Kukosha kwekusimudza kusimba uye kuyananisira kwekudya
Anorexia nervosa (AN) chirwere chinotsanangurwa nekudziviswa kwezvokudya, kazhinji zvichikonzera kusagadzikana. Kusagadzikana kwezvokudya zvinovaka muviri kunokanganisa maitiro ose emuviri, uye uropi hunowanzopukunyuka kusadya kwezvokudya zvinovaka muviri.
Ubongo Hushanduko muAnorexia Nervosa
CH inoshandiswa nekuchinja mune mafungiro uye kufunga. Varwere vanowanzove vane zviratidzo zvekuzvidya mwoyo uye kuora mwoyo izvo zvisati zvichitangira chirwere chekudya kana kuwedzerwa neA.
Ancel Keys 'Minnesota Kudzidza kwakaratidza kuti kuzvidya mwoyo uye kuora mwoyo kwaiva pakati pezviratidzo zvakapiwa nevarume vane hutano vakashongedza nharaunda yekushaya nzara. Uyezve, vanhu vane AN vanowanzosiya hukama hwevanhu, vanowedzera kugadzikana uye vanogadziriswa mukufunga kwavo, uye kazhinji havazivi zvishoma kurwara kwavo. Mumwe mubereki akatsanangura mwanasikana wake, "Sezvo kana kuparara kwepanyama kwakanga kusingatyiswi zvakakwana, akava munhu akasiyana uye anotya. Aizoreva nhema uye achiita kuti ave kunze kwekudya uye awane kushanda kwake. Anoreva zvenhema uye anoshandisa kutsanangurira kubvisa kuwedzera kune shamwari. Pandakaedza 'kungomutora kuti adye,' mharidzo yangu kumurume wangu pamusoro pokuti yaifamba sei, 'Musoro wake wakanga uchitenderera katatu Exorcist-style uye uturu hwakatanga kumhanya kubva pamuromo wake.' "
Tsvakurudzo pamusoro peBongo muAnorexia Nervosa
Pane chibvumirano chekuti kupora kubva kuUN kunoda kudzorera kuyerwa uye kugadziriswa kwekudya.
Izvi zvinofanira kuve zvakanyanya kuiswa mberi pamusoro pehutano-hunotarisira basa rekurapa. Zvidzidzo zvitatu zvenguva ichangobva kuuropi zvinoshanda kuratidza kuti nei izvi zvakakosha.
Chidzidzo chaRoberto uye vashandi pamwe chete navo (2010) vakashandisa nzira dzekufananidzira dzeMRI kudzidza ubongo hwevakadzi makumi maviri nevatatu vane HIV kare uye shure kwekudzorera kuyerwa (kusvika kune 90 muzana yehutano hwavo hwakanaka) uye vakazvienzanisa nehuchenjeri hwevakadzikadzi 21 vasina vane AN.
Migumisiro yakaratidza:
- Vanodzvinyirirwa vanhu vane AN vaiva nehuwandu hwakakosha muhuropi hupfumi nyaya huru kana vachienzaniswa neutano hwakanaka.
- Izvo zvinokanganisa mumusoro wejena zvinowedzera kuve nekugadziriswa kwemazuva mashoma kudzokorora asi hazvina kukwanisa zvizere pamusoro pemakore makumi mashanu ekudzidza.
- Vatsvakurudzi vakapedzisa vachiti: "Kuwirirana pakati peBMI uye kuchinja kwehuwandu kunoratidza kuti nzara inonyanya kuita basa muhutano hwehuropi pakati pevarwere vane AN, kunyange zvazvo nzira iyo nzara inokonzera uropi yemhepo inoramba isiri pachena."
Kuongorora kwakaitwa naWagner uye vashandi pamwe chete navo (2005) vakaita maitiro eUM brain maitiro pamusoro pemadzimai makumi mana mukurarama kwenguva refu kubva kune zvinetso zvekudya (nyaya dzaisanganisira varwere vane AN uye bulimia nervosa). Kureba kwavo kwakadzika kubva pamakore 29 kusvika ku40 (yakareba kupfuura yaRoberto kudzidza). Mhinduro yakaratidza:
- Zvose zvipfungwa zveuropi mumadzimai akadzorerwa zvaive zvakajairika muhuwandu uye zvakafanana kune zvekutonga.
- Ichi chidzidzo chinoratidza kuti chimiro cheupfungwa hunokanganisa hunochinjwa nekugara kwenguva refu .
Chidzidzo cheChui uye vashandi pamwe chete navo (2008) vakaongorora vakadzi vakuru makumi matanhatu nemasere vane nhoroondo yevechidiki-kutanga AN uye vakaenzanisa nevakadzi makumi mana vane utano hwakanaka. Vakatora chikamu vakagamuchira MRI uye chiitiko chekuongorora.
Migumisiro yakaratidza:
- Vatori vechikamu neAA vakasara patsika rakaderera vakanga vasina kukodzera MRI inoongorora.
- Uremu hwakagadziriswa varwere hwakanga hwakawanda huropi hwehupfungwa.
- Vatori vechikamu avo vainge vanga varasikirwa nekuenda kumwedzi kana kuti vaine maitiro asinganzwisisiki vakaratidza kukanganisa kwakakura munzvimbo dzakawanda dzedzinza dzakawanda dzenjere dzinosanganisira mashoko emashoko, kugona kwekuziva, kuverenga, mathemoni, uye kunonoka kugadzirisa mazwi (kunyange kana uropi hwehutano hwakagadziriswa hwakagadziriswa).
Kubata Bongo muAnorexia Nervosa
Zvakatorwa pamwechete, zvidzidzo izvi zvinoratidza kuwirirana kwakaoma pakati pechiremera chepamusoro, chimiro cheuropi, nekugadzirisa kwehuropi kushanda.
Nyaya yehupombwe inowedzera munguva yaA, uye inotora nguva yekuwanazve. Mwedzi mitanhatu mushure mekudzorera uremu hwehutano uropi huzhinji hahuna kugadzirisa kudzokera kune zvakajairika. Asi neawa yakakwana pahutano hwakanaka, uropi hunoita sokuti hunozadza zvakakwana . Uku kutsvakurudza kunoratidza kuti nemakore matatu mushure mekuwana kurerutsa kuwanda, huzhinji hwevanhu hunoonekwa hunoonekwa huri mumuviri.
Zvisinei, kunyange zvazvo uropi hwekudzorera kuyerwa kwehuremu hunoita sehunoita, hutano hwehutano hunogona kunge husati hwadzoka. Zvinoratidzika kuti kuenda kumwedzi kunogona kunge ari murevereri uye unyanzvi huri nani hwekuziva kupora kudarika kuyerwa (kwevakadzi) uye izvo zvizere zvekuziva kugadzirisa zvinogona kusadzoka kusvikira kumwedzi kwachengetwa kwemwedzi mitanhatu. Ichi ndicho chimwe chikonzero nei kudzoka kwekuenderera mberi uye kuenderera mberi kwemashoko ndicho chiratidzo chakakosha chekudzorera.
Vabereki vevarwere vane anorexia vanorondedzera nguva yakareba, kubva pamwedzi mitanhatu kusvika kune maviri pamwe nemakore kuzere "kuporeswa kwepfungwa" kuitika. Zvinorehwa nevabereki pavanotaura nezvekuporesa kweuropi ndezvekuti vanoona huri nani huri nani, "sezvinoita murwere ari kubuda mumhuhu." Uyezve, vabereki vanotaura kuti uropi hwekuporesa hunounza kuchinja kwemafungiro nemafungiro akadai kuti varwere vanoita sevakagadzikana kupora kwavo uye "kudzokera kune vekare (pre-chirwere) pachavo." Rimwe bhuku kuvabereki rakatoti, "Mwana wangu ari kudzoka."
Zvakakosha kubvuma kubatwa-22 kweAA kupora. Vanhu vane AN vanowanzoshaya njere uye vanoda nguva yakasimba pahutano hwakanaka hwehutachiona hwekuziva uye hunovandudza zvizere. Asi, chikamu chimwe chezviratidzo zvekufunga kweAA izvo zvinoita kuti vanotambura vatende kuti "hapana chakaipa" navo uye saka vanoramba kurapwa, iyo inonzi "anosognosia."
Migumisiro yevarwere neMhuri
Icho chikwata chekutsvakurudza uku, maererano naDkt. Ovidio Bermudez, MD, Chief Clinical Officer uye Chiremba Mukuru weChidiki neAdolescent Services paEating Recovery Center muDenver, ndeyekuti vabereki nevashandi vezvokurapa havagoni kukanganisa kuwedzera kuwanda (Updates in Kudzorera maitiro evana vaduku neAnorexia muInpatient Setting, Kudya Recovery Centre Professional Development Series). Dr. Bermudez hurukuro dzinorwarisa varwere vanoremekedzwa dzinoda "kuponeswa kwehupi" kuitira kuti "psychotherapy uye kuchinja kwehutano kunogona kuchinja."
Izvi zvinogona kunge chikonzero chimwechete chokuti mhuri-based treatment (FBT) inowanzobudirira kupfuura kuporesa munhu mumwechete kuvarwere vaduku. Vabereki vanowanzodikanwa kuti vaite basa rinoremedza vana vavo vasina kudya. Inoratidzirawo chinetso chekurapa kwevatana vakwegura vane anorexia vanogona kunge vari kuedza kupora nehutano husina simba. Kutsvakurudza kunotsigira kuti chete kuburikidza nekugadzirisa uye kuwedzerwa kuyerwa kwehutano vanhu vanokwanisa zvakakwana kuchengetedza ivo pachavo kupora.
Sources:
Chui H, Christensen B, Zipursky R, Richards B, Hanratty M, Kabain No, et al. Kugadzirisa basa uye huro hwehupi muvakadzi vane nhoroondo yevechiri kuyaruka-kutanga anorexia nervosa. Pediatrics. 2008; e426-e437.
Roberto C, Mayer L, Brickman A, Muraskin J, Yeung L, Steffener J, et al. Brain tissue volume inoshandura kuwedzera kuwedzera kubudirira kune vanhu vakuru vane anorexia nervosa. International Journal of Eating Disorders. 2011; 44 , 406-411.
Wagner A, Greer P, Bailer UF, Frank GK, Henry SE, Putnam K, et al. Kazhinji uropi hwemakumbo mavhesi mushure mekugara kwenguva refu mukureruka mune anorexia uye bulimia nervosa. Biological Psychiatry . 2006; 59 (3): 291-3.