fsiqikuri aSlilobebi, adreuli gamovlena, profilaqtika; Carevis,zrunvisa da mkurnalobis meTodebi

1. fsiqikuri aSlilobebi, adreuli gamovlena, profilaqtika; Carevis,zrunvisa da mkurnalobis meTodebi neli maWaraSvili; “samSabaToba”; 02.02.10

2. ra aris fsiqikuri janmrTeloba?fsiqikuri jamrTeloba ufro metia vidre fsiqikuri daavadebisar qona. fsiqikuri jamrTeloba gulisxmobs keTildReobis mdgomareobas, rodesac: • adamians SeuZlia sakuTari SesaZleblobebis realizacia; • cxovrebiseul stresebTan gamklaveba; • nayofieri da produqtiuli muSaoba; • sazogadoebis cxovrebaSi wvlilis Setana.

3. msoflioSi daaxloebiT 450 milion adamians aReniSneba Pfsiqikuri janmrTelobis problemebi; • fsiqikuri aSlilobebi yvelaze gavrcelebul daavadebaTa ricxvSi Sedis; • depresia avadmyofobis da Sromisuunarobis gamomwvev mizezTa Soris meoTxe adgilzea; • saSualo da dabal Semosavlian qveynebSi daavadebaTa tvirTis 10-% swored fsiqikur daavadebebze modis; • es ricxvi axlosaa gulsisxlZarRvTa daavadebebis Sesabamis maCvenebelTan;

4. invalidobis gamomwvevi 10 umTavresi mizezis naxevari fsiqikuri daavadebebiTaa gamowveuli, esenia: • depresia, • alkoholizmi, • maniakalur-depresiuli fsiqozi, • Sizofrenia. 2020 wlisaTvis msoflioSi invalidobis uxSiresi mizezi depresia iqneba; daavadebaTa klasifikaciis rigSi depresia gulsisxlZarRvTa daavadebebis Semdeg meore adgils daikavebs.

5. Hharvadis universitetis kvlevis Sedegebis Tanaxmad fsiqikurad seriozulad daavadebulTa 80_% umuSevaria; • moxucTa da xandazmulTa depresiuli aSlilobebi 8-%ia; • maTgan 63-% ver axerxebs mkurnalobas; • depresia am asakobriv jgufSi iwvevs: • insultebis, • parezebis, • kardio-vaskularuli, • infeqciuri daavadebis, maT Soris tuberkulozis provocirebas

6. zrdasruli martoxela usaxlkaro mosaxleobis 1/3-s seriozuli fsiqikuri daavadebebi awuxebs, rasac xSirad alkoholizmi da narkomania emateba.P • pirveladi daxmarebis kabinetebSi misul pacientTa Civilebis 30-80 %daudgeneli xasiaTis fsiqikur aSlilobebs ganekuTvneba; • aSS-Si sikvdilianobis mizezTa Soris TviTmkvleloba mecxre adgilzea.

7. kvlevis ”globaluri iniciativa fsiqiatriaSi” Sedegebis Tanaxmad fsiqikuri aSlilobis mqone adamianebi erT-erT yvelaze daucvel jgufs miekuTvnebian • maTi absoluturi umravlesoba (90-%) umuSevaria; • fsiqikuri aSlilobis mqone pirTa socialuri urTierTobebi Raribia - 88-%-ze meti ZiriTadad saxlSia gamoketili; F • fsiqikuri aSlilobis mqone pirTa 88-%-s konfliqti aqvs ojaxebSi; • mzrunvelTa 68-% umuSevaria radgan dRis umetes nawils fsiqikuri aSlilobiT daavadebuli piris movlas uTmobs, 70-%-s ar dausvenia ramodenime wlis ganmavlobaSi

8. fsiqikuri statusis gamokvlevis mizani: • fsiqikuri aSlilobis simptomis dadgena;P • pacientis mxridan TviT an sxvisi dazianebis saSiSorebis Sefaseba; • Semdgomi mkurnalobis gegmis Sedgena.

9. arsebobs fsiqodiagnostikis sxvadasxva meTodi: • fsiqo statusis gamokvleva (kognicia, koncentracia, saxis gamometyveleba, intonacia, manerebi, TviT Sefaseba, laparakis manera, tonaloba, aRqma); • testireba (arsebobs msoflioSi miRebuli depresiis kiTxvarebi:bk-is,hopkin-si,luSeri-s,mmpa da a.S.) • testis Sedegebis damuSavebis Semdeg fsiqologi akeTebs daskvnas da isazRvreba mkurnalobis Semdegi taqtika, mZime depresiis SemTxvevaSi aucilebelia fsiqiatris CarTva da farmako Terapia; • mkurnalobis 14 dRis Semdeg saWiroa samkurnalo reJimis adeqvaturobis ganmeorebiTi Sefaseba

10. depresia laTinuri sityvaa da niSnavs daTrgunuls depresia adamianis fsiqiuri aSlilobaa, romelsac axasiaTebs: • negatiuri ganwyoba, • sevda, • daTrgunuloba • gunebisa da TviTSefasebis gauareseba, • cxovrebis interesis dakargva. depresia advilad gankurnebadia _ pacientebis 80 %-sruliad ikurneba.

11. depresiis klinika depresiis gancda adamianisTvis damaxasiaTebeli normaluri reaqciaa garegan movlenaze, an raime mniSvnelovan personalur danakargze. gaxangrZlivebuli reaqcia, romelic moicvas ara mxolod guneba-ganwyobis moSlas, aramed sxva cvlilebebsac, diagnostirdeba rogorc depresia depresia moicavs: Secvlil guneba-ganwyobas (daqveiTebuli guneba-ganwyoba an/da anhedonia, anu siamovnebisa da interesis dakargva); fizikur simptomebs (darRveuli mada, Zili, seqsualuri ltolva da motoruli niSnebi: aJitacia an Seneleba, daRliloba); kognitur siptomebs (negatiuri azrovneba, danaSaulis araadekvaturi gancda, gulmaviwyoba, yuradRebis koncentraciis daqveiTeba, suiciduri azrebi).

12. depresiis formebi: mZime depresiuli aSliloba - ganmeorebiTi, sul cota 2 kviriani epizodebiT; mcire depresia - vlindeba naklebi simptomebiT vidre didi depresiis forma; disTimia – xasiaTdeba qronikuli mimdinareobiT, ara nakleb 2 wlis xangrZlivobiT;

13. depresiis statistika • aSS-Si cxovrebis manZilze qalebis 10-24% da mamakecebis 5-12% imyofeba depresiis gamovlenis riskis qveS; • yoveli rva qalidan erTs uviTardeba depresia; • samidan mxolod erTi mimarTavs eqims daxmarebisaTvis; • mZime depresiis mqone hospitalizirebuli pacientebis 15 % sicocxles TviTmkvlelobiT asrulebs; • didi depresia iwyeba axalgazrda asakSi - meore aTwleulis bolos; • qalebSi depresia piks aRwevs 25-44 wlis asakSi; • depresia xSirad Tanaarsebobs sxva qronikul daavadebebTan.

14. tuberkulozi da depresia TB pacientebSi gansakuTrebiT maRalia guneba-ganwyobis moSliT mimdinare mdgomareobebi, Semdegi faqtorebis gamo: • stigma; • mgb+ mdgomareobiT gamowveuli epidsaSiSroeba; • stacionaluri mkurnalobis periodSi specifiuri reJimi; MD

15. 38 DR-TB qali pacienti tuberkulozisa da filtvis daavadebaTa erovnuli centris 100 DR-TB (Poly, MDR da XDR) pacienti gamokiTxul iqna PQR-11 skrining kiTxvariT. Mmsubuqi depresia dafiqsirda 9 pacientTan zomierad gamoxatuli depresia -11-Tan fsiqiatris daxmareba saWiro gaxda zomierad da mZimed gamoxatuli depresiebis dros mZime depresia 18 qalbatonTan

16. 62 DR-TB mamakaci pacienti msubuqi depresia dafiqsirda 12 pacientTan zomierad gamoxatuli 8 pacientTan MmZime depresia 32 pacientTan fsiqiatris daxmareba saWiro gaxda zomierad da mZimed gamoxatuli depresiebis dros

17. depresiis TandarTva aqveiTebs TB pacientebis mkurnalobaze damyolobas da axangrZlivebs mkurnalobis vadebs; • daavadebis simZimis, mkurnalobis xangrZlivobis da reJimis gamo MDR-TB pacientebSi mZime da zomierad gamoxatuli depresiebiprocentulad ufro metia, vidre regularuli TB-iT daavadebul pacientebSi;

18. PQR-11 skrining kiTxvariT gamoikiTxaHkvlevaSi CarTuli regularuli TB-iT daavadebuli 30 pacienti: • msubuqi depresia dafiqsirda 12 pacientTan; • zomierad gamoxatuli - 10 pacientTan (maT Soris 3 warsulSi namkurnalebi iyo); • mZime depresia dafiqsirda 8 pacientTan - CarTulia fsiqiatri.

19. depresiis gamomwvevi mizezebi: • eqspertebi Tvlian, rom genetikur winaswarganwyobas udidesi mniSvneloba eniWeba cxovrebaSi mimdinare stresul situaciebTan erTad; • zogierT faqtorebs SeuZliaT konkretuli qimiuri nivTierebebis - Tavis tvinis e.w. neiromediatorebis, disbalansi gamoiwvion, rac iwvevs depresias.

20. depresiuli Setevebis maprovocirebeli faqtorebi; • medikamentozuri moqmedeba – Zlieri tkivilis moxsnis mizniT narkotikebis moxmareba da steroidebiT mkurnaloba (depresiuli simptomebi xSirad ukvalod qreba am faqtorebis moxsnis Semdeg); • hormonaluri sekreciis darRveva _ farisebri jirkvlis da Tirkmelzeda jirkvlis disbalansi. • qronikuli daavadebebi _ arTriti, gulis -sisxlZarRvTa paTologia, simsivneebi, virusuli da qronikuli infeqciuri daavadebebi.

21. depresiis mkurnalobis mizani: • depresiuli aSlilobis yvela niSnisa da simptomis Semcireba da moxsna; • asimptomuri mdgomareobis doneze avadmyofobis samsaxureobrivi da fsiqosocialuri aqtivobis aRdgena; • recidivis ganviTarebis albaTobis Semcireba;

22. depresiis mkurnalobis saxeobebi: • fsiqoTerapia; • farmakoTerapia.

23. gmadlobT yuradRebisTvis !