Dergi Ara >>
Yıl:2016; Cilt: 6; Sayı: 3>> Özet
Psikiyatride Güncel; 2016;6(3):208-221
Kumar oynama bozukluğunda tanı ve tedavi
C Evren, M Bozkurt
Bakırköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araștırma Hastanesi, İstanbul
Kumar oynama bozukluğu son zamanlarda artan yaygınlığı ve yarattığı kişisel, ailesel ve sosyal problemler nedeniyle gittikçe daha fazla dikkat çekmektedir. Patofizyolojisi tam olarak aydınlatılamamış olsa da serotonerjik, dopaminerjik, noradrenerjik ve opioid sistemlerdeki disfonksiyonun hastalıkta rol oynadığı düşünülmektedir. Kumar oynama bozukluğunun bazı kişilik özellikleri, dürtüsellik ve inhibisyon, çalışma belleği, planlamadaki disfonksiyonlarla da ilişkili olduğu düşünülmektedir. Klinik deneyimler kumar oynama bozukluğunun tedavi edilebilir bir hastalık olduğunu göstermektedir. Ancak henüz tedavide onay almış bir farmakolojik ajan yoktur. Antidepresanlar, opioid reseptör antagonistleri ve duygudurum dengeleyicileri ile ilgili çalışmalar devam etmektedir. Bilişsel davranışçı terapi, motivasyonel görüşme ve kendine yardım grupları hastalara fayda sağlayabilecek psikoterapötik yaklaşımlardandır. Kumar oynama bozukluğunda komorbiditenin yüksek oranda görülmesi ve tedaviye başvuru oranlarının düşük olması nedeniyle sağlık çalışanları bu hastalığın tanınması ve sonrasında tedavisinin yönlendirilmesi konusunda dikkatli olmalıdır.
Diagnosis and treatment of gambling disorder
Gambling disorder is an emerging psychiatric disorder that has recently gained much attention because of its increasing prevalence and devastating personal, familial, and social consequences. Although its pathophysiology is largely unknown neurobiological research has shown the potential involvement of serotonergic, dopaminergic and opioid dysfunction. Some personality dimensions, impulsivity and dysfunctions of inhibition, working memory and planning are also related factors with the disorder. Although clinical experience suggests that gambling disorder is highly treatable, there are no approved pharmacological treatments for this disorder. But studies are ongoing with antidepressants, opioid receptor antagonists, and mood stabilizers. Cognitive behavioral therapies, motivational interventions and self-help groups are psychotherapeutic interventions that may help patients with gambling disorder. Because of its high comorbidity and low treatment admittance healthcare professions must be careful when diagnosing and making a treatment plan for these patients.

http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-black-gold.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-red.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-orange-golden.html http://www.simplehandbaga.com/hermes-jige-clutch-29cm-croco-white-grey.html http://www.simplehandbaga.com/hermes-kelly-32cm-ostrich-vein-6108-black-golden.html http://www.simplehandbaga.com/hermes-jige-clutch-29cm-croco-dark-red.html http://www.simplehandbaga.com/hermes-herbag-31cm-green-canvas-bag.html http://www.simplehandbaga.com/hermes-epsom-leather-wallet-camel-silver.html http://www.simplehandbaga.com/hermes-calf-leather-men-h-belt-138-silver-blue.html http://www.simplehandbaga.com/hermes-so-kelly-28cm-togo-leather-shoulder-bag-green-silver.html http://www.simplehandbaga.com/hermes-kelly-32cm-togo-leather-6108-electric-blue-silver.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-orange.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbag-blue-gold.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-burgundy.html http://www.simplehandbaga.com/hermes-bolide-31cm-togo-leather-pink-bag.html http://www.simplehandbaga.com/hermes-birkin-35cm-handbag-crocodile-leather-green-gold.html http://www.simplehandbaga.com/hermes-constance-23cm-croco-leather-black.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-pink-silver.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-elephant-grey.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-dark-blue-golden.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-black.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-brown.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-orange.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-electric-blue.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-pink.html http://www.simplehandbaga.com/hermes-h-wallet-royal-blue-silver.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbags-black-gold.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-electric-blue.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-blue-silver.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-burgundy.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-grey.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-epsom-leather-grey-gold.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-elephant-grey.html http://www.simplehandbaga.com/hermes-calf-leather-wallet-h005-red.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-camel-gold.html http://www.simplehandbaga.com/hermes-kelly-wallet-togo-leather-black.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-orange.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-pink.html http://www.simplehandbaga.com/hermes-herbag-31cm-burgundy-canvas-bag.html http://www.simplehandbaga.com/hermes-mini-kelly-22cm-epsom-leather-yellow-silver-with-chain-strap.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-blue-silver.html http://www.simplehandbaga.com/hermes-30cm-birkin-bag-togo-leather-with-strap-light-pink-gold.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-rose-silver.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-brown.html http://www.simplehandbaga.com/hermes-jige-clutch-29cm-croco-green.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-brown.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-blue-gold.html http://www.simplehandbaga.com/hermes-birkin-25cm-handbag-6068-orange-silver.html http://www.simplehandbaga.com/hermes-garden-party-handbag-large-36cm-black.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-red-silver.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-epsom-leather-pink-silver.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-pink.html http://www.simplehandbaga.com/hermes-calf-leather-wallet-h005-in-orange.html http://www.simplehandbaga.com/hermes-picotin-lock-togo-leather-red.html http://www.simplehandbaga.com/hermes-mini-kelly-22cm-epsom-leather-green-silver-with-chain-strap.html http://www.simplehandbaga.com/hermes-birkin-25cm-handbag-6068-orange-silver.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbag-yellow-gold.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-orange-golden.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-camel-gold.html http://www.simplehandbaga.com/hermes-calf-leather-men-h-belt-138-gold-light-coffee.html http://www.simplehandbaga.com/hermes-kelly-28cm-bag-togo-leather-blue-gold.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-pink.html http://www.simplehandbaga.com/hermes-garden-party-handbag-large-36cm-red.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbag-burgundy-gold.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-dark-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-light-coffee-silver.html http://www.simplehandbaga.com/hermes-so-kelly-28cm-togo-leather-shoulder-bag-hot-pink-silver.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbags-black-gold.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-white.html http://www.simplehandbaga.com/hermes-garden-party-36cm-leather-handbag-black-hot-pink.html http://www.simplehandbaga.com/hermes-birkin-35cm-handbag-crocodile-leather-brown-gold.html http://www.simplehandbaga.com/hermes-constance-wallet-togo-leather-rose.html http://www.simplehandbaga.com/hermes-bi-fold-wallet-h006-black.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-epsom-leather-red-gold.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-black-silver.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-blue.html http://www.simplehandbaga.com/hermes-calf-leather-men-h-belt-138-silver-blue.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-black.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-brown.html http://www.simplehandbaga.com/hermes-bolide-31cm-togo-leather-orange-bag.html http://www.simplehandbaga.com/hermes-calf-leather-wallet-h005-h-red.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-burgundy.html http://www.simplehandbaga.com/hermes-birkin-35cm-crocodile-leather-handbag-grey-white-gold.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-red-gold.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-dark-khaki-silver.html http://www.simplehandbaga.com/hermes-garden-party-36cm-canvas-handbag-yellow.html http://www.simplehandbaga.com/hermes-calf-leather-8616-handbag-cherry-pink.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-orange.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-orange-silver.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-handbag-crocodile-leather-green-gold.html http://www.simplehandbaga.com/hermes-mini-kelly-22cm-epsom-leather-yellow-silver-with-chain-strap.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-camel.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-black-gold.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-green.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-green.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-blue-gold.html http://www.simplehandbaga.com/hermes-constance-23cm-togo-leather-orange-silver.html