonyesha kumbukumbu zao kupitia michezo.[1] Mtu aliye na tatizo la kiakili linalosababisha mawazo baada ya kiwewe yupo kwenye hatari ya juu ya kujiua au kujiumiza kwa makusudi.[3][4]

Sababu na utambuzi

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Watu wengi ambao wamepitia tukio la kiwewe hawatakuwa na tatizo hilo la kiakili.[3] Watu ambao hupitia kiwewe cha binafsi (kwa mfano ubakaji au unyanyasaji wa mtoto) wana uwezekano mkubwa wa kuwa na tatizo la kiakili linalosababisha mawazo baada ya kiwewe, wakilinganishwa na watu ambao hupitia kiwewe kisicho cha unyanyasaji, kama vile ajali na majanga ya kiasili.[5] Karibu nusu ya watu wanaopatwa na tatizo hilo la kiakili ni baada ya ubakaji.[3] Watoto wana uwezekano wa chini wa kuwa na tatizo la kiakili linalosababisha mawazo baada ya kiwewe, hasa wakiwa na umri wa chini ya miaka 10.[6] Utambuzi unategemea uwepo wa dalili mahususi baada ya tukio la kiwewe.[3]

Kinga na tiba

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Kinga inawezekana iwapo tiba inawalenga walio na dalili za mapema lakini si ikitolewa kwa watu wote bila kujali kama dalili zipo au hazipo.[3] Matibabu makuu ya tatizo hilo ni ushauri na dawa.[2] Aina tofauti za tiba zinaweza kusaidia.[7] Hii inaweza kutokea kwa tiba ya mtu mmoja mmoja au katika kikundi.[2]

Dawa za kumaliza huzuni za aina ya kuchagua kizuizi cha ufyonyaji upya wa serotonini ndizo dawa za kwanza kwa tatizo hilo la kiakili na huwa na manufaa kwa karibu nusu ya watu.[8] Manufaa hayo ni chini kwa walioonekana na tiba.[3] Si wazi iwapo kutumia dawa na tiba pamoja kuna manufaa makubwa.[3][9] Dawa nyingine hazina ushahidi wa kutosha ili kuunga mkono matumizi yake, na kwa upande wa benzodiazepini, inaweza kuleta matokeo mabaya zaidi.[10][11]

Uenezi na historia

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Karibu 3.5% ya watu wazima Marekani wana tatizo hilo kwa mwaka fulani, na 9% ya watu huwa na tatizo hilo kwa wakati fulani maishani mwao.[1] Katika sehemu kubwa ya dunia, viwango kwa wakati fulani kwa mwaka ni kati ya 0.5% na 1%.[1] Viwango vya juu vinaweza kutokea kwa sehemu za vita vya silaha.[3] Hutokea sana kwa wanawake ikilinganishwa na kwa wanaume.[2]

Dalili za matatizo ya kiakili yanayohusiana na kiwewe zimewekwa kwenye kumbukumbu kuanzia angalau enzi za Wayunani.[12] Wakati wa Vita vya Dunia hali hii ilikuwa inajulikana kwa istilahi mbalimbali zikiwemo "tatizo la kisaikolojia kwa sababu ya vita (shell shock)" na "tatizo la kiakili kwa sababu ya kupigana (combat neurosis)".[13]

Istilahi "posttraumatic stress disorder" ilianza kutumika katika miaka ya 1970 katika sehemu kubwa kwa sababu ya utambuzi wa wanajeshi wakongwe wa Marekani wa Vita vya Vietnam.[14] Ilitambuliwa rasmi na Muungano wa Madaktari wa Ugonjwa wa kiakili Marekani mwaka wa 1980 katika toleo la tatu la Mwongozo wa Utambuzi na Takwimu za Matatizo ya Kiakili (DSM-III).[15]

Tanbihi

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  1. 1.0 1.1 1.2 1.3 1.4 1.5 American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (tol. la 5th). Arlington, VA: American Psychiatric Publishing. ku. 271–280. ISBN 978-0-89042-555-8.
  2. 2.0 2.1 2.2 2.3 "Post-Traumatic Stress Disorder". National Institute of Mental Health. Februari 2016. Ilihifadhiwa kwenye nyaraka kutoka chanzo mnamo 9 Machi 2016. Iliwekwa mnamo 10 Machi 2016. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)CS1 maint: date auto-translated (link)
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Bisson JI, Cosgrove S, Lewis C, Robert NP (Novemba 2015). "Post-traumatic stress disorder". Bmj. 351: h6161. doi:10.1136/bmj.h6161. PMC 4663500. PMID 26611143.{{cite journal}}: CS1 maint: date auto-translated (link)
  4. Panagioti M, Gooding PA, Triantafyllou K, Tarrier N (Aprili 2015). "Suicidality and posttraumatic stress disorder (PTSD) in adolescents: a systematic review and meta-analysis". Social Psychiatry and Psychiatric Epidemiology. 50 (4): 525–37. doi:10.1007/s00127-014-0978-x. PMID 25398198.{{cite journal}}: CS1 maint: date auto-translated (link)
  5. Zoladz PR, Diamond DM (Juni 2013). "Current status on behavioral and biological markers of PTSD: a search for clarity in a conflicting literature". Neuroscience and Biobehavioral Reviews. 37 (5): 860–95. doi:10.1016/j.neubiorev.2013.03.024. PMID 23567521.{{cite journal}}: CS1 maint: date auto-translated (link)
  6. National Collaborating Centre for Mental Health (UK) (2005). "Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care". NICE Clinical Guidelines, No. 26. Gaskell (Royal College of Psychiatrists). Ilihifadhiwa kwenye nyaraka kutoka chanzo mnamo 2017-09-08. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help); Unknown parameter |laysource= ignored (help); Unknown parameter |layurl= ignored (help)
  7. Haagen JF, Smid GE, Knipscheer JW, Kleber RJ (Agosti 2015). "The efficacy of recommended treatments for veterans with PTSD: A metaregression analysis". Clinical Psychology Review. 40: 184–94. doi:10.1016/j.cpr.2015.06.008. PMID 26164548.{{cite journal}}: CS1 maint: date auto-translated (link)
  8. Berger W, Mendlowicz MV, Marques-Portella C, Kinrys G, Fontenelle LF, Marmar CR, Figueira I (Machi 2009). "Pharmacologic alternatives to antidepressants in posttraumatic stress disorder: a systematic review". Progress in Neuro-Psychopharmacology & Biological Psychiatry. 33 (2): 169–80. doi:10.1016/j.pnpbp.2008.12.004. PMC 2720612. PMID 19141307.{{cite journal}}: CS1 maint: date auto-translated (link)
  9. Hetrick SE, Purcell R, Garner B, Parslow R (Julai 2010). "Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD)". The Cochrane Database of Systematic Reviews (7): CD007316. doi:10.1002/14651858.CD007316.pub2. PMID 20614457.{{cite journal}}: CS1 maint: date auto-translated (link)
  10. Guina J, Rossetter SR, DeRHODES BJ, Nahhas RW, Welton RS (Julai 2015). "Benzodiazepines for PTSD: A Systematic Review and Meta-Analysis". Journal of Psychiatric Practice. 21 (4): 281–303. doi:10.1097/pra.0000000000000091. PMID 26164054.{{cite journal}}: CS1 maint: date auto-translated (link)
  11. Hoskins M, Pearce J, Bethell A, Dankova L, Barbui C, Tol WA, van Ommeren M, de Jong J, Seedat S, Chen H, Bisson JI (Februari 2015). "Pharmacotherapy for post-traumatic stress disorder: systematic review and meta-analysis". The British Journal of Psychiatry. 206 (2): 93–100. doi:10.1192/bjp.bp.114.148551. PMID 25644881. Some drugs have a small positive impact on PTSD symptoms{{cite journal}}: CS1 maint: date auto-translated (link)
  12. Carlstedt, Roland (2009). Handbook of Integrative Clinical Psychology, Psychiatry, and Behavioral Medicine Perspectives, Practices, and Research. New York: Springer Pub. Co. uk. 353. ISBN 9780826110954. {{cite book}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  13. Herman, Judith (2015). Trauma and Recovery: The Aftermath of Violence–From Domestic Abuse to Political Terror. Basic Books. uk. 9. ISBN 9780465098736. {{cite book}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  14. Klykylo, William M. (2012). Clinical child psychiatry (tol. la 3.). Chichester, West Sussex, UK: John Wiley & Sons. uk. Chapter 15. ISBN 9781119967705. {{cite book}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  15. Friedman MJ (Oktoba 2013). "Finalizing PTSD in DSM-5: getting here from there and where to go next". Journal of Traumatic Stress. 26 (5): 548–56. doi:10.1002/jts.21840. PMID 24151001.{{cite journal}}: CS1 maint: date auto-translated (link)

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