Ukhwantalala

**Ukhwantalala** noma **Ukucindezeleka** kuyisimo sengqondo sokubizwa kabi kanye nokungafuni ukwenza imisebenzi. Ithinta cishe u-3.5% wabantu bomhlaba wonke, noma abantu abangaba yizigidi ezingu-280 emhlabeni wonke jikelele kusukela ngonyaka ka-2020. Ukucindezeleka kuthinta imicabango yomuntu, ukuziphatha, imizwa, kanye umuzwa wenhlalakahle. injabulo noma injabulo umuntu ayithola ngokuhlangenwe nakho okuthile iyancipha, futhi lowo ogulayo uvamise  ukulahlekelwa umdlandla noma isithakazelo kulezo zenzo. Abantu abacindezelekile bangase bezwe usizi, imizwa yokulahlekelwa yithemba,ubunzima ekucabangeni nasekugxileni , ingqondo , ukulala ngokweqile  noma ukungakwazi ukulala., ukudla ngokweqile noma i-anorexia, noma imicabango yokuzibulala.

Ukucindezeleka kungaqubuka ngenxa yezizathu nemithombo eminingi, ngezinye izikhathi ehlangene. Ukucindezeleka kungaba ukusabela okujwayelekile  okuvamile ezenzakalweni zempilo, njengokushonelwa ngothandiweyo. Ngaphezu kwalokho, ukucindezeleka kungaba uphawu lwezinkinga ezithile zengqondo, njengokuphazamiseka okukhulu kokucindezeleka, ukuphazamiseka kwe-bipolar, kanye ne-I-dysthyma. Ukucindezeleka nakho kuyisibonakaliso sezifo ezithile ezingokomzimba kanye nomphumela ongasebenzi wezinye izidakamizwa nokwelashwa kwezokwelapha.

Ubunzima Ebuntwaneni, njengokushonelwa, ukunganakekelwa ukuhlukunyezwa ngokwengqondo, ukuhlukumezwa ngokomzimba, ukuhlukunyetwa ngokocansi  noma ukuphathwa ngendlela engafani kwabantwana ngabazali kwezingane zakubo, kungafaka isandla ekucindezelekeni ebudaleni. Ukuhlukunyezwa ngokomzimba noma ngokobulili ebuntwaneni ikakhulukazi kuhlobene kakhulu namathuba okucindezeleka kukho konke ukuphila komuntu osindile. Abantu abaye babhekana nokuhlangenwe nakho okubuhlungu kwasebuntwaneni okune noma ngaphezulu banamathuba aphindwe izikhathi ezingu-3.2 kuya kwezingu-4.0 okuba nokucindezeleka. Izinga eliphansi lezindlu, ukungasebenzi kahle  ukushoda kwezindawo zokuhlala kanye nokuvezwaemikhulungwaneni  nasekushiseni komoya nasekungcoleni komoya kuhlotshaniswa nemizwa yokucindezeleka, okugcizelela  isidingo sokucatshangelwa ekuhlelweni kokuvimbela imiphumela enjalo. Indawo iye yahlotshaniswa nokucindezeleka kanye neminye imizwelo emibi. Izinga lokucindezeleka phakathi kwalabo abahlala ezindaweni ezinkulu zasemadolobheni libonakala liphansi kunalabo abangenalo. Ngokufanayo, labo abavela emadolobheni amancane nasezindaweni zasemaphandleni bavame ukuba namazinga aphakeme okucindezeleka, ukukhathazeka, nokungaphili kahle kwengqondo.

Ekubhekeni kuye lwakhombisa njalo ukuthi odokotela babe nezimanga  aphakeme okucindezeleka nokuzibulala uma kuqhathaniswa nabantu kweminye imilayini eminingi yomsebenzi - ngokuzibulala, okungu-40% ngaphezulu kodokotela besilisa kanye no-130% ngaphezulu kodokotela besimame

Izenzakalo zokuphila nezinguquko ezingabangela isimo sokucindezeleka zihlanganisa, kodwa azilinganiselwe, ukubeletha, ukunqamuka kokuya esikhathini kowesfazane, ubunzima obungokwezimali, ukungabikhona kwemisebenzi, ukucindezeleka (njengokusebenza, imfundo, inkonzo yezempi, umndeni, izimo zokuphila, umshado, njll.), ukuxilongwa kwezokwelapha (umdlavuza, i-HIV, isifo sikashukela, njll), ukuhlukunyezwa, ukulahlekelwa othandekayo, umhawu, umona inhliziyo embi noma Ukulimala okuyinhlekelele. Izimpawu ezifanayo zokucindezeleka zihlobene nokuzizwa enecala komuntu osindile. Abashadile bangase babe nesimo sokucindezeleka ngemuva Ukwenqatshwa komphakathi, ukucindezela kontanga, noma ukuhlukunyezwa.

Umzimba wocwaningo olude lwezinga eliphakeme uye wahlobanisa ukusebenza kabi kanye nezimpawu zokucindezeleka ezengeziwe nezifo. Ukucindezela endaweni yomsebenzi kwandisa ingozi yokucindezeleka kufaka phakathi umthwalo omkhulu womsebenzi, ukuzimela okuncane, ukungalingani komzamo ongathandeki wemivuzo, kanye nokuhlukumezeka  lapha endaweni yomsebenzi.

Ukucindezeleka ebunganeni i nasebusheni kufana nokuphazamiseka kokucindezeleka okukhulu kwabantu abadala, yize abasebasha bengabonisa ukucasuka okwengeziwe noma ukulawula ukuziphatha esikhundleni semizwa ejwayelekile yokudabuka, engenalutho, noma engenathemba ebonakala kubantu abadala. abantwana abacindezelekile, ezibhekene nokulahlekelwa noma usizi, noma ezinezinye izifo eziyinhloko zisengozini enkulu yokucindezeleka. Ukucindezeleka kwentsha kuvame ukuhambisana nokuphazamiseka kwengqondo ngaphandle kwezinye izifo zengqondo, ngokuvamile ukuphazamiseka kokukhathazeka, ikakhulukazi ukuphazame kokukhathazeka komphakathi, nokuphazamisekeni kokuziphatha. Ukucindezeleka nakho kuvame ukuqhubeka emindenini.

Ukucindezeleka kuhlotshaniswa ne-extroversion ephansi, futhi abantu abanezinga eliphakeme le-I-neuroticism banamathuba amaningi okuba nezimpawu zokucindezeleka futhi banamathuba kakhulu okuthola ukuxilongwa kokuphazamiseka kokucindezeleka. Ngaphezu kwalokho, ukucindezeleka kuhlotshaniswa ukunganaki. Ezinye izici ezingavela ngenxa yokunganaki okuphansi zihlanganisa ukuphazamiseka nokunganeliseki ngokuphila. Abantu bangaba sengotini yokucindezeleka nokucindezeleka ngenxa yalezi zici.

Kungenzeka ukuthi ezinye izizukulwane zokuqala ze-*I-Beta*-blockers zibanga ukucindezeleka kwezinye iziguli, yize ubufakazi balokhu bungenaso isiqinisko futhi  bungavumelani. Kunobufakazi obubukhali bokuxhumana phakathi kwe-i-alpha interferon therapy nokucindezeleka. kantu olunye ucwaningo luthole ukuthi ilunga  elilodwa kwezintathu leziguli ezelashwa nge-alpha interferon yaqala ukucindezeleka ngemuva kwezinyanga ezintathu zokwelashwa.  (Ukwelashwa kwe-Beta interferon kubonakala kungathinti emazingeni okucindezeleka.) Kunobufakazi obuqinile bokuthi i-finasteride uma isetshenziswa ekwelapheni i-alopecia yandisa izimpawu zokucindezeleka kwezinye iziguli. Ubufakazi obuxhumanisa i-isotretinoin, ukwelashwa kwezimpawu, nokucindezeleka kunamandla. Eminye imithi ebonakala ikhulisa ingozi yokucindezeleka ihlanganisa ama-anticonvulsants, ama-antimigraine drugs, ama-antipsychotics, kanye nAma-hormone afana ne-gonadotropin-releasing hormone agonist.

Izidakamizwa eziningana zokuxhaphaza zingadala noma zibhebhethekise ukucindezeleka, kungaba ngokudakwa, ukuhoxa, kanye nokusetshenziswa okungapheli. Lezi zihlanganisa uphuzo oludakayo, ama-sedative (kuhlanganise nAma-benzodiazepine), ama-opioids (kuhlanganise nezibulala izinhlungu ezidingwa ngemithi kanye nezidakamizwa ezingekho nhlobo emthethweni  okunjenge heroin), ama-stimulant (njenge-cocaine ne-amphetamines), ama-hallucinogens, kanye nama-inhalants.

Isimo sokucindezeleka singaba umphumela wezifo eziningi ezithathelwanayo. Ukungafuni ukudla, izimo zezinzwa, nezinkinga zomzimba, kufaka phakathi I-hypoandrogenism (kubesilisa), Isifo sika-Addison, Isifo sikaCushing, i-anemia eyonakele, I-hypothyroidism, I-hyperparathyroidism, isifo se-Lyme, I-multiple sclerosis, Isifo se-Parkinson, isifo sama-celiac, ubuhlungu obungapheli, isifo sikashukela, umdlavuza, ne-HIV Ukuswela amandla kwe-autistic kungangase kutholakale ngokungeyikho njengokucindezeleka.

Ucwaningo luthole ukuthi noma kuphi kusukela kumaphesenti angu-30 kuya kwangu-85 eziguli eziphethwe izinhlungu ezingapheli nazo zicindezelekile ngokwezokwelashwa. Ucwaningo lwango-2014 oludalwa ngu-Hooley et al. lwagcina  ngokuthi ubuhlungu obungapheli bukhulisa amathuba okufa ngokuzibulala kabili noma kathathu. Ngo-2017, i-British Medical Association yabona ukuthi amaphesenti angu-49 eziguli ezinobuhlungu obunganciphi zase-UK nawo ayenokucindezeleka.

## Amaphatho