Sesavali

 adamianis qcevasTan dakavSirebul seriozul problemebs miekuTvneba

kvebis qceviTi darRvevebi. igi xSirad xangrZlivad mimdinare
avadmyofobaa, romelic Sesabamisad grZelvadian mkurnalobas
moiTxovs.
 Tan sdevs an safuZvlad udevs fsiqikuri moSlilobebi.
 rac ufro adre xdeba am darRvevebis diagnostireba, miT ufro advilia
dakarguli funqciebis aRdgena.
 ufro xSiria qalebSi, vidre mamakacebSi.
 daavadeba upiratesad Tavs iCens mozardobis
periodSi da xSirad Tan axlavs fsiqologiuri
darRvevebi;
 kvebis qceviTi darRvevebisaTvis
damaxasiaTebelia polaruli ukiduresobebi.
 kvebis qcevis darRvevebis formebi:

nervuli anoreqsia: xasiaTdeba pacientis mier

wonis winaswarganzraxuli klebiT, misTvis
sasurveli mcire wonis SenarCunebisadmi
gadametebuli swrafviT.

nervuli bulimia:
damaxasiaTebeli ,,Rormucelobis“ periodebiT,
rasac Tan erTvis ,,TviTgawmendis“
dauokebeli Jini.

kompulsuri (ukontrolo) gadaWarbebuli kveba:

viTardeba sakvebis miRebis ukontrolobiT da
pacientis mxridan sakiTxisadmi daudevari
midgomiT. ar axasiaTebT gawmenda-
ganTavisuflebis Catareba.
 kvebiTi darRvevebi damokidebulia sxvadasxva faqtorze:
 genetikuri winaswarganwyoba;
 emociuri foni;
 bavSvobis asakSi Camoyalibebuli kvebiTi qcevebi;
 zogjer misi mizezi fiziologiuri darRvevebi:
 hipoTalamusis sisuste SimSilisa da simaZRris SegrZnebaze;
 serotinini, romelic ganapirobebs emociuri sferos mdgomareobas
da Sesatyvis qcevebs.
 nebiTi sferos sisuste;
 azrovnebis paTologias.
 skriningi mizanSewonilia Semdeg jgufebSi:
 axalgazrda qalebi, romelTa sxeulis masis indeqsi normis farglebs
scildeba;
 Warbi wonis pacientebi, romlebic ojaxis eqims am problemis
gamo mimarTaven;
 qalebi menstrualuri ciklis moSliTa an amenoreiT;
 pacientebi gastrointestinuri CivilebiT;
 pacientebi sxeulis masis indeqsis daqveiTebiT;
 pacientebi, romlebic xSir Rebinebas uCivian;
 bavSvebi da mozardebi zrdaSi CamorCeniT;
 axalgazrda pacientebi I tipis Saqriani diabetiT, romlebic
mkurnalobis reJims cudad icaven;
 SCOFF
 guls xom ar irevT imis gamo, rom Tavs zedmetad “savsed” grZnobT?

 xom ar TvliT, rom Wamis dros Tavs ver akontrolebT?

 ukanaskneli sami Tvis ganmavlobaSi wonaSi ramdeni daikeliT?

(6.4kg-ze meti dadebiTi pasuxia: 1qula)

 sxvebi amboben, rom gaxdari xarT, magram Tqven TvliT, rom Warbi
wona gaqvT.

 SegiZliaT TqvaT, rom Tqvens cxobrebaSi Wama yvelaze mTavaria

Sefaseba: dadebiTi pasuxi 1 qula. 2 qulaze meti nervuli anoreqsiis an

bulimiis momatebuli riski.
 daavadebis Sorswasuli formebis dros mniSvnelovania Semdegi
klinikuri niSnebis gamovlena:
 gamofituli garegnoba, avardnili Tvalebi an loyebi, kani – miwisferi da mSrali,
bradikardia, hipotenzia, hipoTermia, orTostazi, , mitraluri sarqvlis prolafsi,
ariTmiebi, Tmisa da frCxilebis cvlilebebi, hiperkarotinemia, subkoniunqtivaluri
hemoragia, gingiviti, kbilis minanqris ganleva, kbilis kariesi, parotiti, sarZeve
jirkvlebis atrofia, SeSupeba, muclis palpaciiT ‐ ganavlovani maryuJebi, raselis
niSani, akrocianozi, reinos sindromi, trusos niSani, an hiporefleqsia.
 mkurnalobis procesSi CarTulia
ojaxis eqimi, kvebis specialisti, fsiqiatri da fsiqoTerapevti.

 ojaxis eqimis mier pacients unda miewodos amomwuravi informacia jansaRi

dietisa da kvebis racionis dagegmvis Sesaxeb.

 TviT-marTvis procesze monitoringi da saWiroebis SemTxvevaSi saTanado

mxardaWera.

 ojaxis eqimis mier medikamenturi mkurnalobis reJimze mimdinare

meTvalyureoba;.

 kognitiuri, qceviTi, interpersonaluri an ojaxuri Terapia;

 farmakologiuri mkurnaloba.

 kvebis qceviTi darRvevebis marTvisTvis medikameturi da sxva saxis

mkurnalobis daniSvna ojaxis eqimis kompetenciis farglebs scildeba. amitom
am tipis darRvevebze saeWvo SemTxvevaSi unda moxdes pacientis
mimarTva fsiqiatrTan.

 dieturi reJimis SesarCevad mimarTva dietologTan.

 kompulsuri gadaWarbebili kvebiTi darRvevebis mkurnaloba
 mkurnalobisaTvis gamoiyeneba: serotoninis ukumitacebis inhibitorebi (SSRI),
efeqtianobisa da usafrTxoebis gamo SerCevis pirveli rigis medikamentebia;
 fluoqsetini (60mg/dReSi) antidepresantia. amcirebs kompulsur gadaWarbebul
kvebiT darRvevas da amsubuqebs Rebinebas nervuli bulimiiT Sepyrobil
pacientebSi,
 antiepilefsiuri medikamentebisa da madis damTrgunveli saSualebebi.
 anoreqsiiT daavadebuli pacientis mkurnaloba:
 normaluri wonis aRdgena: samizne namati kviraSi 0,5kg, saWiroa 3500-dan
7000 kaloriis miRebaa.
 fsiqologiuri problemebis identifikacia
 azrebisa da qcevebis koreqcia an reducireba;
 antidepresantebis monoTerapiis saxiT gamoyeneba rekomendebuli ar aris.
 olanzapini _ atipuri antifsiqozuri saSualeba

nervuli anoreqsiis SemsubuqebisTvis.

 fsiqotropuli medikamentebi;
 individualuri, jgufuri da

ojaxze orientirebuli fsiqoTerapia.

 bulimiis mkurnaloba:
 gadaWarbebuli kvebisa da Semdgom “gawmendis” procedurebis
aRkveTa an Semcireba.

 kvebiTi rekomendaciebi, fsiqoTerapiis kursi, efeqtiania qcevaze

orientirebuli fsiqoTerapia.

 medikamenturi mkurnaloba. antidepresantebi _ fluoqsetini

(Tanmxlebi depresiis, mousvenrobiTa da sxva fsiqikuri
problemebisas).

 saWiroebis SemTxvevaSi, fsiqiatrTan pacientis dauyovnebeli vizitis

organizeba.
 savaldebulo hospitalizacia naCvenebia:

 pacientebSi suicidis maRali riskiT

 gamoxatulia sicocxlisTvis saSiSi garTulebebi: mZime

bradikardia, hipotenzia, hipoTermia, eleqtrolituri cvlis
mniSvnelovani darRveva, samizne organoebis dazianeba

 sxeulis masis daqveiTeba janmrTeli sxeulis masis 85%‐ze

metad.
mimdinare meTvalyureoba pacientze kvebis qceviTi
darRvevebiT
 garTulebebiT mimdinare daavadebis da Tanmxlebi risk‐
faqtorebis SemTxvevaSi, pacients esaWiroeba ufro intensiuri
meTvalyureoba. zogadi praqtikis/ojaxis eqimi pacientTan erTad
unda adgendes gegmas, sadac aisaxeba pacientis
saWiroebebi, miznebi, dagegmili konsultaciebi specialistebTan
da sxv.
kvebis qceviTi darRvevebiT daavadebuli pacientebis samedicino
meTvalyureobis procesSi arsebiTi mniSvneloba aqvs bazisuri
eTikuri principebis dacvas.
 gansakuTrebiT, pacientis avtonomiis pativiscemas;
 klinikuri gadawyvetilebis procesSi misi monawileobis uzrunvelyofas,
 informirebul Tanxmobasa da konfidencialobas.
 fsiqikuri m.S. nervuli anoreqsiis SemTxvevaSi pacientis nebis gareSe
iZulebiTi kvebis sakiTxi mxolod ukidures SemTxvevebSi SeiZleba
daisvas;
 saboloo gadawvetileba mravaldisciplinaruli gundisa da pacientis ojaxis
(uflebamosili warmomadgenlis) monawileobiT unda iqnas miRebuli.
 gmadlobT
yuradRebisTvis