I-schizophrenia iwukuphazamiseka kwengqondo okuyinkimbinkimbi okuthinta indlela umuntu acabanga ngayo, azizwa ngayo, nokuziphatha ngayo. Ngaphambi kokuqala kwezimpawu eziyinhloko ze-schizophrenia, abantu abaningi bahlangabezana nalokho okwaziwa njengezimpawu ze-prodromal. Lezi zimpawu ziyizimpawu zokuqala ezingase zibonise ukukhula kwalesi sifo futhi zihlanganisa ukushintsha kwemizwa, ukuziphatha, nokucabanga. Kulo mongo, sizoxoxa ngezimpawu eziyisikhombisa ezivame kakhulu ze-prodromal ze-schizophrenia kanye nokubaluleka kwazo ekuhlonzweni kokuqala kanye nokwelashwa kwalesi sifo.
Funda ngezinhlobo ezingu-7 ze-schizophrenia nezici zazo ezihlukene zokuxilongwa okufanele.
Ngaphambi kokuthi sixoxe ngezimpawu eziyisikhombisa ze-prodromal ze-schizophrenia, kubalulekile ukuqonda izinhlobo eziyisikhombisa ezahlukene zalesi sifo sengqondo. Uhlobo ngalunye lwe-schizophrenia lunezici ezihlukile, ezingasiza ekuxilongweni okufanele kanye nokwelashwa okufanele.
Izinhlobo eziyisikhombisa ze-schizophrenia yilezi: i-paranoid schizophrenia, i-schizophrenia engahlelekile, i-catatonic schizophrenia, i-schizophrenia engahlukanisiwe, i-residual schizophrenia, i-schizophrenia elula, ne-hebephrenic schizophrenia. Uhlobo ngalunye lunezimpawu ezithile ezingahlukahluka kumuntu nomuntu.
I-Paranoid schizophrenia ibonakala ngokukhohlisa nokubona izinto ezingekho, kuyilapho i-schizophrenia engahlelekile iveza ukucabanga nokuziphatha okungahlelekile. I-Catatonic schizophrenia imakwa ngokunyakaza okuphindaphindayo kanye nokuma okungajwayelekile.
I-schizophrenia engahlukanisiwe yenzeka lapho umuntu eveza izimpawu zezinhlobo ezahlukene ze-schizophrenia, okwenza ukuxilongwa kube inselele kakhulu. I-schizophrenia eyinsalela yenzeka lapho izimpawu zincipha, kodwa ezinye ziqhubeka.
I-schizophrenia elula ibonakala ngokuwohloka okuhamba kancane nokuqhubekayo kwemisebenzi yengqondo nengokomzwelo, kuyilapho i-hebephrenic schizophrenia ibonakala ngokuziphatha komntwana nokungahlelekile.
Ukuqonda izinhlobo ezahlukene ze-schizophrenia kubalulekile ukuze ubone kahle izimpawu futhi uqale ukwelashwa okufanele. Uhlobo ngalunye ludinga izindlela zokwelapha eziqondile, ngakho-ke ukuxilongwa okunembile kubalulekile.
Manje njengoba usuzazi izinhlobo ezingu-7 ze-schizophrenia nezici zazo ezihlukene, ake sikhulume ngezimpawu ze-7 prodromal zalesi sifo sengqondo, ezingasiza ekuhlonzeni kusenesikhathi kanye nokwelashwa okuphumelelayo.
Ukuqonda Isigaba Se-Prodromal Se-Schizophrenia: Izimpawu Nezimpawu Ngaphambi Kokuxilongwa Okusemthethweni.
Ukuqonda isigaba se-prodromal se-schizophrenia kusho ukuqaphela izimpawu nezici ezingase zivele ngaphambi kokuxilongwa okusemthethweni. Phakathi nalesi sigaba, abantu bangabonisa izimpawu eziningi ezibonisa ukukhula okungenzeka kwe-schizophrenia, kodwa lezi ngokuvamile azinakwa noma zibangelwa ezinye izimbangela.
Kunezimpawu eziyisikhombisa ze-prodromal ze-schizophrenia ezibalulekile okufanele wazi. Enye yalezi zimpawu ukuwohloka kwamakhono okuxhumana nabantu kanye nokuxhumana, lapho umuntu engase abe yedwa futhi abe nobunzima bokugcina ubudlelwano phakathi kwabantu. Olunye uphawu ukwehla kokusebenza kwesikole noma umsebenzi, okubonisa ukwehla kokusebenza kwengqondo.
Ezinye izimpawu ze-prodromal zihlanganisa ukushintshashintsha kwemizwelo, njengokucasuka noma ukunganaki, izinguquko ezindleleni zokulala, njengokuqwasha noma ukozela ngokweqile, nobunzima bokugxilisa ingqondo nokukhumbula. Ukwengeza, kungase kube nokukhathazeka okukhulayo kanye ne-paranoia, kanye nokuhlangenwe nakho okungavamile kokuqonda, okufana nokubona izinto ezingekho noma imicabango ekhohlisayo.
Ukuqaphela lezi zimpawu ze-prodromal kusenesikhathi kungaholela ekuxilongweni okushesha nangempumelelo kakhudlwana kwe-schizophrenia, okuvumela ukwelashwa okufanele nokuthuthukisa izinga lokuphila lesiguli. Ngakho-ke, kubalulekile ukuqaphela lezi zimpawu futhi ufune usizo lochwepheshe uma kudingeka.
Izimpawu eziyinhloko ze-schizophrenia: yiziphi izimpawu ezivame kakhulu zesifo?
Izimpawu ze-Prodromal ze-schizophrenia ziyizimpawu zokuqala ezingase zivele ngaphambi kokuqala kwesifo. Ukuqaphela lezi zimpawu kungasiza ekuxilongeni nokwelapha i-schizophrenia kusenesikhathi, ngaleyo ndlela kuthuthukise izinga lempilo yesiguli. Nazi izimpawu ezingu-7 ezivame kakhulu ze-schizophrenia:
1. Ukuzihlukanisa nabantu: Abantu abahlushwa yi-schizophrenia bangase bazihlukanise nabangane nomndeni, bakhethe ukuchitha isikhathi eside bebodwa.
2. Ukushintshashintsha kwemizwa: Ukushintshashintsha kwemizwa njalo, njengokucasuka, ukudabuka, noma ukukhathazeka, kungaba uphawu oluyisixwayiso lwe-schizophrenia.
3. Ubunzima bokugxilisa ingqondo: Izinkinga zenkumbulo kanye nobunzima bokugxilisa ingqondo emisebenzini elula kungase kubonise ukuqala kwalesi sifo.
4. Ukuphazamiseka kokulala: Ukungalali kahle noma ukulala ngokweqile ngaphandle kwesizathu esicacile kungaba izimpawu ze-prodromal schizophrenia.
5. Ukungazethembi ngokweqile: Ukungazethembi njalo izinhloso zabanye, ngisho nangaphandle kwesizathu, kungaba uphawu lokwesaba okuhlobene ne-schizophrenia.
6. Ukushintsha kokubona kwezinzwa: Ukubona izinto ezingekho noma ezizwakalayo kungase kwenzeke ezigabeni zokuqala ze-schizophrenia, okuholela ekuhlanekezelweni kweqiniso.
7. Ukucabanga okungahlelekile: Ubunzima bokuveza imibono ehambisanayo noma ukugcina ukucabanga okunengqondo kungaba uphawu lwe-prodromal schizophrenia.
Uma wena noma othile omaziyo ehlangabezana nanoma yiziphi zalezi zimpawu, kubalulekile ukufuna usizo lwezokwelapha olukhethekile ngokushesha ngangokunokwenzeka. Ukuxilongwa kusenesikhathi kanye nokwelashwa okufanele kubalulekile ekulawuleni i-schizophrenia kanye nokwenza ngcono izinga lempilo yesiguli.
Izimpawu zeProdromal: qonda ukuthi ziyini kanye nokubaluleka kwazo empilweni yomuntu.
Izimpawu ze-Prodromal ziyizimpawu zokuqala ezibonakala ngaphambi kokuqala kwesifo. Zibalulekile ngoba zingasiza ekuhlonzweni kusenesikhathi kanye nokwelashwa kwezimo ezehlukene zempilo, okuhlanganisa i-schizophrenia.
I-schizophrenia isifo sengqondo esiyingozi esithinta indlela umuntu acabanga ngayo, azizwa ngayo, futhi aziphatha ngayo. Izimpawu ze-Prodromal ze-schizophrenia izimpawu ezingase zivele amasonto noma izinyanga ngaphambi kokuqala kokugula. Ukuhlonza lezi zimpawu kusenesikhathi kungaholela ekuxilongweni ngokushesha kanye nesibikezelo esingcono sesiguli.
Kunezimpawu eziyisikhombisa eziyinhloko ze-schizophrenia ezingabonwa kubantu abahlakulela lesi sifo. Lezi zimpawu zihlanganisa ukushintsha kokulala, ukuzihlukanisa nomphakathi, ubunzima bokugxilisa ingqondo, ukucasuka, ukushintshashintsha kwemizwelo, ukukhathazeka, kanye nezimpawu ezingokomzimba ezifana nekhanda elibuhlungu nezinkinga zesisu.
Kubalulekile ukuqaphela lezi zimpawu, ikakhulukazi uma kunomlando womndeni we-schizophrenia noma okunye ukuphazamiseka kwengqondo. Ukufuna usizo lwezokwelapha olukhethekile lapho uhlonza lezi zimpawu kungabaluleka ukuze uthole ukwelashwa okuphumelelayo futhi uthuthukise izinga lempilo yesiguli.
Ngakho-ke, ukwazi nokuqonda izimpawu ze-prodromal ze-schizophrenia kubalulekile empilweni yomuntu, njengoba kungavumela ukuxilongwa kusenesikhathi kanye nokwelashwa okufanele, kube nomthelela empilweni engcono kanye nenhlalakahle kulabo abaphethwe yilesi simo.
Izimpawu eziyisi-7 ze-prodromal ze-schizophrenia
I-schizophrenia ingenye yezinkinga zempilo yengqondo ezithena amandla kakhulu eziqashelwa njengamanje. Inkambo yayo engapheli iphawulwa ukwehla okuphawulekayo kwezinga lempilo, kokubili kulabo abahlushwa yiyo kanye nalabo ababazungezile.
Njengesiyaluyalu, futhi ngenxa yokukhanya kwemfihlakalo okuzungeza ukubonakaliswa kwayo komtholampilo, kube yisihloko semisebenzi eminingi yokulalelwayo nokubonwayo lapho ezinye izici zayo ziye zagcizelelwa ngokweqile, kuyilapho ezinye zingakamelelwa.
Isigaba sokuqala, isibonelo, sivame ukunganakwa, ngisho nasezigulini eziningi kanye nemindeni yazo. Kungalesi sigaba lapho izimpawu ze-prodromal ze-schizophrenia zibonakala khona, okuzobe kugxilwe kulo mbhalo.
Kodwa-ke, sizoqale sihlole incazelo emfushane yezimpawu zezimpawu zesifo uma sesisungulwe ngokugcwele.
- Isihloko esinconyiwe: “Izinhlobo ezingu-6 ze-schizophrenia (kanye nezici ezihambisanayo)”
Iyini i-schizophrenia?
I-Schizophrenia yisifo esifakwe esigabeni esijwayelekile sezimo zengqondo . Ungahlukanisa amaqembu amabili amakhulu ezimpawu eziphawulekayo: ezinhle nezimbi.
Lolu hlobo lokuthayipha oluyisisekelo, olwahlongozwa ekuqaleni yi-Crow, lwahlala luwuhlelo oluvumelekile amashumi eminyaka ngenxa yobulula balo. Ngokuvamile, izimpawu ezinhle zichaza "ukweqile" kanye nezimpawu ezimbi "ukushoda" ekubonakalisweni kwesifo.
Izimpawu ezinhle
Izimpawu ezinhle ze-schizophrenia wukubona izinto ezingekho kanye nokukhohlisa. Eyokuqala ichaza okuhlangenwe nakho okungaqondakali okungaphazamisa noma iyiphi indlela yezinzwa, futhi lokhu kwakamuva kuhlanganisa isethi yemibono evezwe kakhulu noma encane esetshenziswa umuntu ukuchaza iqiniso layo (yize kungenasisekelo esanele senhloso). Ngokuvamile, ukwethembeka okuqinile kubangelwa kokubili, ukumelana nabo bonke ubufakazi obungase buphikise.
Imibono evame kakhulu iwukuzwa , ivezwa njengamazwi abantu abhekisela ngqo esigulini noma axhumana engxoxweni lapho lokhu kuyindaba eyinhloko. Okuqukethwe komyalezo kuvame ukuhambisana nesimo sengqondo somuntu owutholayo. Imibono engabonakali noma ethintekayo ingalandela ngokulandelana kwezikhathi.
Ukukhohlisa kusho iqoqo lemibono lapho umuntu ezama khona ukwenza umqondo wokuhlangenwe nakho kwakhe okungavamile kokuqonda futhi okuqukethwe kwawo kungase kuthembeke kakhulu (njengoba kungaba njalo ngenkohliso yokushushiswa okwenzeka ku-paranoid schizophrenia) noma kube kungenangqondo futhi okuxakile endaweni yamasiko (ukuxhumana nezidalwa ezivela kwezinye izilinganiso, amandla amaningi okuphindukuzalwa, njll).
Ulimi olungahlelekile noma olungenangqondo lungabonakala futhi . Ukuvezwa kwamazwi kubonakala sengathi kuthinteka amafomula okubhala angenawo uhlelo lolimi olubonakalayo kanye nokwakheka kwama-neologism (amagama asunguliwe), kanye nemisho engenakho ukuxhumana okunengqondo noma inkulumo ethambekele ekuphazamisekeni. Konke lokhu kusikisela ukuba khona okuyisisekelo kokuphazamiseka kwengqondo okusemthethweni.
Izimpawu ezingezinhle
Izimpawu ezingezinhle azaziwa abantu abaningi, nokho zinomthelela omkhulu ekukhubazekeni kwalabo abaphethwe yilesi simo. Ngaphezu kwalokho, ziyizibonakaliso zomtholampilo ezimelana nokwelashwa kwemithi okujwayelekile (ama-antipsychotic asebenza njengabaphikisi be-dopamine emigudwini emine yobuchopho ehilelekile kule neurotransmitter).
Izimpawu ezingezinhle zihlanganisa ukunganaki (ukuncipha kwesisusa noma ukuntula isithakazelo), i-abulia (ukulahlekelwa isifiso sokuhlanganyela emisebenzini yansuku zonke), euphoria (ukungabi namandla okucabanga nolimi), kanye ne-anhedonia (ubunzima bokuthola injabulo ezimweni ezazijabulisa ngaphambili). Ngaphezu kwalokho, izinguquko ezinqubweni zokuqonda ezibalulekile ekuthuthukisweni (inkumbulo, ukunaka, ukuqonda komphakathi, njll.) zingase zibe khona ndawonye.
Kubalulekile futhi ukuqaphela ukuthi ukuba khona kwezinye izinkinga zempilo yengqondo kuvamile njengoba abantu bephila ne-schizophrenia. Okuvame kakhulu ukucindezeleka okukhulu nezinye izinkinga zokukhathazeka, kanye nokucabanga ukuzibulala. Kufanele kuqashelwe ukuthi, ngokuphambene nenkolelo evamile, abantu abane-schizophrenia abanalo ubudlova noma abayingozi kakhulu kunomphakathi jikelele.
Kusukela manje kuqhubeke, sizohlola izimpawu zokuqala ze-schizophrenia , okungukuthi, lokho okwaziwa ngamagama akhethekile ngokuthi ukubonakaliswa kwe-prodromal.
Izimpawu ze-Prodromal ze-schizophrenia
Izimpawu ze-Prodromal zifaka phakathi zonke lezo zimpawu zokuqala zesifo . Ngokuphathelene ne-schizophrenia, zichaza isikhathi esiphakathi kwezimpawu zokuqala ezibonisa inkinga (izinguquko eziphawulekayo ezivela ezindleleni zokuziphatha nemicabango yangaphambilini) kanye nokuqala kwe-psychosis uqobo. Cishe abantu abangu-75% abahlushwa yi-schizophrenia badlule kulesi sigaba kuqala.
Ngezansi, sizocubungula sijule kuzimpawu ze-prodromal ezigqanyiswe ezincwadini zesayensi. Ubude bazo bungase bulinganiselwe emavikini ambalwa nje noma budlule iminyaka eminingi, kodwa noma kunjalo, busikisela ukuphazamiseka okungazelelwe kwendlela umuntu enza ngayo nacabanga ngayo.
1. Ukuzihlukanisa nabantu
Ukuzihlukanisa nabantu kungenye yezimpawu ezisobala kakhulu ngesikhathi sesigaba sokukhulelwa se-schizophrenia . Umuntu uyazikhipha empilweni yomphakathi futhi uhlala ngaphandle kwamandla omndeni.
Ungase uchithe isikhathi esiningi uvaleleke ekamelweni lakho noma uhlale ukude ngokomzwelo ngisho nalapho izimo lapho izinga elithile lokusebenzelana lilindeleke khona (ngokwesibonelo, imihlangano), kuthinteke ubuqotho bezibopho zakho.
2. Izinguquko ekuthuthukisweni kwemisebenzi yansuku zonke
Uma umuntu ephila impilo yobungcweti noma yezemfundo, noma ezinikele emisebenzini yomndeni noma eminye imisebenzi, ukuqapha laba bantu kungabhekwa njengokubaluleke kakhulu phakathi nalolu hlelo lokuqeqeshwa.
Kukhona ukuyekwa kwemisebenzi ayenzayo nsuku zonke, okungaholela ekungenzeki kokugcina ukuzibandakanya kwakhe ezindaweni ezahlukene (ukulahlekelwa umsebenzi, ukwehluleka ezifundweni, ukuwohloka kobudlelwano, njll.).
3. Ukuhlanzeka komuntu siqu kanye nokuqeqeshwa kwenhlanzeko
Kuyabonakala ukunganakwa okukhulu ngisho nokunakekelwa komuntu siqu okuyisisekelo, njengokuxubha amazinyo noma ukugeza . Kulesi sigaba, umuntu angase athathe ukubukeka okuzimele ngokomzimba futhi angakhombisi sithakazelo ekushintsheni isimo, ngisho nalapho ebhekene nezimfuno ezicacile ezivela kwabanye. Lesi simo siwumthombo ojwayelekile wokungqubuzana emndenini futhi singaphazamisa kakhulu ukuhlala ndawonye.
Kungase futhi kube nokuwohloka kokubukeka komzimba ngenxa yokuphila unganyakazi noma ukungazivocavoci, kube noshintsho olukhulu emikhubeni yokudla okuholela ekuncipheni okukhulu noma ekuzuzeni isisindo (kanye nezinguquko ze-anthropometric). Ngezinye izikhathi, izinguquko ekwakhiweni komzimba ziyamangalisa.
4. Ukukhathazeka nokucindezeleka
Kokubili ukukhathazeka nokucindezeleka kuyizimpawu ezilimaza kakhulu i-prodromal ze-schizophrenia , njengoba zifaka isandla ekulimaleni kwempilo yemizwa. Zingabonakaliswa njengokushintshashintsha kwemizwa okuphawulekayo, ukudangala ngokomzwelo, ukucasuka, noma ukwethuka. Kwezinye izikhathi, zibonakala njengentukuthelo engaguquki nengalingani, ekhuthaza ukungqubuzana.
Lezi zimpawu zivame ukuthola izinto ezanele ukuze zanelise indlela yokuxilonga yokuphazamiseka kwengqondo okuhlukene ezindaweni zazo (njengokucindezeleka okukhulu, ukuphazamiseka kokwesaba, ukukhathazeka komphakathi, njll.), kube inkinga ehlangene edinga ukunakwa okuzimele.
5. Ubumpofu bolimi nokucabanga
Kulesi sigaba, izimpawu zokuqala zobumpofu ekusetshenzisweni kolimi kanye nomcabango ziqala ukubonakala . Eqinisweni, abalobi abaningi bakhomba ukukhubazeka kokuqala kwezinqubo zokuqonda, yize lokhu kucashile kakhulu kunalokho okubonwa ngesikhathi sokuthuthuka kwesifo sengqondo uqobo.
Ubufakazi buqokomisa umthelela kulezi zinqubo zokuqonda ezilandelayo: isivinini sokucutshungulwa kolwazi (ikhono lokuphatha izinsiza ezidingekayo ukuze sibhekane nezidingo zezimo esibhekene nazo), ukunakwa okuqhubekayo (ukugcinwa isikhathi eside kokugxila kokunaka kusivuseleli) kanye nenkumbulo yokusebenza (ikhono lokugcina ulwazi oludingekayo ukuze wenze ngempumelelo umsebenzi umuntu ahileleke kuwo).
Okunye okutholakele futhi kuphakamisa izinga elithile lokuncipha kwenkumbulo yomlomo (ukukhumbula amagama), ukuxazulula izinkinga (ikhono lokuchaza uhlelo lwesenzo oluhloselwe ukufeza umgomo noma ukuxazulula isimo esinzima), kanye nokuqonda komphakathi (umbhalo wekhodi, ukugcinwa, ukubuyisa, nokusebenzisa ulwazi oluhlobene nokuguquguquka komphakathi; okuhlanganisa ukuhlonza okulindelwe abanye).
Konke lokhu kungase kube nomthelela ngandlela thize kwezinye izimpawu ze-prodromal, njengokulahlekelwa umsebenzi noma ukuzihlukanisa nabantu, futhi kufanele kuhlolwe ngesikhathi uchwepheshe we-neuropsychological.
6. Imibono exakile noma ekhathazayo
Ngalesi sikhathi, imicabango ephindaphindayo ingase ivele eduze nesihloko esithile, esakha yonke imisebenzi yansuku zonke. I-eksisi ye-gravitation ebalulekile ingase ishintshe kungazelelwe ibheke kulezi zihloko, ezimweni eziningi, umuntu ayengakaze akhulume ngayo ngaphambili. Ngakho-ke, kuwumcabango ocindezelayo okhuphula ukukhathazeka okuvamile kuhlelo lwesibili lokubaluleka.
I-schizotypal personality disorder (ukugcinwa kwezinkolelo ezibhekwa njengezixakile endaweni ezungezile kanye nokuba mpofu kwenkulumo ethinta inhliziyo) ithanda isakhiwo noma isisekelo lapho kungase kwakhiwe khona i-psychosis elandelayo futhi kwakubhekwa njengento ebalulekile engozini, ngakho-ke, kulesi sigaba, ukuvela kabusha kwalesi sibonakaliso sangaphambilini kungabonwa.
7. Ukuqwasha
Ubunzima bokulala bubuye buwuphawu oluvamile esigabeni se-prodromal se-schizophrenia. Zingenzeka nganoma yiziphi izinhlobo eziningana: ukuqala (ukululama kokulala), ukunakekelwa (ukuphazamiseka njalo ebusuku), nokuvuka ekuseni (ukuqeda ukulala ngaphambi kwesikhathi esifisa).
Kwezinye izimo, ukuguqulwa kwezigqi ze-circadian kubonwa, ukuze umuntu alale futhi avuke sekwephuzile kakhulu.
Kungani izimpawu ze-prodromal zibalulekile?
Ulwazi ngezimpawu ze-prodromal ze-schizophrenia, nakuba zivame ukunganakwa, lubaluleke kakhulu. Lokhu kungenxa yokuthi aziveli nje kuphela ezinyangeni eziholela ekuthuthukisweni kwesithombe esigcwele, kodwa futhi zingasebenza njengezinkomba zokuqala kwesigameko esibuhlungu kubantu asebevele bethola ukuxilongwa. Ngakho-ke, ukuhlonza kwabo kuvumela ukulindelwa kwezinyathelo ezifanele zokuvimbela nokwelapha.
Kodwa-ke, kubalulekile ukuqaphela ukuthi ukuba khona kwalezi zimpawu akusho ngempela ukuthi ukuphazamiseka kuzokhula esikhathini esizayo, njengoba lokhu kwenzeka kuphela ku-20% kuya ku-40% wamacala. Kuwuphawu oluyisixwayiso olubalulekile ukwazi nokuqalisa noma yiziphi izisetshenziswa zokusiza ezifanele.
Izinkomba ze-Bibliographic:
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George, M., Maheswari, S., Chandran, S. noManohar, J. S. (2017). Ukuqonda i-prodrome ye-schizophrenia. Ijenali yaseNdiya yezengqondo, 59 (4), 505-509.
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White, T., Anjum, A. and Schulz, S. (2006). I-prodrome ye-schizophrenia. I-American Journal of Psychiatry, 163 (3), 376-380.