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Rashin jin tsoro

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Rashin jin tsoro
Hoton wani da ke fama da fargabar tsoro, wanda wani mutum ya tabbatar da shi
Kyakkyawan Ilimin kwakwalwa, ilimin halayyar asibiti
Alamomi Lokaci na tsoro mai tsanani, bugun zuciya, gumi, girgiza, gajeren numfashi, rashin jin daɗi [1][2]
Farko na yau da kullun Ba zato ba tsammani kuma maimaitawa [1]
Dalilan da suka haifar Ba a sani ba [3]
Abubuwan haɗari Tarihin iyali, shan sigari, damuwa ta tunani, tarihin cin zarafin yara [2]
Hanyar ganewa Dangane da alamun bayyanar cututtuka bayan kawar da wasu abubuwan da ke haifar da su [2][3]
Binciken bambance-bambance Cutar zuciya, hyperthyroidism, amfani da miyagun ƙwayoyi [2][3]
Magani Shawarwari, magunguna [3]
Magunguna Magungunan rage baƙin ciki, benzodiazepines, beta blockers [1] [3]
Matsakaicin lokaci 2.5% na mutane a wani lokaci [4]
  1. 1 2 3 "Anxiety Disorders". Mental Health Information: Health Topics. National Institute of Mental Health. March 2016. Archived from the original on 29 September 2016. Retrieved 1 October 2016.
  2. 1 2 3 4 American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing, pp. 208–217, 938, ISBN 978-0-89042-555-8
  3. 1 2 3 4 5 "Panic Disorder: When Fear Overwhelms". National Institute of Mental Health. 2013. Archived from the original on 4 October 2016. Retrieved 1 October 2016.
  4. ↑ Craske MG, Stein MB (December 2016). "Anxiety". Lancet. 388 (10063): 3048–3059. doi:10.1016/S0140-6736(16)30381-6. PMID 27349358. S2CID 208789585.

Rashin jin tsoro cuta ce ta damuwa wacce ake nunawa ta hanyar sake farfadowa ba zato ba tsammani.[1] Hare-haren tsoro lokaci ne na tsoro mai tsanani wanda zai iya haɗawa da bugun zuciya, gumi, girgiza, gajeren numfashi, rashin ƙarfi, ko jin ƙaiƙayi mai zuwa.[1] Matsakaicin matakin alamun yana faruwa a cikin minti.[2] Wataƙila akwai damuwa game da samun ƙarin hare-hare da guje wa wuraren da hare-haren suka faru a baya.[1]

Ba a fahimci ainihin dalilin rikicewar tsoro ba; duk da haka, akwai dalilai da yawa da ke da alaƙa da rikicewar, kamar damuwa ko abin da ya faru na rayuwa, samun dangin dangi na kusa da rikice-rikice, da rashin daidaituwa na Neurotransmitters.[3] Binciken ya haɗa da kawar da wasu abubuwan da ke haifar da damuwa ciki har da wasu cututtukan hankali, yanayin kiwon lafiya kamar cututtukatattun zuciya ko hyperthyroidism, da amfani da miyagun ƙwayoyi. [3] Ana iya yin bincike don yanayin ta amfani da tambayoyin.[4]

Ana yawan magance matsalar tsoro tare da shawarwari da magunguna.[3] Irin shawarwarin da aka yi amfani da su yawanci shine maganin halayyar fahimta (CBT), wanda ke da tasiri a cikin fiye da rabin mutane.[3][5] Magungunan da aka yi amfani da su sun haɗa da magungunan antidepressants, benzodiazepines, da beta blockers. [3][1] Bayan dakatar da magani, har zuwa kashi 30% na mutane suna da maimaitawa.[5]

Rashin jin tsoro yana shafar kusan 2.5% na mutane a wani lokaci a rayuwarsu.[5] Yawancin lokaci yana farawa a lokacin balaga ko farkon balaga, amma yana iya shafar mutane na kowane zamani.[3] Ba a saba gani ba a cikin yara da tsofaffi. Mata sun fi maza damar kamuwa da matsalar tsoro.[3]

Alamomi da alamomi

[gyara sashe | gyara masomin]

Mutanen da ke fama da rikicewar tsoro yawanci suna da jerin abubuwan da suka faru na matsanancin damuwa yayin hare-haren tsoro. Wadannan hare-haren yawanci suna ɗaukar kimanin minti goma, kuma suna iya zama na ɗan gajeren lokaci kamar minti 1-5, amma suna iya ɗaukar minti ashirin zuwa awa ɗaya, kuma a wasu lokuta suna iya ɗaukar ma fiye ko har sai an yi sa hannun taimako. Ƙarfin da alamun tsoro yayin hare-haren tsoro na iya bambanta.[6][7]

A wasu lokuta, harin na iya ci gaba da karfi sosai ko kuma yana da alama yana karuwa cikin tsanani. Gudanar da rikicewar tsoro na iya zama ƙalubale, amma dabaru da yawa na iya taimaka wa mutane su sarrafa alamun su da inganta rayuwarsu ta zamantakewa. Alamomin yau da kullun na ciwon tsoro sun haɗa da bugun zuciya mai sauri, gumi, dizziness, dyspnea, rawar jiki, tsoro mara sarrafawa kamar: tsoron rasa iko da hauka, [8] tsoron mutuwa [9] da hyperventilation. Sauran alamun sune jin ƙuntatawa, shanyayye, ciwon kirji, ƙishirwa, ƙishiri ko ƙishiri, sanyi ko walƙiya mai zafi, matsalolin hangen nesa, rauni, kuka da kuma wasu ma'anar canjin gaskiyar. [10] Bugu da kari, mutumin yawanci yana da tunanin lalacewa mai zuwa. Mutanen da ke fuskantar wani abu sau da yawa suna da sha'awar tserewa daga halin da ya haifar da harin. Damuwa game da rikicewar tsoro yana da tsanani sosai kuma yana da mahimmanci idan aka kwatanta da wannan daga rikicewar damuwa. Ana iya haifar da hare-haren tsoro ta hanyar fallasa wasu abubuwan motsawa (misali, ganin linzamin kwamfuta) ko saituna (misali، ofishin likitan hakora). [11][12] Hare-haren tsoro na dare sun zama ruwan dare a cikin mutanen da ke fama da matsalar tsoro.[13] Sauran hare-haren na iya bayyana ba tare da dalili ba. Wasu mutane suna magance waɗannan abubuwan a kai a kai, wani lokacin yau da kullun ko mako-mako.

Ƙananan alamun bayyanar cututtuka suna kama da alamun tsoro amma suna da alamun kaɗan. Yawancin mutanen da ke fama da Cutar Parkinson suna fuskantar hare-haren tsoro da kuma iyakancewar alamomi.[14]

Binciken da ke binciken alaƙar da ke tsakanin interoception da rikicewar tsoro ya nuna cewa mutanen da ke fama da rikice-rikicen tsoro suna jin bugun zuciya sosai lokacin da likitocin magunguna suka motsa su, suna ba da shawarar cewa suna fuskantar ƙarin wayar da kan jama'a idan aka kwatanta da batutuwa ba tare da Cutar Parkinson ba.[15][16]

Misalai na tunanin mutum

[gyara sashe | gyara masomin]

Abubuwan da ke tattare da tunanin mutum, abubuwan da ke faruwa a rayuwa, sauye-sauyen rayuwa, da muhalli, da kuma sau da yawa tunani a hanyar da ke wuce gona da iri na jiki, an kuma yi imanin cewa suna taka rawa a farkon matsalar tsoro. Sau da yawa, hare-haren farko suna haifar da cututtukan jiki, babban damuwa, ko wasu magunguna. Mutanen da ke ɗaukar nauyin da ya wuce gona da iri na iya haifar da halin firgici. Mutanen da ke fama da rikicewar damuwa (PTSD) suma suna nuna yawan rikicewar tsoro fiye da yawan jama'a.[17]

Wani bincike na Zhang da sauransu (2021) sun gano abubuwan da suka faru a lokacin yaro (ACEs) a matsayin abubuwan haɗari na rikicewar tsoro. Wadannan ACEs sun hada da cin zarafin jiki, cin zarafin motsin rai, sakaci na motsin rai. [18] Cin zarafin jima'i, maye na iyaye, da rabuwa da iyaye. Binciken tsari da meta-analysis na Gardner da sauransu (2019) sun sami alaƙa tsakanin rikice-rikice na damuwa da nau'o'i daban-daban na cin zarafin yara.[19]

An kuma bincika kasancewar motsi na fahimta. Masu ra'ayi sun yi imanin cewa mutanen da ke fama da rikicewar tsoro na iya fuskantar halayen tsoro saboda suna kuskuren jin daɗin jikinsu don yanayin barazana ga rayuwa.[1] Wadannan ji na jiki suna sa wasu mutane su ji kamar ba su da iko, wanda zai iya haifar da jin tsoro. Wannan kuskuren ra'ayi game da jin daɗin jiki ana kiransa damuwa, kuma binciken ya nuna cewa mutanen da suka sami mafi girma a kan binciken damuwa sun ninka sau biyar da za a gano su da rikicewar tsoro.[2]

Amfani da kwayoyi

[gyara sashe | gyara masomin]

Rashin amfani da kwayoyi sau da yawa yana da alaƙa da hare-haren tsoro. A cikin binciken, kashi 39% na mutanen da ke fama da matsalar tsoro sun yi amfani da abubuwa don nishaɗi. Daga cikin wadanda suka yi amfani da barasa, kashi 63% sun ba da rahoton cewa amfani da barasa ya fara kafin farawar tsoro, kuma kashi 59% na wadanda ke amfani da abubuwan haramtacce sun ba da labarin cewa amfani da kwayoyi ya fara. Binciken da aka gudanar ya rubuta dangantakar matsalar amfani da sinadarai. Rashin amfani da kwayoyi ya fara ne kafin farawar tsoro, kuma an yi amfani da kwayoyin don maganin kansu don hare-haren tsoro ta 'yan batutuwa ne kawai.[20]

Amphhetamines

[gyara sashe | gyara masomin]

A cikin wani binciken, an bincika mutane 100 masu dogara da methamphetamine don cututtukan ƙwaƙwalwa; daga cikin mutane 100, an rarraba kashi 36% a matsayin masu cututtuken ƙwaƙwalwa. Rashin jin daɗi da rikice-rikice sun fi yawa fiye da rikicewar damuwa, wanda ya kai kashi 7% na mutane 100 da aka samo.[21]

Shan taba

[gyara sashe | gyara masomin]

Shan taba yana ƙara haɗarin kamuwa da cuta ta firgici tare da ko ba tare da agoraphobia ba [22] da hare-haren firgici; shan taba da aka fara tun yana ƙuruciya ko farkon balaga musamman yana ƙara wannan haɗarin kamu da cuta na firgici. [23] [24][25][26] Duk da yake ba a fahimci yadda shan sigari ke kara fashewar tsoro ba, an samo wasu ra'ayoyi. Shan sigari na iya haifar da fargabar tsoro ta hanyar haifar da canje-canje a cikin aikin numfashi (misali, jin ƙarancin numfashi). Wadannan canje-canjen numfashi, bi da bi, na iya haifar da kamuwa da fargabar fargabar, saboda alamun numfashi sune sanannen fasalin fargabar.[24][27] An sami rashin daidaituwa na numfashi a cikin yara masu tsananin damuwa, wanda ke nuna cewa mutumin da ke da waɗannan matsalolin na iya zama mai saukin kamuwa da fashewar tsoro, don haka ya fi dacewa da ciwon tsoro. Nicotine, mai motsawa, na iya taimakawa ga hare-haren tsoro.[28][29] Koyaya, janyewar nicotine na iya haifar da damuwa mai mahimmanci wanda zai iya taimakawa ga hare-haren tsoro.[30]

Hakanan yana yiwuwa marasa lafiya na tsoro su sha sigari a matsayin hanyar maganin kansu don rage damuwa. Nicotine da sauran mahaɗan psychoactive tare da kaddarorin antidepressant a cikin hayaki na taba, wanda ke aiki a matsayin Masu hana monoamine oxidase a cikin kwakwalwa, na iya canza yanayi kuma suna da tasiri mai kwantar da hankali, dangane da kashi.

Yawancin binciken asibiti sun nuna kyakkyawar alaƙa tsakanin cin caffeine da rikicewar tsoro da / ko tasirin damuwa.[31][32] Mutanen da ke fama da matsalar tsoro sun fi damuwa da tasirin damuwa na caffeine. Ɗaya daga cikin manyan tasirin damuwa na caffeine shine karuwar bugun zuciya.[33][34][35][36]

Wasu magungunan sanyi da mura da ke dauke da magungunan rigakafi na iya ƙunsar ephedrine" id="mwAWQ" rel="mw:WikiLink" title="Pseudoephedrine">pseudoephedrine, ephedrine, phenylephrine, naphazoline da oxymetazoline. Ana iya kauce wa waɗannan ta hanyar amfani da magungunan da aka tsara don hana hawan jini.[37]

Kimanin kashi 30% na mutanen da ke fama da matsalar tsoro suna amfani da barasa kuma kashi 17% suna amfani da wasu magungunan psychoactive.[38] Wannan ya faru ne idan aka kwatanta da 61% (alcohol) da 7.9% (sauran Magunguna masu amfani da hankali) [39] na yawan mutanen da ke amfani da barasa da magunguna masu hankali, bi da bi.[40] Amfani da kwayoyi na nishaɗi ko barasa gabaɗaya yana ƙara alamun bayyanar cututtuka. Yawancin magungunan motsawa (caffeine, nicotine, cocaine) za a sa ran za su kara tsananta yanayin, tunda suna kara alamun tsoro kai tsaye, kamar bugun zuciya.

Deacon da Valentiner (2000) [41] sun gudanar da binciken da ya bincika hare-haren tsoro da kuma amfani da kwayoyi a cikin samfurin da ba na asibiti ba na matasa waɗanda suka fuskanci hare-harun tsoro na yau da kullun. Marubutan sun gano cewa idan aka kwatanta da kulawar lafiya, amfani da maganin kwantar da hankali ya fi girma ga mahalarta da ba na asibiti ba waɗanda suka fuskanci hare-haren tsoro. Wadannan binciken sun dace da shawarar da Cox, Norton, Dorward, da Fergusson suka bayar (1989) cewa marasa lafiya na tsoro suna warkar da kansu idan sun yi imanin cewa wasu abubuwa za su ci nasara wajen rage alamun su.[42] Idan marasa lafiya na rikice-rikicen tsoro suna da magani da kansu, akwai yiwuwar wani ɓangare na yawan mutanen da ba a gano su ba waɗanda ba za su nemi taimakon ƙwararru ba sakamakon maganin kansu. A zahiri, ga wasu marasa lafiya, ana gano matsalar tsoro ne kawai bayan sun nemi magani don al'adar maganin kansu.[43]

Duk da yake barasa da farko yana taimakawa wajen sauƙaƙe alamun cutar firgici, amfani da barasa mai haɗari na matsakaici ko na dogon lokaci na iya haifar da rikicewar firgici don bunkasa ko kara muni yayin maye, musamman a lokacin cutar shan barasa.[1] Wannan tasirin ba na musamman ba ne ga barasa amma kuma yana iya faruwa tare da amfani da kwayoyi na dogon lokaci waɗanda ke da irin wannan hanyar aiki ga barasa kamar benzodiazepines waɗanda wani lokacin ana ba da su azaman tranquilizers ga mutanen da ke da matsalolin barasa, duk da haka, benzodiazepins sun fi zaɓaɓɓun wakilai na damuwa fiye da barasa, wanda ke da alaƙa da yawa ga masu karɓar waɗanda benzodiazepine ba sa tasiri.[1] Dalilin da ya sa ake amfani da barasa ba daidai ba yana kara tabarbarewar tsoro saboda lalacewar sunadarai da aiki na kwakwalwa da kuma gaskiyar cewa barasa wakili ne mara kyau kuma sau da yawa ya fi farin ciki cewa benzodiazepines, duk da haka, tsawon aikinsa gajere ne kuma zaɓin sa ba shi da kyau.[2][3][4] Tunda yawancin benzodiazepines suna da zaɓaɓɓen GABA A tabbatacce allosteric modulators, tasirin damuwa wanda ya haɗu da karuwar aikin GABAergic ya fi ƙarfin barasa, wanda ke ɗaurewa ga wasu masu karɓa da yawa kuma yana da zaɓi mara kyau a matsayin wakili na GABAergics, kuma barasa har ma yana aiki ne a matsayin mai ba da ƙarancin allosteric na masu karɓar NDMA, wanda mai yiwuwa yana ba da gudummawa ga raunin tasirin sa da farin ciki, tare da sauran masu karɓar manufa.

Kimanin kashi 10% na marasa lafiya za su fuskanci alamun janyewa na dogon lokaci, wanda zai iya haɗawa da rikicewar tsoro, bayan dakatar da benzodiazepines. Alamun janyewa masu tsawo suna kama da waɗanda aka gani a cikin watanni biyu na farko na janyewa amma yawanci suna da matsanancin matakin tsanani idan aka kwatanta da alamun da aka gani a farkon watanni 2 ko 3 na janyewar. Ba a san ko irin waɗannan alamun da ke ci gaba da daɗewa ba bayan janyewa suna da alaƙa da janyewar magunguna na gaskiya ko kuma suna da alaƙar lalacewar tsarin neuronal sakamakon amfani da benzodiazepines ko janyewa. Duk da haka, irin waɗannan alamun suna raguwa yayin da watanni da shekaru ke wucewa, a ƙarshe suna ɓacewa gaba ɗaya.[44]

Yawancin marasa lafiya da ke halartar ayyukan kiwon lafiya na kwakwalwa don yanayin da ya haɗa da rikice-rikicen damuwa, kamar rikice-rikice na tsoro ko Tsoron jama'a, sun haɓaka waɗannan yanayin sakamakon barasa na nishaɗi ko amfani da maganin kwantar da hankali. Damuwa na iya kasancewa da barasa ko dogaro mai kwantar da hankali, wanda ke aiki don ci gaba ko kara tabarbarewar damuwa. Mutumin da ke fuskantar tasirin guba na amfani da barasa na nishaɗi ko amfani da maganin kwantar da hankali ba zai amfana daga wasu magunguna ko magunguna don yanayin rashin hankali ba, saboda ba sa magance tushen dalilin alamun. Warkewa daga alamun sedative na iya kara muni na ɗan lokaci yayin janyewar barasa ko janyewar benzodiazepine.[45][46][47][48]

An gano aikin norepinephrine na yau da kullun a cikin mutanen da ke fama da fargabar fargabar kudi; yankunan kwakwalwa masu alaƙa sun haɗa da amygdala, ventromedial nucleus na hypothalamus, da Locus Ceruleus.

Rage sautin GABA-ergic, karuwar aikin mai karɓar adenosine, karuwar matakan cortisol, da rikice-rikice a wasu hormones da / ko neurotransmitters (misali, norepinephrine). Bugu da ƙari, binciken da aka yi a cikin dangi na farko ya nuna shaidar haɗin kwayar halitta.[49] Bambance-bambance da aka gabatar suna kallon yankunan chromosomal 13q, 14q, 22q, da 4q31-q34 a matsayin yiwuwar haɗuwa da gado.[50] An rage hanawa rigakafi a cikin marasa lafiya tare da rikicewar tsoro.[51]

Neuroanatomy na rikicewar tsoro ya fi dacewa da na mafi yawan rikicewar damuwa. Nazarin Neuropsychological, neurosurgical, da neuroimaging sun haɗa da insula, amygdala, hippocampus, anterior cingulate cortex (ACC), lateral prefrontal cortex, da periaqueductal grey. A lokacin hare-haren tsoro mai tsanani, kallon kalmomin da ke cike da motsin rai, da hutawa, yawancin binciken sun sami hauhawar jini ko metabolism. Koyaya, lura da hyperactivity na amygdala ba cikakke ba ne, musamman a cikin binciken da ke haifar da hare-haren tsoro ta hanyar sunadarai. An lura da hyperactivity na Hippocampus yayin hutawa da kallon hotuna masu caji, wanda aka yi la'akari da cewa yana da alaƙa da son zuciya game da ƙwaƙwalwar ajiya game da tunanin damuwa. Insula hyperactivity a lokacin farawa da kuma a yayin abubuwan tsoro mai tsanani ana zaton suna da alaƙa da tsarin intrception mara kyau; fahimtar cewa jin daɗin jiki "ba daidai ba ne" shine binciken transdiagnostic (watau an samo shi a cikin rikice-rikice masu yawa), kuma yana iya danganta da rashin aiki na insula. Nazarin Rodent da na ɗan adam sun haɗa da launin toka na periaqueductal a cikin haifar da martani na tsoro, kuma an ba da rahoton abubuwan da suka shafi tsari da metabolism a cikin PAG a cikin rikicewar tsoro. Cutar gaban tana da alaƙa da rikicewar tsoro ta hanyar layin shaida da yawa. An bayar da rahoton lalacewar ACC ta baya ta haifar da rikicewar tsoro. An kuma bayar da rahoton ACC mai girma da dorsolateral prefrontal cortex yayin tayar da alamomi da kallon motsin rai, kodayake binciken ba daidai ba ne.[52]

Masu bincike da ke nazarin wasu mutane da ke fama da rikicewar tsoro sun ba da shawarar cewa suna iya samun rashin daidaituwa a cikin Tsarin limbic da ɗaya daga cikin sunadarai masu sarrafawa GABA-A. Rage samar da GABA-A yana aika da bayanan ƙarya ga amygdala wanda ke tsara tsarin amsawar "yaƙi ko tashi" na jiki kuma, a sakamakon haka, yana samar da alamun ilimin lissafi wanda ke haifar da rikici. Clonazepam, wani benzodiazepine mai hana kamuwa da cuta tare da tsawon rabin rayuwa, ya ci nasara wajen kiyaye yanayin a karkashin iko.[53]

Kwanan nan, masu bincike sun fara gano matsakanci da masu daidaitawa na fannoni na rikicewar tsoro. Ɗaya daga cikin irin wannan matsakanci shine matsin lamba na carbon dioxide, wanda ke matsakanci dangantakar tsakanin marasa lafiya na tsoro da ke karɓar horo na numfashi da damuwa; don haka, horo na numfasawa yana shafar matsin lamba ta carbon dioxide a cikin jinin jini na mai haƙuri, wanda hakan ke rage damuwa.[54] Wani matsakanci shine damuwa na hypochondriacal, wanda ke daidaita dangantakar tsakanin damuwa da alamun tsoro; don haka, damuwa yana shafar damuwa na hypocondriacal. [55]

An gano kula da barazanar da aka fahimta a matsayin mai matsakaici a cikin rikicewar tsoro, yana daidaita dangantakar da ke tsakanin damuwa da agoraphobia; don haka, matakin da ake ganin barazanar sarrafawa yana nuna matakin da damuwa ke haifar da agorapfobia.[56] Wani mai kula da rikicewar tsoro kwanan nan shine bambancin kwayar halitta a cikin kwayar halitta don Galanin; waɗannan bambancin kwayoyin halitta suna daidaita dangantakar da ke tsakanin mata da rikice-rikicen tsoro da matakin tsananin bayyanar cututtukan tsoro.[57]

Binciken ganewa

[gyara sashe | gyara masomin]

Ka'idodin bincike na DSM-IV-TR don rikicewar tsoro suna buƙatar ba zato ba tsammani, hare-haren tsoro na maimaitawa, wanda ya biyo baya a kalla misali ɗaya ta akalla wata ɗaya na canjin halayyar da ya danganta, damuwa mai ɗorewa game da ƙarin hare-hare, ko damuwa game da sakamakon harin. Akwai nau'o'i biyu, daya tare da kuma daya ba tare da agoraphobia ba. Ana cire ganewar asali ta hanyar hare-hare saboda magani ko yanayin kiwon lafiya, ko kuma ta hanyar hare'ar tsoro wanda ya fi dacewa da wasu cututtukan hankali. Ka'idodin bincike na ICD-10: Muhimmin fasalin shine hare-haren maimaitawa na matsanancin damuwa (tsoro), wanda ba a iyakance shi ga kowane yanayi ko saiti na yanayi ba sabili da haka ba za a iya hango su ba. Alamomin da suka fi dacewa sun hada da:

  • Farkon bugun zuciya kwatsam
  • ciwon kirji ko tsananin
  • gajeren numfashi ko hyperventilationHawan iska
  • jin dadi
  • mamaki
  • jin rashin gaskiya (depersonalization ko derealization)
  • tsoro na biyu na mutuwa, rasa iko, ko haukace

Bai kamata a ba da rikicewar tsoro a matsayin babban ganewar asali ba idan mutumin yana da rikice-rikice na baƙin ciki a lokacin da hare-haren suka fara; a cikin waɗannan yanayi, hare-harun tsoro tabbas suna da alaƙa da baƙin ciki.[58]

The Panic Disorder Severity Scale (PDSS) wata tambaya ce don auna tsananin rikicewar tsoro.[59]

Rashin lafiyar jiki matsala ce mai tsanani wacce, a lokuta da yawa, za a iya magance ta da kyau, kodayake babu wani magani da aka sani. Gano magunguna da ke haifar da cikakken martani kamar yadda zai yiwu, kuma yana iya rage sake dawowa, yana da mahimmanci.[60] Magungunan halayyar fahimta da kuma maganganun kai masu kyau na musamman don tsoro sune magungunan da aka zaɓa don rikicewar tsoro.[61] Bincike da yawa sun nuna cewa kashi 85 zuwa 90 cikin dari na marasa lafiya da ke fama da cutar firgici da aka kula da su tare da CBT sun warke gaba ɗaya daga hare-haren firgici a cikin makonni 12.[62] Lokacin da maganin halayyar fahimta ba wani zaɓi ba ne, ana iya amfani da maganin magani. Ana ɗaukar SSRIs a matsayin zaɓi na farko na maganin magani. [63][64][65]

Rashin jin tsoro ba daidai yake da alamun tsoro ba, kodayake yawancin tsoro galibi suna haifar da rikicewar tsoro. CBT da wani nau'in gwajin psychodynamic psychotherapy an nuna inganci wajen magance rikicewar tsoro tare da ba tare da agoraphobia ba.[66][67][68] Yawancin gwaje-gwaje na asibiti sun nuna cewa CBT ta sami rahoton rashin tsoro a cikin 70-90% na marasa lafiya kimanin shekaru 2 bayan magani.[62]

Binciken Cochrane na 2009 ya sami ƙarancin shaida game da ingancin maganin kwakwalwa a hade tare da benzodiazepines, irin wannan ba za a iya ba da shawarwari ba.[69]

  • Hawan iska da gangan - yana haifar da haske, raguwa, hangen nesa, damuwamamaki
  • Yin juyawa a cikin kujera - yana haifar da rikice-rikice, rikice-rikicenRashin jituwa
  • Rashin numfashi - yana haifar da dyspnea, ƙuntatawar hanyar iska
  • riƙe numfashi - yana haifar da jin cewa ba shi da numfashi
  • Gudun a wuri - yana haifar da karuwar bugun zuciya, numfashi, gumi
  • Tashin jiki - yana haifar da jin daɗin kasancewa mai tsananin damuwa da faɗakarwa

Wani nau'i na psychotherapy wanda ya nuna tasiri a cikin gwaje-gwaje na asibiti mai sarrafawa shine psychodynamic psychotherapy mai mai da hankali kan tsoro, wanda ke mai da hankali ga rawar dogaro, damuwa ta rabuwa, da fushi wajen haifar da rikicewar tsoro. Ka'idar da ke tattare da ita ta nuna cewa saboda rashin lafiyar kwayoyin halitta, abubuwan da suka faru na farko, ko duka biyun, mutanen da ke fama da matsalar tsoro suna da dogaro da wasu don jin tsaron su, wanda ke haifar da damuwa da rabuwa da fushin karewa. Magani ya haɗa da fara bincika abubuwan da ke haifar da abubuwan tsoro, sannan bincika psychodynamics na rikice-rikicen da ke haifar le rikice-rikice na tsoro da hanyoyin tsaro waɗanda ke ba da gudummawa ga hare-haren, tare da mai da hankali ga canja wurin da rabuwa da matsalolin damuwa da ke tattare da alaƙar mai warkarwa da mai haƙuri.[70]

Nazarin asibiti na kwatankwacin ya nuna cewa dabarun shakatawa na tsoka da motsa jiki na numfashi ba su da inganci wajen rage hare-haren tsoro. Ayyukan numfashi na iya ƙara haɗarin sake dawowa.[71]

Kyakkyawan magani ta ƙwararren ƙwararre na iya hana hare-haren tsoro ko aƙalla rage tsananin su da mitar su, suna kawo gagarumin taimako ga kashi 70 zuwa 90 cikin dari na mutanen da ke fama da matsalar tsoro.[72] Komawa na iya faruwa, amma sau da yawa ana iya bi da su yadda ya kamata kamar yadda ya faru na farko.

vanApeldoorn, F.J. et al. (2011) sun nuna ƙimar ƙididdigar magani wanda ya haɗa da maganin SSRI tare da maganin halayyar fahimta (CBT). [73] Gloster et al. (2011) sun ci gaba da bincika rawar da mai warkarwa ke takawa a cikin CBT. Sun rarraba marasa lafiya zuwa ƙungiyoyi biyu: ɗayan ana kula da shi tare da CBT a cikin yanayin da ke jagorantar warkarwa, kuma na biyu yana karɓar CBT ta hanyar umarni kawai, ba tare da zaman da ke jagorar warkarwa ba. Binciken ya nuna cewa rukuni na farko yana da ɗan ingantaccen amsawa, amma duka ƙungiyoyin biyu sun nuna gagarumin ci gaba a rage alamun tsoro. Wadannan binciken suna ba da gaskiya ga aikace-aikacen shirye-shiryen CBT ga marasa lafiya waɗanda ba su iya samun damar sabis na warkewa saboda rashin samun kuɗi, ko rashin samun damar ƙasa.[74] Koszycky et al. (2011) sun tattauna ingancin maganin halayyar halayyar kai tsaye (SCBT) a yanayin da marasa lafiya ba su iya riƙe ayyukan mai warkarwa ba. Nazarin su ya nuna cewa yana yiwuwa ga SCBT a hade tare da SSRI ya zama mai tasiri kamar CBT mai jagorantar warkarwa tare da SSRS. Kowane ɗayan waɗannan karatun yana ba da gudummawa ga sabuwar hanyar bincike wanda ke ba da damar yin amfani da ingantaccen maganin da za a sauƙaƙa ga yawan jama'a.[75]

Magungunan halayyar fahimta

[gyara sashe | gyara masomin]

Magungunan halayyar fahimta yana ƙarfafa marasa lafiya su fuskanci abubuwan da ke haifar da damuwa. Ta hanyar fuskantar ainihin dalilin damuwa, ana tunanin yana taimakawa wajen rage tsoron da ba daidai ba wanda ke haifar da batutuwan su fara da. Magungunan suna farawa ne tare da motsa jiki na numfashi, sannan kuma suna lura da canje-canje a cikin ji na jiki da zaran damuwa ta fara shiga jiki. Ana ƙarfafa abokan ciniki da yawa su riƙe mujallu. A wasu lokuta, masu warkarwa na iya gwadawa da haifar da damuwa don a iya gano tushen tsoro.[76]

Kamar yadda yake tare da cututtuka da yawa, samun tsarin tallafi na dangi da abokai waɗanda suka fahimci yanayin na iya taimakawa wajen kara yawan warkewa. A lokacin harin, ba sabon abu ba ne ga wadanda abin ya shafa su sami rashin hankali, tsoro nan take, wanda sau da yawa mai goyon baya wanda ya saba da yanayin zai iya kawar da shi. Don ƙarin magani mai tsanani ko aiki, akwai ƙungiyoyin tallafi ga waɗanda ke da damuwa, wanda zai iya taimaka wa mutane su fahimci kuma su magance matsalar.

Jagororin magani na yanzu American Psychiatric Association da American Medical Association da farko suna ba da shawarar ko dai maganin halayyar ko ɗaya daga cikin hanyoyin shiga tsakani na psychopharmacological. Akwai wasu shaidu da ke tallafawa fifiko na hanyoyin magani.[66][77][78]

Another option is self-help based on principles of cognitive-behavioral therapy.[79] Using a book or a website, a person does the kinds of exercises that would be used in therapy, but they do it on their own, perhaps with some email or phone support from a therapist.[79] A systematic analysis of trials testing this kind of self-help found that websites, books, and other materials based on cognitive-behavioral therapy could help some people.[79] The best-studied conditions are panic disorder and social phobia.[79]

Ana amfani da bayyanar interoceptive a wasu lokuta don rikicewar tsoro. Ana kimanta abubuwan da ke haifar da damuwa na mutane daya bayan daya kafin gudanar da bayyanar interoceptive, kamar magance ƙarancin bugun jini ta hanyar motsa jiki mai sauƙi.[15] Duk da shaidar ingancin asibiti, an ruwaito cewa kashi 12-20% na masu maganin kwakwalwa ne kawai ke amfani da wannan aikin. Dalilan da za a iya amfani da su don wannan rashin amfani sun haɗa da "rashin wuraren horo, cikas na dabaru (misali, buƙata na lokaci-lokaci don bayyanar tsawon lokaci fiye da zaman magani na yau da kullun), manufofi game da gudanar da fallasa a waje da wurin aiki, kuma watakila mafi mahimmanci, ra'ayoyin magunguna marasa kyau (misali., cewa fallasawar interoceptive ba ta dace ba, ba za a iya jurewa ba, ko ma da lahani).[15]

Magunguna masu dacewa suna da tasiri ga rikicewar tsoro. Zaɓuɓɓukan Masu hana sake dawo da serotonin sune jiyya na farko maimakon benzodiazapins saboda damuwa da ƙarshen game da haƙuri, dogaro, da cin zarafi.[80] Kodayake akwai ƙananan shaidu cewa tsoma baki na magunguna na iya canza tsoro kai tsaye, an yi karatun kaɗan, kuma maganin magani na tsoro yana sauƙaƙa maganin tsoro (alal misali a Turai inda kashi 8% kawai na marasa lafiya ke karɓar magani mai dacewa). [81]

  • Antidepressants (SSRIs, MAOIs, tricyclic antidepressants da norepinephrine reuptake inhibitors): SSRIs da aka fi amfani da su yayin magance matsalar tsoro sun haɗa da Prozac (Fluoxetine), Luvox (Fluvoxamine), Zoloft (Sertraline), Cipralex / Lexapro (Escitalopram) da Paxil (Paroxetine). Wadannan an bayar da rahoton su a matsayin mafi tasiri wajen hana hare-haren tsoro.[82] Mafi yawan bincike da tallafawa magungunan antidepressants na tricyclic sune Tofranil da Anafranil . [82] Sauran magungunan antidepressants na tricyclic da aka yi amfani da su don magani sun haɗa da Pamelor, Norpramin, da Elavil. Duk da yake waɗannan suna iya taimakawa wajen magance matsalar tsoro, bincike bai kasance cikakke ba idan aka kwatanta da magunguna biyu da aka ambata a baya. Ana iya amfani da Masu hana monoamine oxidase (MAOIs) a matsayin magani na biyu ko na uku, amma sun nuna iyakantaccen inganci a cikin maganin rikicewar tsoro, kuma suna ɗaukar haɗarin haɗari na mummunan sakamako da hulɗar magani.[83]
  • Masu yaki da damuwa (benzodiazepines): Ƙungiyar Kula da Lafiya ta Amirka (APA) ta bayyana cewa benzodiazepines na iya zama tasiri don maganin rikicewar tsoro kuma yana ba da shawarar cewa zaɓin ko amfani da benzodiazepins, antidepressants tare da kaddarorin anti-panic ko psychotherapy ya kamata ya dogara da tarihin mutum mai haƙuri da halaye.[84] Sauran masana sun yi imanin cewa ana kauce wa benzodiazepines saboda haɗarin ci gaban haƙuri da dogaro da jiki.[85] Ƙungiyar Ƙungiyoyin Ƙwararrun Ƙwararrun Halitta ta Duniya, ta ce bai kamata a yi amfani da benzodiazepines a matsayin zaɓi na farko ba amma zaɓi ne don yanayin da ke tsayayya da magani na rikicewar tsoro.[86] Duk da karuwar mayar da hankali kan amfani da magungunan antidepressants da sauran wakilai don maganin damuwa kamar yadda aka ba da shawarar mafi kyawun aiki, benzodiazepines sun kasance magani da aka saba amfani dashi don rikicewar tsoro.[87][88] Sun ba da rahoton cewa a ra'ayinsu babu isasshen shaida don ba da shawarar magani ɗaya akan wani don rikicewar tsoro. APA ta lura cewa yayin da benzodiazepines suna da fa'idar saurin fara aiki, cewa wannan yana raguwa da haɗarin haɓaka Dogaro da benzodiazepine.[89] Cibiyar Nazarin Kwarewar Kwarewar Kiwon Lafiya ta Kasa ta zo ga wani ƙarshe daban, sun nuna matsalolin yin amfani da gwaje-gwaje na asibiti marasa sarrafawa don tantance tasirin maganin magunguna kuma bisa ga binciken da aka sarrafa na placebo sun kammala cewa benzodiazepines ba su da tasiri a cikin dogon lokaci don rikicewar tsoro kuma sun ba da shawarar cewa kada a yi amfani da benzodiazepins fiye da makonni 4 don rikice-rikice. Maimakon haka, jagororin asibiti na NICE suna ba da shawarar madadin magungunan magunguna ko magungunan tunani. Idan aka kwatanta da placebos, benzodiazepines suna nuna yiwuwar fifiko a cikin gajeren lokaci amma shaidar ba ta da inganci tare da iyakanceccen amfani ga aikin asibiti.[90]

Ga wasu mutane, za a iya rage damuwa sosai ta hanyar dakatar da amfani da caffeine.[91] Damuwa na iya ƙaruwa na ɗan lokaci yayin janyewar caffeine .[92][93]

Shekaru masu nakasa da aka daidaita don rikicewar tsoro ga kowane mazauna 100,000 a shekara ta 2004: babu bayanai da suka kasa da 95 95-96.5 96.5-98 98-99.5 99.5-101 101-102.5 102.5-104 104-105.5 105.5-105 105. 5-107 107-108.5 108.5-110 fiye da 110 
  no data
  less than 95
  95–96.5
  96.5–98
  98–99.5
  99.5–101
  101–102.5
  102.5–104
  104–105.5
  105.5–107
  107–108.5
  108.5–110
  more than 110

Rashin jin tsoro yawanci yana farawa a farkon balaga; kusan rabin duk mutanen da ke da rikicewar tsoro suna haifar da yanayin tsakanin shekaru 17 zuwa 24, musamman wadanda ke fuskantar abubuwan da suka faru. Koyaya, wasu binciken sun nuna cewa yawancin matasa da abin ya shafa a karon farko suna tsakanin shekaru 25 zuwa 30. Mata suna da sau biyu fiye da maza don kamuwa da cuta ta firgici.[94][95][96]

Rashin tsoro na iya ci gaba da watanni ko shekaru, dangane da yadda ake neman magani da kuma lokacin da ake neman magani. Idan ba a kula da shi ba, zai iya kara muni har zuwa inda rayuwar mutum ta sha wahala sosai ta hanyar fashewar tsoro da kuma ƙoƙarin gujewa ko ɓoye yanayin. Mutane da yawa sun sami matsaloli tare da dangantakar mutum, ilimi, da aiki yayin da suke gwagwarmaya don magance matsalar tsoro. Wasu mutanen da ke fama da matsalar tsoro na iya ɓoye yanayinsu saboda lalacewar rashin lafiya. A wasu mutane, alamun na iya faruwa akai-akai na watanni ko shekaru, sannan shekaru da yawa na iya wucewa tare da ƙananan ko babu alamun. A wasu lokuta, alamun suna ci gaba a wannan matakin har abada. Har ila yau, akwai wasu shaidu cewa mutane da yawa (musamman wadanda ke da alamun bayyanar cututtuka tun suna ƙanana) na iya fuskantar cikakkiyar dakatar da alamun daga baya a rayuwa (misali, sama da shekaru 50). [97]

A shekara ta 2000, Hukumar Lafiya ta Duniya ta gano yaduwar da ke faruwa na rikicewar tsoro sun yi kama da juna a duk faɗin duniya. Yawan shekaru da suka dace da 100,000 ya kasance daga 309 a Afirka zuwa 330 a Gabashin Asiya ga maza kuma daga 613 a Afirka zuwa 649 a Arewacin Amurka, Oceania, da Turai ga mata.[98]

Binciken da aka yi a baya ya nuna cewa kashi 40% na marasa lafiya na tsoro sun ba da rahoton cewa cutar ta fara ne kafin su kai shekaru 20.[99] A cikin wata kasida da ke nazarin abin da ke faruwa na rikicewar tsoro a cikin matasa, Diler et al. (2004) [100] sun gano cewa kawai 'yan binciken da suka gabata sun bincika faruwar rikicewar firgici na yara. Sun ba da rahoton cewa waɗannan binciken sun gano cewa alamun cutar firgici na yara kusan sun yi kama da waɗanda aka samu a cikin manya (misali bugun zuciya, gumi, rawar jiki, hasken zafi, ƙishirwa, damuwa, damuwa ta ciki, da sanyi).[101][102][103][104][105] Rashin damuwa yana tare da adadi mai yawa na wasu cututtukan hankali a cikin manya.[106] Irin wannan cututtukan da ake gani a cikin manya ana kuma bayar da rahoton su a cikin yara da ke fama da matsalar tsoro ta yara. Last and Strauss (1989) sun bincika samfurin matasa 17 tare da rikicewar tsoro kuma sun sami ƙimar cututtukan damuwa, babban rikicewar baƙin ciki, da rikice-rikice na hali.[107] Eassau et al. (1999) kuma sun sami adadi mai yawa na cututtukan comorbid a cikin samfurin al'umma na matasa tare da hare-haren tsoro ko rikicewar tsoro na yara.[103] A cikin samfurin, an gano matasa suna da cututtukan comorbid masu zuwa: babban rikicewar baƙin ciki (80%), rikicewar dysthymic (40%), rikicewar damuwa (40%), rikicen somatoform (40%), amfani da miyagun ƙwayoyi (40%), da takamaiman tsoro (20%). Dangane da wannan aikin da ya gabata, Diler et al. (2004) sun sami irin wannan sakamako a cikin binciken da suka yi inda aka bincika matasa 42 da ke fama da matsalar tsoro. Idan aka kwatanta da matasa marasa damuwa, yara da ke fama da rikicewar tsoro suna da ƙimar rikicewar damuwa da rikice-rikicen bipolar.

OYara sun bambanta da matasa da manya a cikin fassararsu da ikon bayyana kwarewarsu. Kamar manya, yara suna fuskantar alamun jiki ciki har da hanzarin bugun zuciya, gumi, rawar jiki ko girgiza, gajeren numfashi, ƙishirwa ko ciwon ciki, mamaki ko haske. Bugu da kari, yara suna fuskantar alamun fahimta kamar tsoron mutuwa, jin dadin kasancewa daga kanka, da jin dadin rasa iko ko hauka. Yara sau da yawa ba sa iya bayyana waɗannan bayyanar tsoro mafi girma; suna jin cewa wani abu ba daidai ba ne kuma suna jin tsoro sosai. Yara na iya bayyana alamun jiki kawai. Har yanzu ba su haɓaka ikon sanya waɗannan alamun tare da lakafta su a matsayin tsoro ba. Iyaye galibi suna jin ba su da taimako lokacin da suke kallon ɗansu yana shan wahala. Za su iya taimaka wa yara su ba da suna ga kwarewarsu, kuma su ba su damar shawo kan tsoron da suke fuskanta [1]

Matsayin iyaye a cikin magani da shiga tsakani ga yara da aka gano suna da rikicewar tsoro McKay & Starch (2011). Sun nuna cewa akwai matakai da yawa inda ya kamata a yi la'akari da shigar iyaye. Na farko ya haɗa da kimantawa na farko. Ya kamata a bincika iyaye, da kuma yaro, don halayen da burin magani, da kuma matakan damuwa ko rikici a gida. Na biyu ya haɗa da tsarin magani wanda ya kamata mai warkarwa ya sadu da iyali a matsayin ɗayan sau da yawa. Da kyau, duk dangin ya kamata su kasance da masaniya kuma su horar da su a cikin tsarin maganin halayyar fahimta (CBT) don ƙarfafa yaron ya daidaita kuma ya fuskanci tsoro maimakon yin amfani da halayyar tsaro. McKay & Storch (2011) sun ba da shawarar horo / samfurin dabarun warkewa da kuma shiga cikin iyaye a cikin kula da yara don inganta ingancin magani.

Duk da shaidar da ke nuna kasancewar rikicewar fargabar fargabar, DSM-IV-TR a halin yanzu kawai ya gane rikicewar damuwa guda shida a cikin yara: rikicewar rabuwa, rikicewar yawan damuwa, takamaiman tsoro, rikice-rikicen damuwa, rikice na damuwa, rikici na zamantakewa (a.a. phobia zamantakewa), da rikicewar tashin hankali na bayan rauni. An cire rikice-rikicen tsoro daga wannan jerin.

Manazarta

[gyara sashe | gyara masomin]
  1. 1 2 3 4 "Anxiety Disorders". Mental Health Information: Health Topics. National Institute of Mental Health. March 2016. Archived from the original on 29 September 2016. Retrieved 1 October 2016."Anxiety Disorders". Mental Health Information: Health Topics. National Institute of Mental Health. March 2016. Archived from the original on 29 September 2016. Retrieved 1 October 2016. Cite error: Invalid <ref> tag; name "NIH2016" defined multiple times with different content.
  2. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named "DSM5".
  3. 1 2 3 4 5 6 7 "Panic Disorder: When Fear Overwhelms". National Institute of Mental Health. 2013. Archived from the original on 4 October 2016. Retrieved 1 October 2016. Cite error: Invalid <ref> tag; name "NIH2013" defined multiple times with different content.
  4. ↑ Herr NR, Williams JW, Benjamin S, McDuffie J (July 2014). "Does this patient have generalized anxiety or panic disorder?: The Rational Clinical Examination systematic review". JAMA. 312 (1): 78–84. doi:10.1001/jama.2014.5950. PMID 25058220.
  5. 1 2 3 Craske MG, Stein MB (December 2016). "Anxiety". Lancet. 388 (10063): 3048–3059. doi:10.1016/S0140-6736(16)30381-6. PMID 27349358. S2CID 208789585.
  6. ↑ "Panic disorder". UK National Heath Service. 16 February 2021.
  7. ↑ Smith, Melinda; Robinson, Lawrence; Segal, Jeanne. "Panic Attacks and Panic Disorder". HelpGuide (in Turanci). Archived from the original on 9 July 2021. Retrieved 6 July 2021.
  8. ↑ Craske, Michelle G.; Kircanski, Katharina; Epstein, Alyssa; Wittchen, Hans-Ulrich; Pine, Danny S.; Lewis-Fernández, Roberto; Hinton, Devon (February 2010). "Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V". Depression and Anxiety. 27 (2): 93–112. doi:10.1002/da.20654. PMID 20099270. S2CID 17789728.
  9. ↑ Freire, Rafael C.; Perna, Giampaolo; Nardi, Antonio E. (July 2010). "Panic Disorder Respiratory Subtype: Psychopathology, Laboratory Challenge Tests, and Response to Treatment". Harvard Review of Psychiatry. 18 (4): 220–229. doi:10.3109/10673229.2010.493744. PMID 20597592. S2CID 13567414.
  10. ↑ Diler, Rasim Somer; Birmaher, Boris; Brent, David A.; Axelson, David A.; Firinciogullari, Sekip; Chiapetta, Laurel; Bridge, Jeff (2004). "Phenomenology of panic disorder in youth". Depression and Anxiety. 20 (1): 39–43. doi:10.1002/da.20018. PMID 15368595. S2CID 23612310.
  11. ↑ "Panic Attacks and Panic Disorder - Mental Health Disorders". MSD Manual Consumer Version (in Turanci). Retrieved 2025-05-24.
  12. ↑ "Panic attacks and panic disorder - Symptoms and causes". Mayo Clinic (in Turanci). Retrieved 2025-05-24.
  13. ↑ O'Mahony, J.F; Ward, B.G (2003). "Differences between those who panic by day and those who also panic by night". Journal of Behavior Therapy and Experimental Psychiatry (in Turanci). 34 (3–4): 239–249. doi:10.1016/j.jbtep.2003.10.001. PMID 14972671.
  14. ↑ "Anxiety". Parkinson's Foundation.
  15. 1 2 3 Khalsa, Sahib S.; Lapidus, Rachel C. (2016). "Can Interoception Improve the Pragmatic Search for Biomarkers in Psychiatry?". Frontiers in Psychiatry. 7: 121. doi:10.3389/fpsyt.2016.00121. PMC 4958623. PMID 27504098.
  16. ↑ Khoury, Nayla M.; Lutz, Jacqueline; Schuman-Olivier, Zev (2018). "Interoception in Psychiatric Disorders: A Review of Randomized, Controlled Trials with Interoception-Based Interventions". Harvard Review of Psychiatry. 26 (5): 250–263. doi:10.1097/HRP.0000000000000170. ISSN 1465-7309. PMC 6129986. PMID 30188337.
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