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¶ÂÚ›ÏË„Ë

∆Ô Ê·ÈÓfiÌÂÓÔ Ù˘ ¯Ú‹Û˘, ηٿ¯ÚËÛ˘ Î·È ÂÍ¿ÚÙËÛ˘ ·fi „˘¯Ô‰Ú·ÛÙÈΤ˜ Ô˘Û›Â˜ ·ÔÙÂÏ›ۋÌÂÚ· ¤Ó· ·fi Ù· ÛÔ‚·ÚfiÙÂÚ· ÎÔÈÓˆÓÈο ÚÔ‚Ï‹Ì·Ù· Ô˘ ηÏÔ‡ÓÙ·È Ó· ·ÓÙÈÌÂÙˆ›ÛÔ˘Ó fiϘÔÈ ÂÈÛً̘ Ô˘ ·Û¯ÔÏÔ‡ÓÙ·È Ì ÙÔÓ ¿ÓıÚˆÔ. ∏ ‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ Â›Ó·È ÌÈ·‰È·Ù·Ú·¯‹ Ë ÔÔ›· Û˘Ó‰¤ÂÙ·È ¿ÌÂÛ· Ì ÙË ¯Ú‹ÛË Î·È Î·Ù¿¯ÚËÛË Ô˘ÛÈÒÓ ·ÏÏ¿ Û˘¯Ó¿ ·Ú·Ì¤-ÓÂÈ ·‰È¿ÁÓˆÛÙË Î·È ‰ËÌÈÔ˘ÚÁ› ÛÔ‚·Ú¤˜ ‰˘ÛÎÔϛ˜ ÛÙ· ¿ÙÔÌ·.

ŒÚ¢Ó˜ ‰Â›¯ÓÔ˘Ó fiÙÈ Ë ‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ Û¯ÂÙ›˙ÂÙ·È Ì ÙË ‰È·Ù·Ú·¯‹ ¯Ú‹-Û˘, ηٿ¯ÚËÛ˘ ‹ ÂÍ¿ÚÙËÛ˘ ·fi „˘¯ÔÙÚfi˜ Ô˘Û›Â˜ Î·È fiÙÈ ·Ú·ÙËÚÔ‡ÓÙ·È „ËÏ¿ ÔÛÔÛÙ¿Û˘Û¯¤ÙÈÛ˘ ÙˆÓ ‰‡Ô ‰È·Ù·Ú·¯ÒÓ. ∏ Û˘ÓÓÔÛËÚfiÙËÙ· ·˘Ù‹ Ô˘ ·Ú·ÙËÚ›ٷÈ, Ê·›ÓÂÙ·È Ó· ›ӷÈÂÚÈÛÛfiÙÂÚÔ Á˘Ó·ÈΛ· ̆ fiıÂÛË ·Ú¿ ·ÓÙÚÈ΋ Î·È ÂÓÒ Ë ı¤ÛË ·˘Ù‹ ÂȂ‚·ÈÒÓÂÙ·È Û fiϘ Û¯Â-‰fiÓ ÙȘ ¤Ú¢Ó˜, ‰ÂÓ Â›Ó·È ÍÂοı·ÚÔ ·ÎfiÌ· ÔÈÔÈ ·Ú¿ÁÔÓÙ˜ Û˘Ì‚¿ÏÏÔ˘Ó ÛÙËÓ Â˘·ÏˆÙfiÙËÙ·ÂÓfi˜ ·ÙfiÌÔ˘ ÁÈ· Û˘ÓÓÔÛËÚfiÙËÙ·. OÈ ‰‡Ô ‰È·Ù·Ú·¯¤˜ Ê·›ÓÂÙ·È fiÙÈ ¤¯Ô˘Ó ͯˆÚÈÛÙ¿ ·ÈÙÈÔÏÔÁÈοÛÙÔȯ›· ·ÏÏ¿ Î·È ÎÔÈÓ¤˜ ÛËÌ·ÓÙÈΤ˜ ÁÂÓÂÙÈΤ˜ Î·È ÂÚÈ‚·ÏÏÔÓÙÈΤ˜ Û˘ÓÂÈÛÊÔÚ¤˜. º·›ÓÂÙ·È fï˜fiÙÈ Ë „˘¯ÔÏÔÁÈ΋ ‰˘ÛÊÔÚ›· ÏfiÁˆ ÙÚ·‡Ì·ÙÔ˜ ÌÔÚ› Ó· Â›Ó·È ·Ú¿ÁÔÓÙ·˜ ÁÈ· ÛÔ‚·Ú‹ ¯Ú‹ÛËÔ˘ÛÈÒÓ Î·È Ë ÌË ·ÓÙÈÌÂÙÒÈÛË ÙÔ˘ ÙÚ·‡Ì·ÙÔ˜ ÌÔÚ› Ó· ·˘Í‹ÛÂÈ ÙË ÛÔ‚·ÚfiÙËÙ· Ù˘ ¯Ú‹Û˘ ÌÂÙËÓ ¿ÚÔ‰Ô ÙÔ˘ ¯ÚfiÓÔ˘ Î·È Ó· Ô‰ËÁ‹ÛÂÈ Û ¯ÂÈÚfiÙÂÚ· ·ÔÙÂϤÛÌ·Ù· ıÂڷ›·˜ ÁÈ· ¯Ú‹ÛË Ô˘-ÛÈÒÓ. ∂ÈÚfiÛıÂÙ·, ·Ó ‰ÂÓ ÂÓÙÔÈÛı› Î·È ·Ó ‰ÂÓ ıÂڷ¢Ù› Ë ‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ÛÙÚ˜ Ù·˘Ùfi¯ÚÔÓ·, ÙfiÙ ÔÔÈÂÛ‰‹ÔÙ ÚÔÛ¿ıÂȘ ıÂڷ›·˜ ÙÔÍÈÎÔÂÍ¿ÚÙËÛ˘, ‰ÂÓ ı· ›ӷȷÔÙÂÏÂÛÌ·ÙÈΤ˜.

∏ ıÂڷ›· ÙÔÍÈÎÔÂÍ¿ÚÙËÛ˘ Â›Ó·È ¤Ó· ‰›Ô ÓÔÛËÏ¢ÙÈÎÔ‡ ÂӉȷʤÚÔÓÙÔ˜ ÁÈ·Ù› ÙÔ Ê·ÈÓfi-ÌÂÓÔ Ù˘ ¯Ú‹Û˘ „˘¯Ô‰Ú·ÛÙÈÎÒÓ Ô˘ÛÈÒÓ ÂËÚ¿˙ÂÈ ÙÔ˘˜ ·ÓıÚÒÔ˘˜ Û fiÏÔ˘˜ ÙÔ˘˜ ÙÔÌ›˜ :‚ÈÔÏÔÁÈο, Û˘Ó·ÈÛıËÌ·ÙÈο , „˘¯ÔÏÔÁÈο , ÎÔÈÓˆÓÈο , ÔÈÎÔÓÔÌÈο, ÓÂ˘Ì·ÙÈο. ∂›Ó·È ÊÈÏÔÛÔÊ›·Ù˘ ¡ÔÛËÏ¢ÙÈ΋˜ ∂ÈÛÙ‹Ì˘ Ë ÂÛÙ›·ÛË ÛÙÔÓ ¿ÓıÚˆÔ Î·È ÛÙȘ ·Ó¿ÁΘ ÙÔ˘. ∂›Û˘ ‚·ÛÈ΋·Ú¯‹ Ù˘ ¡ÔÛËÏ¢ÙÈ΋˜ Â›Ó·È Î·È Ë Î·Ï‡ÙÂÚË ‰˘Ó·Ù‹ ÊÚÔÓÙ›‰· ÁÈ· οı ¿ÓıÚˆÔ. ™ÙËÓ ÂÚ›-ÙˆÛË ·˘Ù‹ "ÊÚÔÓÙ›‰·" Â›Ó·È Ë ·ÍÈÔÏfiÁËÛË ÙˆÓ Ú·ÁÌ·ÙÈÎÒÓ Û˘ÓıËÎÒÓ, Ë ‰ÈÂÚ‡ÓËÛË ÁÈ· ÙËÓÈı·ÓfiÙËÙ· Û˘Ó‡·Ú͢ ÙˆÓ ‰‡Ô ‰È·Ù·Ú·¯ÒÓ Î·È ·ÚÔ¯‹ ÙÔ˘ ηχÙÂÚÔ˘ ‰˘Ó·ÙÔ‡ ıÂڷ¢ÙÈ-ÎÔ‡ ÚÔÁÚ¿ÌÌ·ÙÔ˜ ÁÈ· οı ıÂڷ¢fiÌÂÓÔ.

£ÂˆÚËÙÈ΋ ÚÔÛ¤ÁÁÈÛË Ù˘ Û¯¤Û˘ ¯Ú‹Û˘ Ô˘ÛÈÒÓÎ·È ÙÔ˘ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜

Drug use and post traumatic stress: A theoretical approach

º·Ú̷ο˜ ∞ÓÙÒÓ˘RN, RMN, MSc (cand.), IC&RCCertified Addiction counselor.

Senior nurse, Cyprus Ministry of Health, [Gefyra]Harm retraction Center.

¢Ú ¶··ÛÙ·‡ÚÔ˘ E˘Úȉ›ÎËRN, PhD, Lecturer, School of Health Sciences,

Department of Nursing,Cyprus University of Technology

K·Ú·ÁÈ¿ÓÓ˘ °ÂÒÚÁÈÔ˜RMN, MSc, School Nursing,

department of social sciences,Nursing program, European University, Cyprus

Farmakas AntonisRN, RMN, MSc (cand.), IC&RCCertified Addiction counselor.

Senior nurse, Cyprus Ministry of Health, [Gefyra]Harm retraction Center.

Dr Papastavrou EvridikiRN, PhD, Lecturer, School of Health Sciences,

Department of Nursing,Cyprus University of Technology

Karayiannis GeorgiosRMN, MSc, School Nursing,

department of social sciences,Nursing program, European University, Cyprus

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∂ÈÛ·ÁˆÁ‹∆Ô Ê·ÈÓfiÌÂÓÔ Ù˘ ̄ Ú‹Û˘, ηٿ¯ÚËÛ˘

Î·È ÂÍ¿ÚÙËÛ˘ ·fi „˘¯Ô‰Ú·ÛÙÈΤ˜ Ô˘Û›Â˜·ÔÙÂÏ› Û‹ÌÂÚ· ¤Ó· ·fi Ù· ÛÔ‚·ÚfiÙÂÚ·ÎÔÈÓˆÓÈο ÚÔ‚Ï‹Ì·Ù· Ô˘ ηÏÔ‡ÓÙ·È Ó··ÓÙÈÌÂÙˆ›ÛÔ˘Ó fiϘ ÔÈ ÂÈÛً̘ Ô˘·Û¯ÔÏÔ‡ÓÙ·È Ì ÙÔÓ ¿ÓıÚˆÔ.( Triffleman1995, Reynolds 2005). ¶ÚfiÎÂÈÙ·È ÁÈ· ¤Ó·ÔχÏÔÎÔ Î·È ÔÏ˘·Ú·ÁÔÓÙÈÎfi Ê·ÈÓfi-ÌÂÓÔ, fi¯È Ì ÙËÓ ¤ÓÓÔÈ· ·ÏÒ˜ Î·È ÌfiÓÔ ÙÔ˘Û˘Ó‰˘·ÛÌÔ‡ ‹ Ù˘ ·ÏÏËÏ›‰Ú·Û˘ ‰È·-ÊfiÚˆÓ ·Ú·ÁfiÓÙˆÓ, ·ÏÏ¿ Ì ÙËÓ ¤ÓÓÔÈ·Ù˘ ÂÓÈ·›·˜ ‰È·‰Èηۛ·˜, Ô˘ ¤¯ÂÈ ÙËÓ ‰È΋Ù˘ ‰˘Ó·ÌÈ΋, ·Ó·Ù‡ÛÛÂÙ·È Û ÔÏÏ¿ ›-‰· Î·È ·ÊÔÚ¿ fiϘ ÙȘ ·Ú·Ì¤ÙÚÔ˘˜ Ù˘·ÓıÚÒÈÓ˘ ‡·Ú͢. ™ÙËÓ ÂÔ¯‹ Ì·˜ fiϘÔÈ „˘¯Ô‰Ú·ÛÙÈΤ˜ Ô˘Û›Â˜ Ô˘ ÌÔÚÔ‡Ó Ó·Á›ÓÔ˘Ó ·ÓÙÈΛÌÂÓ· ÙÔÍÈÎÔÌ·Óȷ΋˜ ÂÌÂÈ-Ú›·˜, ¤Ú¯ÔÓÙ·È Ó· Û˘ÌÏËÚÒÛÔ˘Ó ÎÂÓ¿ ÛÙÔÓ„˘¯ÈÛÌfi ÌÈ·˜ ¢¿ÏˆÙ˘ ÚÔÛˆÈÎfiÙËÙ·˜.∏ ÂÍ¿ÚÙËÛË Â›Ó·È ÚÔ˚fiÓ Ù˘ Û˘Ó¿ÓÙËÛ˘ÌÈ·˜ Ô˘Û›·˜ Ì ÌÈ· Û˘ÁÎÂÎÚÈ̤ÓË ÂÏÏÂÈÌ-Ì·ÙÈ΋ ÚÔÛˆÈÎfiÙËÙ· Û ÌÈ· ‰Â‰Ô̤ÓËÎÔÈÓˆÓÈÎÔÔÏÈÙÈÛÙÈ΋ ÛÙÈÁÌ‹. °È· ÙȘ ¢¿-ψÙ˜ ·˘Ù¤˜ ÚÔÛˆÈÎfiÙËÙ˜ Ë ̄ Ú‹ÛË Ô˘-ÛÈÒÓ Á›ÓÂÙ·È ¤Ó·˜ ÙÚfiÔ˜ ̇ ˆ‹˜, Â›Ó·È Ô ÙÚfi-Ô˜ ˙ˆ‹˜ ÙˆÓ ÈÔ ·‰‡Ó·ÌˆÓ ÎÚ›ÎˆÓ Ù˘ÎÔÈÓˆÓ›·˜ ·ÓÂÍ¿ÚÙËÙ· Û ÔÈÔ ÎÔÈÓˆÓÈÎfiÛÙÚÒÌ· ·Ó‹ÎÔ˘Ó ( ª¿ÙÛ· 2001).

∏ ¯Ú‹ÛË „˘¯Ô‰Ú·ÛÙÈÎÒÓ Ô˘ÛÈÒÓ ‰ÂÓ·ÔÙÂÏ› Ê·ÈÓfiÌÂÓÔ Ù˘ ÛËÌÂÚÈÓ‹˜ ÎÔÈÓˆ-Ó›·˜, Â›Ó·È ¤Ó· Ê·ÈÓfiÌÂÓÔ Ô˘ Û˘Ó·ÓÙ¿ η-Ó›˜ ·fi Ù· ·Ó¿Ú¯·È· ¯ÚfiÓÈ·. ∏ ¯Ú‹ÛË‹Ù·Ó ¿ÓÙÔÙÂ Û˘Ó˘Ê·Ṳ̂ÓË Ì ÙȘ ÎÔÈÓˆ-ÓÈΤ˜, ÔÏÈÙÈÛÙÈΤ˜, ıÚËÛ΢ÙÈΤ˜ Î·È ¿Ï-Ϙ ÏÂÈÙÔ˘ÚÁ›Â˜ ÌÈ·˜ ÔÚÈṲ̂Ó˘ ÎÔÈÓˆÓ›·˜,¤ÙÛÈ Ë Ô˘Û›· ·ÔÙÂÏÔ‡Û ÙÔÓ ÎÚ›ÎÔ Ô˘Û˘Ó‰¤ÂÈ ÙÔ ¿ÙÔÌÔ Ì ÙËÓ ÎÔÈÓˆÓ›·. ™‹ÌÂÚ·Ë ¯Ú‹ÛË „˘¯Ô‰Ú·ÛÙÈÎÒÓ Ô˘ÛÈÒÓ ¤Íˆ ·fiοı ÎÔÈÓˆÓÈ΋ ÏÂÈÙÔ˘ÚÁ›· ·ÔÙÂÏ› ÙÔÓÎÚ›ÎÔ Ô˘ ·ÔÛ˘Ó‰¤ÂÈ ÙÔ ¿ÙÔÌÔ ·fi ÙÔÓÎÔÈÓˆÓÈÎfi ÈÛÙfi. ∏ ‰È·Ù·Ú·¯‹ ÂÍ¿ÚÙËÛ˘·fi „˘¯Ô‰Ú·ÛÙÈΤ˜ Ô˘Û›Â˜ Â›Ó·È ÌÈ· ‰È·-Ù·Ú·¯‹ fiÔ˘ Û˘¯Ó¿ Û˘Ó˘¿Ú¯ÂÈ Ì ¿ÏϘ„˘¯È·ÙÚÈΤ˜ ‰È·Ù·Ú·¯¤˜.

∆Ô Ê·ÈÓfiÌÂÓÔ Ù˘ Û˘Ó‡·Ú͢ ‰˘Ô ‰È·-Ù·Ú·¯ÒÓ, Ù˘ Û˘ÓÓÔÛËÚfiÙËÙ·˜ ‹ Ù˘ ÏÂ-ÁfiÌÂÓ˘ ‰ÈÏ‹˜ ‰È¿ÁÓˆÛ˘, Â›Ó·È ¤Ó· ı¤Ì·Ô˘ ¤¯ÂÈ ÌÂÈ ÛÙÔ Â›ÎÂÓÙÚÔ ÙÔ˘ ÚÔ‚ÏË-Ì·ÙÈÛÌÔ‡ ÙˆÓ ÂȉÈÎÒÓ, ̂ ˜ ÚÔ˜ ÙÔÓ ÙÚfiÔıÂڷ¢ÙÈ΋˜ ·ÓÙÈÌÂÙÒÈÛ˘ Î·È ̂ ˜ ÚÔ˜ÙËÓ ·ÈÙÈ·Ù‹ Û¯¤ÛË ÙˆÓ ‰˘Ô ‰È·Ù·Ú·¯ÒÓ. ∏Û¯¤ÛË „˘¯È·ÙÚÈ΋˜ ‰È·Ù·Ú·¯‹˜ Î·È ÂÍ¿Ú-ÙËÛ˘ Â›Ó·È ÔχÏÔÎË Î·È ÔÏÏÔ› ÂÈÛÙ‹-ÌÔÓ˜ ̆ ÔÛÙËÚ›˙Ô˘Ó fiÙÈ Ë „˘¯Ô·ıÔÏÔÁ›·Â‡ÎÔÏ· Á›ÓÂÙ·È Û ÔÏϤ˜ ÂÚÈÙÒÛÂȘ ÙÔ¤‰·ÊÔ˜ ÁÈ· ÙËÓ ·Ó¿Ù˘ÍË ÌÈ·˜ ÂÍ¿ÚÙËÛ˘.™Â ¤Ú¢ӷ Ì ٛÙÏÔ «ÃÚ‹ÛË Ô˘ÛÈÒÓ Î·È „˘-

Abstract

The phenomenon of use, misuse and drug depedndance is one of the major social problemsthat the human sciences are called to deal with. Post traumatic stress disorder (PTSD) is a disorderthat it is directly correlated with drug use, but it often remains undiagnosed and creates seriousdifficulties to people.

Research evidendc shows that PTSD is highly correlated with substance use disorder (SUD).This type of commorbidity seems to be a female affair more than a male and although thiscommorbidity is confirmed in almost every research, it is not clear yet which factors predisposeto the vulnerability of a person for commorbidity. These two disorders seem to have differentcausal elements and also significant common genetic and environmental inputs. It seems thoughthat psychological morbidity due to trauma might be a factor for serious drug use and if the traumais left untreated, the severity of drug use might be increased and lead to poor therapy results forthe drug use disorder.

SUD therapy is a field of nursing interest because the phenomenon of substance use affectspeople in every aspect: biological, emotional,social, financial and spiritual. The philosophy ofnursing science is to focus on humans and their needs as multidimentional entities. It is also abasic principle in nursing, to offer the best possible treatment and care. In this case, care is theassessment of patients for the possibility of commorbidity for the delivery of the most appropriatetherapeutic program and every patient should receive the best possible therapy for him.

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¯È·ÙÚÈ΋ Û˘ÓÓÔÛËÚfiÙËÙ·» Ô˘ ‰ÈÂÍ‹¯ıËÛÙËÓ ∂ÏÏ¿‰· Ê¿ÓËÎ·Ó ÔÛÔÛÙ¿ 90,3% ÁÈ·Û˘ÓÓÔÛËÚfiÙËÙ· (∫ÔÎΤ‚Ë Î·È ™ÙÂÊ·Ó‹˜1995). ¶·Ú¿ÏÏËÏ· Ë ÂıÓÈ΋ ¤Ú¢ӷ Û˘Ó-ÓÔÛËÚfiÙËÙ·˜ ÛÙȘ ∏¶∞ (NCS 1990-1992)η٤ÏËÍ Û ÔÛÔÛÙfi 79% ÁÈ· Û˘ÓÓÔÛË-ÚfiÙËÙ·. ( Kessler 1995)

∏ ¢È·Ù·Ú·¯‹ ªÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ™ÙÚ˜(PTSD) Â›Ó·È ÌÈ· ‰È·Ù·Ú·¯‹ Ô˘ Ù·ÍÈÓÔ-ÌÂ›Ù·È Û‡Ìʈӷ Ì ÙÔ ‰È·ÁÓˆÛÙÈÎfi ÂÁ¯ÂÈ-Ú›‰ÈÔ DSM-IV ÛÙȘ ·Á¯Ò‰ÂȘ ‰È·Ù·Ú·¯¤˜Î·È ÂÌÊ·Ó›˙ÂÙ·È ˆ˜ Û˘Ó¤ÂÈ· ¤ÎıÂÛ˘ Û¤ӷ „˘¯ÔÏÔÁÈÎfi ÙÚ·˘Ì·ÙÈÎfi ÁÂÁÔÓfi˜ ηÈÂ›Ó·È Û˘¯Ófi Ê·ÈÓfiÌÂÓÔ Û ¿ÙÔÌ· Ì ‰È·-Ù·Ú·¯‹ SUD (substance use disorder, ‰È·-Ù·Ú·¯‹ ÂÍ¿ÚÙËÛ˘ ·fi „˘¯Ô‰Ú·ÛÙÈΤ˜Ô˘Û›Â˜ ). ŒÚ¢ӷ ÙˆÓ Brown Î·È Û˘ÓÂÚ-Á·ÙÒÓ (1995) ¤‰ÂÈÍ ÔÛÔÛÙfi 25% Ì ‰È-Ï‹ ‰È¿ÁÓˆÛË (ªÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ™ÙÚ˜PTSD & ‰È·Ù·Ú·¯‹ ¯Ú‹Û˘ Ô˘ÛÈÒÓ SUD)·Ó¿ÌÂÛ· Û ‰Â›ÁÌ· ¯ÚËÛÙÒÓ „˘¯Ô‰Ú·-ÛÙÈÎÒÓ Ô˘ÛÈÒÓ. ¶·Ú¿ÏÏËÏ· Ë ¤Ú¢ӷ ÙˆÓClark Î·È Û˘ÓÂÚÁ·ÙÒÓ (2001) ¤‰ÂÈÍ Ô-ÛÔÛÙfi 29% Ì ‰ÈÏ‹ ‰È¿ÁÓˆÛË. ∂›Û˘,ÈÔ ÚfiÛÊ·Ù˜ ¤Ú¢Ó˜ ÙˆÓ Mills et al.(2006) ¤‰ÂÈÍ·Ó ·ÚfiÌÔÈ· ÔÛÔÛÙ¿.

¶·Ú¿ÏÏËÏ· ı· ÌÔÚÔ‡Û ηÓ›˜ Ó· ‰ÈÂ-ÚˆÙËı› ·Ó ·ÚÎÂÙ¿ ·fi Ù· ¿ÙÔÌ· ÌÂ Û˘Ó-ÓÔÛËÚfiÙËÙ· ηٷϋÁÔ˘Ó ÙÂÏÈο Ó· ÌË ˙Ë-ÙÔ‡Ó ıÂڷ›· ÁÈ·Ù› ‰ÂÓ ˘¿Ú¯Ô˘Ó ÚÔ-ÁÚ¿ÌÌ·Ù· ÂȉÈο ۯ‰ȷṲ̂ӷ ÁÈ· ·˘Ù¿. ∏ª¿ÙÛ· (2001), ˘ÔÛÙËÚ›˙ÂÈ ÂÈηÏÔ‡ÌÂÓËÙËÓ ÎÏÈÓÈ΋ ÂÌÂÈÚ›· fiÙÈ Ù· ¿ÙÔÌ· Ì ‰ÈÏ‹‰È¿ÁÓˆÛË ¤¯Ô˘Ó ÌÂÁ¿Ï˜ ıÂڷ¢ÙÈΤ˜ ‰˘-Ó·ÙfiÙËÙ˜ ÂÊfiÛÔÓ ·ÓÙÈÌÂÙˆÈÛÙÔ‡Ó ÛÙÔηٿÏÏËÏÔ Ï·›ÛÈÔ.

¢È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜(Post Traumatic Stress Disorder - PTSD)

∆Ô PTSD, ‹ ‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈ-ÎÔ‡ ÛÙÚ˜ Â›Ó·È ÌÈ· ‰È·ÁÓˆÛÙÈ΋ ηÙËÁÔ-Ú›· ÛÙÔ DSM –IV-TR Î·È ÛÙÔ ICD-10 Ô˘‚·Û›˙ÂÙ·È ÛÙËÓ ·ÈÙÈÔÏÔÁ›·. °È· Ó· ‰È·ÁÓˆ-ÛÙ› ¤Ó· ¿ÙÔÌÔ Ì ‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘-Ì·ÙÈÎÔ‡ ÛÙÚ˜ Ú¤ÂÈ Ó· ̆ ¿Ú¯ÂÈ ¤Ó· ÙÚ·˘-Ì·ÙÈÎfi ÁÂÁÔÓfi˜. ∏ ÌÂÙ·ÙÚ·˘Ì·ÙÈ΋ ‰È·Ù·-Ú·¯‹ ¤ÂÙ·È ÂÓfi˜ ÙÚ·˘Ì·ÙÈÎÔ‡ ÁÂÁÔÓfiÙÔ˜.∆Ô ¿ÙÔÌÔ Í·Ó·˙› ÙÔ ÙÚ·‡Ì· Û fiÓÂÈÚ·,˘ÔʤÚÂÈ ·fi ·ӷϷ̂·ÓfiÌÂÓ˜ ÛΤ-„ÂȘ Î·È ÂÈÎfiÓ˜.

∏ ‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜PTSD ÂÌÊ·Ó›˙ÂÙ·È ÌÂÙ¿ ÙËÓ ¤ÎıÂÛË Û ¤Ó··Û˘Ó‹ıÈÛÙÔ, ÛÙÚÂÛÔÁfiÓÔ, „˘¯ÔÏÔÁÈο ÙÚ·˘-Ì·ÙÈÎfi ÁÂÁÔÓfi˜. T˘Èο Ë ‰È·Ù·Ú·¯‹ ·˘Ù‹Â›Ó·È ·ÔÙ¤ÏÂÛÌ· ¿Á¯Ô˘˜ ÌÂÙ¿ ·fi ÛÔ-‚·Ú‹ ÛÙÚ·ÙȈÙÈ΋ Ì¿¯Ë ‹ Ê˘ÛÈΤ˜ ‹ ·Ó-ıÚÒÈÓ˜ ηٷÛÙÚÔʤ˜. T· ¿ÙÔÌ· Ô˘ ‚ÈÒ-ÓÔ˘Ó ‚È·ÛÌfi ‹ ›ıÂÛË, ÛÂÍÔ˘·ÏÈ΋ ηÎÔ-Ô›ËÛË, ··ÁˆÁ‹, ‚·Û·ÓÈÛÙ‹ÚÈ·, ÏËÌ̇-Ú˜, ÛÂÈÛÌÔ‡˜, ‰˘Ó·Ùfi Ó· ·Ó·Ù‡ÍÔ˘Ó Ùˉȷٷڷ¯‹, ÂÓÒ ¿ÙÔÌ· Ì ‰È·Ù·Ú·¯‹ ÌÂ-Ù·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ ¤¯Ô˘Ó „ËÏ¿ ÔÛÔ-ÛÙ¿ ·ÏÎÔÔÏÈÛÌÔ‡ Î·È Î·Ù¿¯ÚËÛ˘ Ô˘ÛÈÒÓ.(APA 1994,ª·‰È¿ÓÔ˜ 2003, Sadock’s &Sadock’s 2007).

T· ı‡Ì·Ù· Ì ‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·-ÙÈÎÔ‡ ÛÙÚ˜ ·Ó·‚ÈÒÓÔ˘Ó Ù· ÛÙÚÂÛÔÁfiÓ·ÁÂÁÔÓfiÙ· ̤۷ ·fi Ô‰˘ÓËÚ¤˜ ÂÈÎfiÓ˜, ·Ó·-ÌÓ‹ÛÂȘ, fiÓÂÈÚ· Î·È ÂÊÈ¿ÏÙ˜. ÕÏÏ· ¯·Ú·-ÎÙËÚÈÛÙÈο Â›Ó·È Ë ·ÔÌ¿ÎÚ˘ÓÛË ·fi ‹ ËÌ›ˆÛË ÛÙËÓ ·ÓÙ·fiÎÚÈÛË ÛÙÔÓ ¤Íˆ Îfi-ÛÌÔ, Ë ˘ÂÚ‚ÔÏÈ΋ ·ÓÙ›‰Ú·ÛË ÛÙÔÓ ·ÈÊÓÈ-‰È·ÛÌfi, ̆ ÂډȤÁÂÚÛË Î·È ‰È·Ù·Ú·¯¤˜ ÙÔ˘‡ÓÔ˘.T· Û˘ÌÙÒÌ·Ù· Ù˘ ‰È·Ù·Ú·¯‹˜ Û˘-¯Ó¿ ¯ÂÈÚÔÙÂÚÂ‡Ô˘Ó ÌÂÙ¿ ·fi ¤ÎıÂÛË ÛÂηٷÛÙ¿ÛÂȘ ‹ ‰Ú·ÛÙËÚÈfiÙËÙ˜ ·ÚfiÌÔȘ̠ÙÔ ·Ú¿ÁÔÓÙ· Ô˘ ÚÔοÏÂÛ ÙÔ ¿Á-¯Ô˜.

¢È·Ù·Ú·¯‹ ̄ Ú‹ÛË ,̃ ηٿ¯ÚËÛË ̃‹ ÂÍ¿Ú-ÙËÛ˘ „˘¯Ô‰Ú·ÛÙÈÎÒÓ Ô˘ÛÈÒÓ (SubstanceUse Disorder - SUD)

∏ ÂÍ·ÚÙ‹ÛË Î·Ù·Ù¿ÛÛÂÙ·È Î·È ÛÙ· ‰˘ÔÛ˘ÛÙ‹Ì·Ù· ηٿٷ͢ ÙfiÛÔ ÛÙÔ ICD-10,DCR ÔÛÔ Î·È ÛÙÔ DSM-IV (ª·‰È¿ÓÔ˜, 2003).™ÙÔ ICD-10 ηıÔÚ›˙ÂÙ·È Ì¿ÏÈÛÙ· ˆ˜ Û‡Ó-‰ÚÔÌÔ Î·È ÚÔÛ‰ÈÔÚ›˙ÂÙ·È ˆ˜ Ë Â·ÓÂÈ-ÏËÌ̤ÓË ̄ Ú‹ÛË ÂÓfi˜ Ê·ÚÌ¿ÎÔ˘ ‹ Ì›·˜ Ô˘-Û›·˜ Ì ‹ ̄ ˆÚ›̃ ۈ̷ÙÈ΋ ÂÍ¿ÚÙËÛË (Sadock&Sadock, 2007).

™‡Ìʈӷ Ì ÙÔ ‰È·ÁÓˆÛÙÈÎfi Î·È ÛÙ·ÙÈ-ÛÙÈÎfi ÂÁ¯ÂÈÚ›‰ÈÔ ÁÈ· ÙȘ „˘¯È·ÙÚÈΤ˜ ‰È·-Ù·Ú·¯¤˜

DSM-IV ÂÍ¿ÚÙËÛË Â›Ó·È Ë Î·Ù¿ÛÙ·ÛË ËÔÔ›· ÔÊ›ÏÂÙ·È ÛÙËÓ ÂÚÈÔ‰È΋ ‹ ¯ÚfiÓÈ·‰ËÏËÙËÚ›·ÛË Ô˘ ÚÔηÏÂ›Ù·È ·fi ÙËÓ Â·-Ó·Ï·Ì‚·ÓfiÌÂÓË Î·Ù·Ó¿ÏˆÛË Ó·ÚΈÙÈÎÒÓÔ˘ÛÈÒÓ ‹ Û˘ÓıÂÙÈÎÒÓ. H ηٿÛÙ·ÛË ·˘Ù‹¯·Ú·ÎÙËÚ›˙ÂÙ·È ·fi ÙËÓ ·Î·Ù·Ó›ÎËÙË ÂÈ-ı˘Ì›· ‹ ·Ó¿ÁÎË Î·Ù·Ó¿ÏˆÛ˘ Ó·ÚΈÙÈÎÒÓ

ÙfiÌÔ˜ 11, Ù‡¯Ô˜ 3Vol 11, No 3

K˘Úȷο NÔÛËÏ¢ÙÈο XÚÔÓÈο 2010Cyprus Nursing Chronicles 2010

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·ÊÔ˘ ÙÔ ÂÍ·ÚÙË̤ÓÔ ¿ÙÔÌÔ Â¯ÂÈ ·Ó¿ÁÎËÙËÓ Ô˘Û›· ÁÈ· Ó· ÏÂÈÙÔ˘ÚÁ‹ÛÂÈ (ª·‰È·Ófi˜,2004). ¶·Ú·ÙËÚÂ›Ù·È ÌÈ· Ù¿ÛË Û˘Ó¯ԇ˜·‡ÍËÛ˘ ÙˆÓ ‰fiÛÂˆÓ Î·È Ù¤ÏÔ˜ ÂÌÊ·Ó›˙Ô-ÓÙ·È Ù· ηٷÛÙÚÔÊÈο ·ÔÙÂϤÛÌ·Ù· Ù˘¯Ú‹Û˘ ÁÈ· ÙÔ ¿ÙÔÌÔ Î·È ÙËÓ ÎÔÈÓˆÓ›·.

Afi Ù· ·Ó¿Ú¯·È· ¯ÚfiÓÈ· ÔÈ ¿ÓıÚˆÔÈÛ οı ÎÔÈÓˆÓ›·, Û fiÏÔ˘˜ ÙÔ˘˜ ÔÏÈÙÈ-ÛÌÔ‡˜, ¤Î·Ó·Ó ¯Ú‹ÛË ‰È·ÊfiÚˆÓ Ô˘ÛÈÒÓ(ª·‰È·Ófi˜, 2004). OÈ Ô˘Û›Â˜ ·˘Ù¤˜, ÛÙȘÔԛ˜ Û˘ÌÂÚÈÏ·Ì‚¿ÓÔÓÙ·È Ù· Ó·ÚΈÙÈο,ÙÔ ·ÏÎÔfiÏ Î·È ÙÔ ÙÛÈÁ¿ÚÔ, ÔÓÔÌ¿˙ÔÓÙ·È „˘-¯fiÙÚÔ˜, ÁÈ·Ù› ÂȉÚÔ‡Ó ÛÙÔÓ „˘¯ÈÛÌfiÙÔ˘ ·ÓıÚÒÔ˘ Î·È ÚÔηÏÔ‡Ó ÌÂÙ·‚ÔϤ˜ÛÙÔ Â›Â‰Ô Ù˘ ÓÔËÙÈ΋˜ ÛÊ·›Ú·˜, ÙÔ˘Û˘Ó·ÈÛı‹Ì·ÙÔ˜ ‹ Ù˘ Û˘ÌÂÚÈÊÔÚ¿˜ ÙÔ˘·ÙfiÌÔ˘.

∏ ¯Ú‹ÛË Ì ÔÚÈṲ̂ÓÔ ÙÚfiÔ ÌÈ·˜ „˘-¯ÔÙÚfiÔ˘ Ô˘Û›·˜ ‹ Î·È ÂÚÈÛÛfiÙÂÚˆÓ, ‹Ù·Ó¿ÓÙ· ‰Â̤ÓË ÌÂ Û˘ÁÎÂÎÚÈ̤Ó˜ ÔÏÈÙÈ-ÛÙÈΤ˜, ÎÔÈÓˆÓÈΤ˜ Î·È ÔÈÎÔÓÔÌÈΤ˜ ÏÂÈ-ÙÔ˘ÚÁ›Â˜ ÌÈ·˜ ÔÚÈṲ̂Ó˘ ÎÔÈÓˆÓ›·˜. ÕÏÏÔÙÂÁÈÓfiÙ·Ó ÛÙÔ Ï·›ÛÈÔ ÈÂÚÒÓ ÙÂÏÂÙÒÓ (‰ÈÔ-Ó˘ÛÈ·ÎÒÓ, ‚·Î¯ÈÎÒÓ Î·È ¿ÏÏˆÓ ÛÙËÓ AÚ¯·›·EÏÏ¿‰·), Ì˘ÛÙÈÎÈÛÙÈÎÒÓ ‹ ıÚËÛ΢ÙÈÎÒÓÙÂÏÂÙÔ˘ÚÁÈÒÓ (¯Ú‹ÛË Â¸ÙfiÏ ·fi ÙÔ˘˜IӉȿÓÔ˘˜ ÙÔ˘ MÂÍÈÎÔ‡ ‹ „¢‰·ÈÛıËÛÈÔ-ÁfiÓˆÓ Ì˘Î‹ÙˆÓ ÛÙË N¤· K·ÏˉÔÓ›· ‹ ʇÏ-ÏˆÓ Îfiη˜ ·fi ÙÔ˘˜ Èı·ÁÂÓ›˜ ÙˆÓ ÕӉˆÓÙ˘ §·ÙÈÓÈ΋˜ AÌÂÚÈ΋˜), ÙÂÏÂÙÒÓ Ì‡ËÛ˘ÛÙËÓ ÂÊ˂›· ‹ ÛÂ Ì˘ÛÙ‹ÚÈ·, ÌÂÙ¿‚·Û˘ÛÙÔÓ fiÏÂÌÔ Î·È ¿ÏÏ·. ÕÏÏÔÙ ¿ÏÈ Ë ̄ Ú‹ÛËÌÈ·˜ „˘¯ÔÙÚfiÔ˘ Ô˘Û›·˜ ÁÈÓfiÙ·Ó ÁÈ· ıÂ-ڷ¢ÙÈÎÔ‡˜ ÏfiÁÔ˘˜. H ·Ó·ÊÔÚ¿ ÙÔ˘ OÌ‹-ÚÔ˘ ÛÙȘ „˘¯fiÙÚÔ˜ Ô˘Û›Â˜ ·ÔÙÂÏ› ÌÈ··fi ÙȘ ·Ï·ÈfiÙÂÚ˜ ·Ó·ÊÔÚ¤˜.Afi ÙËÓÂÏÏËÓÈ΋ ϤÍË fiÈÔÓ (Ôfi˜ Ù˘ ̋ΈÓÔ˜)ÚÔ‹ÏıÂ Ë Ï·ÙÈÓÈ΋ opium. O ŸÌËÚÔ˜ ·Ó·-ʤÚÂÈ fiÙÈ ÙÔ ÓËÂÓı¤˜ Ù˘ ̋ΈÓÔ˜ ¯ÚË-ÛÈÌÔÔÈ‹ıËΠ·fi ÙËÓ EϤÓË ÙÔ˘ MÂÓ¤-Ï·Ô˘ (M¿ÙÛ· 2001:48).

O fiÚÔ˜ «ÙÔÍÈÎÔÌ·Ó›·» fiˆ˜ ¿ÏψÛÙÂÎ·È Ô fiÚÔ˜ «·ÏÎÔÔÏÈÛÌfi˜», ¯ÚËÛÈÌÔÔÈ‹-ıËÎ·Ó ÁÈ· ÚÒÙË ÊÔÚ¿ ÙÔÓ 19Ô ·ÈÒÓ·. OfiÚÔ˜ «ÙÔÍÈÎÔÌ·Ó›·» ·fi ÙË Ï¤ÍË ÙÔÍÈÎfiÓÔ˘ ÛËÌ·›ÓÂÈ ‰ËÏËÙ‹ÚÈÔ Î·È ÙË Ï¤ÍË Ì·Ó›·Ô˘ ·Ó·Ê¤ÚÂÙ·È Û ÌÈ· „˘¯È·ÙÚÈ΋ ‰È·Ù·-Ú·¯‹, ›¯Â ·fi ÙËÓ ÚÒÙË ÛÙÈÁÌ‹ ÌÈ· ËıÈÎ‹Î·È ·Ú¿ÏÏËÏ· ÌÈ· È·ÙÚÈ΋ ‰È¿ÛÙ·ÛË. YÔ-‰‹ÏˆÓ ÌÈ· ÎÔÈÓˆÓÈ΋ Ì¿ÛÙÈÁ· Î·È Ù·˘Ùfi-¯ÚÔÓ· ÌÈ· ÓfiÛÔ, ˆ˜ Û˘Ó¤ÂÈ· Ù˘ ÂÍ¿ÚÙË-

Û˘ ÙÔ˘ ·ÙfiÌÔ˘ ·fi „˘¯ÔÙÚfi˜ Ô˘Û›Â˜.TÔ 1964 ÌÈ· ÂÈÙÚÔ‹ ÂȉÈÎÒÓ Ù˘ ¶·ÁÎfi-ÛÌÈ·˜ OÚÁ¿ÓˆÛ˘ YÁ›·˜ ·ÔÊ·Û›˙ÂÈ Ó··ÓÙÈηٷÛÙ‹ÛÂÈ ÙÔÓ fiÚÔ ÙÔÍÈÎÔÌ·Ó›· Ì ÙÔÓfiÚÔ ÂÍ¿ÚÙËÛË.

TÔ 1990 Ô Goodman ÂÈÛ¿ÁÂÈ ÙÔÓ fiÚÔ«addiction», ÚÔÛ‰ÈÔÚ›˙ÔÓÙ·˜ Ì' ·˘ÙfiÓ ÌÈ·‰È·‰Èηۛ·, ‰È·Ì¤ÛÔ˘ Ù˘ ÔÔ›·˜ ÌÈ· Û˘-ÌÂÚÈÊÔÚ¿ Ô˘ ÌÔÚ› Ó· ÚÔηϤÛÂÈ Â˘-¯·Ú›ÛÙËÛË ‹ Ó· ··Ï‡ÓÂÈ ÌÈ· ·›ÛıËÛË ÂÛˆ-ÙÂÚÈ΋˜ ηÎÔ˘¯›·˜, ¯ÚËÛÈÌÔÔÈÂ›Ù·È ÌÂÙÚfiÔ Ô˘ ¯·Ú·ÎÙËÚ›˙ÂÙ·È ·fi ÙËÓ Â·-Ó·Ï·Ì‚·ÓfiÌÂÓË ·‰˘Ó·Ì›· ÂϤÁ¯Ô˘ ·˘Ù‹˜Ù˘ Û˘ÌÂÚÈÊÔÚ¿˜ Î·È ÙË Û˘Ó¯‹ Âȉ›ˆÍ‹Ù˘, ÌÔÏÔÓfiÙÈ ÙÔ ¿ÙÔÌÔ ÁÓˆÚ›˙ÂÈ ÙȘ ·ÚÓË-ÙÈΤ˜ Ù˘ Û˘Ó¤ÂȘ (ª¿ÙÛ· 2001:70). HϤÍË addiction ÚÔ¤Ú¯ÂÙ·È ·fi ÙÔ Ï·ÙÈÓÈÎfiaddicare, Ô˘ ÛËÌ·›ÓÂÈ ÂȉÈο˙ˆ ÏfiÁˆ¯ÚÂÒÓ. Addictus Â›Ó·È Ô ˘Ô‚È‚·Ṳ̂ÓÔ˜ÛÙËÓ Î·Ù¿ÛÙ·ÛË ÙÔ˘ ÛÎÏ¿‚Ô˘ ÏfiÁˆ ̄ ÚÂÒÓ,·˘Ùfi˜ Ô˘ ¤¯ÂÈ ˘ÔıË·ÛÂÈ ÙÔ ›‰ÈÔ ÙÔÛÒÌ· ÙÔ˘. O fiÚÔ˜ addiction ˘Ô‰ËÏÒÓÂÈÛ˘ÌÂÚÈÊÔÚ¤˜ ηٷӷÁηÛÌÔ‡.

∏ ∂Í¿ÚÙËÛË «addiction» Á›ÓÂÙ·È Úfi-‚ÏËÌ· ÌfiÓÔ ÛÙËÓ ÂÚ›ÙˆÛË Ô˘ ·ÔÙÂ-Ï› ÁÈ· ÙÔ ¿ÙÔÌÔ ÙË ÌÔÓ·‰È΋ χÛË Ô˘ ‰È·-ı¤ÙÂÈ ÁÈ· ÙËÓ ·ÓÙÈÌÂÙÒÈÛË Ù˘ Ô‰‡Ó˘ ÙÔ˘.°È· οÔÈÔ˘˜ ÙÔÍÈÎÔÌ·Ó›˜ Ë ÂÈÏÔÁ‹ ·˘-ÙÔ‡ ÙÔ˘ ÙÚfiÔ˘ ˙ˆ‹˜ ‰ÂÓ ·ÔÙÂÏ› ·Ú¿ÌÈ· ÛÙÚ·ÙËÁÈ΋ ÂÈ‚›ˆÛ˘ ·Ó¿ÌÂÛ· ÛÙȘ¿ÏϘ. H ¢·ÏˆÙfiÙËÙ· ÙÔ˘˜ Â›Ó·È Û˘Ó¿Ú-ÙËÛË ÔÏÏÒÓ ·Ú·ÁfiÓÙˆÓ. ŒÓ·˜ ·fi ·˘-ÙÔ‡˜ ÌÔÚ› Ó· Â›Ó·È Î·È Î¿ÔÈÔ˘ Ù‡Ô˘„˘¯È΋ ‰È·Ù·Ú·¯‹, Ë ÔÔ›· ÙÔ˘˜ οÓÂÈ ÂÈÚ-Ú›˜ ÛÙË ¯Ú‹ÛË Ô˘ÛÈÒÓ Û·Ó ¤Ó· ›‰Ô˜«Ê·ÚÌ¿ÎÔ˘», Ì ÙËÓ Â˘Ú‡ÙÂÚË ¤ÓÓÔÈ· ÙÔ˘fiÚÔ˘. OÈ ̆ ÔÛÙËÚÈÎÙ¤˜ ·˘Ù‹˜ Ù˘ ¿Ô„˘ÌÈÏÔ‡Ó ÁÈ· ·˘ÙÔıÂڷ›· Ì ÙËÓ ¤ÓÓÔÈ· fiÙÈË ¯Ú‹ÛË ÙˆÓ Ó·ÚΈÙÈÎÒÓ Ô˘ÛÈÒÓ ÛÙÔ˘˜„˘¯·ÛıÂÓ›˜ ·Ô‚ϤÂÈ ‚·ÛÈο ÛÙËÓ ·Ó·-ÎÔ‡ÊÈÛË ·fi ÙÔÓ „˘¯ÈÎfi fiÓÔ, ÙËÓ ·Ó˘-fiÊÔÚË Î·Ù¿ÛÙ·ÛË Ô˘ ‰ËÌÈÔ˘ÚÁ› Ë „˘-¯È·ÙÚÈ΋ ‰È·Ù·Ú·¯‹ (Ë Î·Ù¿ıÏÈ„Ë, ÙÔ ¤ÓÙÔÓÔ¿Á¯Ô˜, Ô ·ÓÈÎfi˜, ÔÈ „¢‰·ÈÛı‹ÛÂȘ, ÔÈ ·-Ú·ÏËÚËÌ·ÙÈΤ˜ ȉ¤Â˜).

∂ȉËÌÈÔÏÔÁÈο ÛÙÔȯ›· ÁÈ· ÙÔ PTSD

OÈ ¿ÓıÚˆÔÈ Ô˘ ÂÎÙ›ıÂÓÙ·È Û ¤Ó·ÙÚ·˘Ì·ÙÈÎfi ÁÂÁÔÓfi˜ ı· ·Ó·Ù‡ÍÔ˘Ó Û˘-ÌÙÒÌ·Ù· Û¯ÂÙÈ˙fiÌÂÓ· Ì PTSD Û ÔÛÔ-ÛÙ¿ 20-50% (Alim et al 2006, Zatzick et al2007).

¢‡Ô ÌÂÁ¿Ï˜ ÂȉËÌÈÔÏÔÁÈΤ˜ ¤Ú¢Ó˜,Ë ∂ıÓÈ΋ (∏¶∞) (1986-1988) ∞Ó·ÚÔÛ·Ú-ÌÔṲ̂ÓË ŒÚ¢ӷ ÁÈ· ÙÔ˘˜ µÂÙÂÚ¿ÓÔ˘˜ ÙÔ˘µÈÂÙÓ¿Ì (National Vietmams ReadjustmentSurvey - NVVRS) Î·È Ë ∂ıÓÈ΋ (∏¶∞) ŒÚ¢ӷÁÈ· ÙË ™˘ÓÓÔÛËÚfiÙËÙ· (National ComorbiditySurvey - NCS) (1990-1992) ·Û¯ÔÏ‹ıËηÓÌ ٷ ÂÚˆÙ‹Ì·Ù· : (·) TÈ Â›Ó·È ÙÔ PTSD; (‚)¶fiÛÔ Û‡ÓËı˜ ›ӷÈ; Î·È (Á) ¶ÔÈ· ¿ÙÔÌ·¤¯Ô˘Ó ·˘Ù¿ Ù· Û˘ÌÙÒÌ·Ù·;

T· ·ÔÙÂϤÛÌ·Ù· Ù˘ ¤Ú¢ӷ˜ NCS¤‰ÂÈÍ·Ó fiÙÈ Ë ÂÈÎÚ¿ÙËÛË ÙÔ˘ PTSD ÛÙÔÁÂÓÈÎfi ÏËı˘ÛÌfi Â›Ó·È 7,8%, Ì ÙȘ Á˘Ó·›-Θ Ó· ¤¯Ô˘Ó ‰ÈÏ¿ÛȘ Èı·ÓfiÙËÙ˜ (10,4%)·fi ÙÔ˘˜ ¿Ó‰Ú˜ (5%) Ó· ·Ó·Ù‡ÍÔ˘Ó PTSDηٿ ÙË ‰È¿ÚÎÂÈ· Ù˘ ̇ ˆ‹˜ ÙÔ˘˜. H ¤Ú¢ӷNVVRS ¤‰ÂÈÍ fiÙÈ Ë Â›ÙˆÛË ÙÔ˘ PTSDηٿ ÙË ‰È¿ÚÎÂÈ· Ù˘ ̇ ˆ‹˜ ÌÂٷ͇ ÙˆÓ ·ÌÂ-ÚÈηÓÔ‚ÚÂÙ·ÓÒÓ ÙÔ˘ ÔϤÌÔ˘ ÛÙÔ BÈÂÙÓ¿ÌÂ›Ó·È 30,9% ÁÈ· ÙÔ˘˜ ¿Ó‰Ú˜ Î·È 26,9% ÁÈ·ÙȘ Á˘Ó·›Î˜ (Mc Dermott et al, 1995).

∂ȉËÌÈÔÏÔÁÈο ÛÙÔȯ›· ÁÈ· ÙÔ SUD

∆· ÔÛÔÛÙ¿ ‰È·Ê¤ÚÔ˘Ó ÛËÌ·ÓÙÈο ·fi¯ÒÚ· Û ¯ÒÚ·. ™Â ÛÙÔ¯Â˘Ì¤Ó˜ ÌÂϤÙÂ˜Ô˘ ‰ÈÂÓÂÚÁ‹ıËÎ·Ó Û ¯ÒÚÔ˘˜ ÌÔ˘ÛÈÎÒÓÎ·È ¯ÔÚ¢ÙÈÎÒÓ ÂΉËÏÒÛˆÓ, ·Ú·ÙËÚ‹-ıËÎ·Ó ÔÛÔÛÙ¿ ÂÈÎÚ¿ÙËÛ˘ Ù˘ ¯Ú‹Û˘ÎÔη˝Ó˘ (ÙÔ˘Ï¿¯ÈÛÙÔ ÌÈ· ÊÔÚ¿ Û ÔÏfi-ÎÏËÚË ÙË ̇ ˆ‹) ¤ˆ˜ Î·È 60%. ™Â ¤Ó· ‰Â›ÁÌ·ÛÙȘ ∏.¶.∞. ÔÈ Kesler et al. (1995), ‚ڋηÓÔÛÔÛÙ¿ ¯Ú‹Û˘ Ô˘ÛÈÒÓ Ì¤¯ÚÈ 35% ÁÈ·ÙÔ˘˜ ¿Ó‰Ú˜ Î·È 18% ÁÈ· ÙȘ Á˘Ó·›Î˜. ∆·ÔÛÔÛÙ¿ ‹Ù·Ó ˘„ËÏfiÙÂÚ· ÁÈ· ÙÔ˘˜ Ï¢-ÎÔ‡˜ ·Ú¿ ÁÈ· ÙÔ˘˜ Ì·‡ÚÔ˘˜ ‹ ÙÔ˘˜ η-Ù·ÁfiÌÂÓÔ˘˜ ·fi ÙËÓ πÛ·Ó›·. ™‡Ìʈӷ ÌÂÙÔ ∂˘Úˆ·˚Îfi ∫¤ÓÙÚÔ ¶·Ú·ÎÔÏÔ‡ıËÛË˜Î·È ∆ÂÎÌËÚ›ˆÛ˘ ÁÈ· Ù· ¡·ÚΈÙÈο Î·È ÙËÓ∂Í¿ÚÙËÛË (EMCDDA), ÙÔ 2006, ÌÈ· ¤Ú¢ӷÌÂٷ͇ ∂ÏÏËÓÔ΢ڛˆÓ ËÏÈΛ·˜ 15-64 ̄ Úfi-ÓˆÓ ¤‰ÂÈÍ ÙËÓ ÂÈÎÚ¿ÙËÛË Ù˘ οÓÓ·‚˘Û fiÏË ÙË ˙ˆ‹ ÛÙÔ 6,6%, Î·È ÙËÓ ÂÈÎÚ¿-ÙËÛË ÙÔ˘ ecstasy Û fiÏË ÙË ̇ ˆ‹ ÛÙÔ 1,6%.∆Ô 2007 ÔÈ ÚÔ‚ÏËÌ·ÙÈÎÔ› ¯Ú‹ÛÙ˜ ÔȈ-

‰ÒÓ ·Ó¿ 1000 ¿ÙÔÌ· ËÏÈΛ·˜ 15-64 ˘Ô-ÏÔÁ›ÛÙËÎ·Ó ÌÂٷ͇ 1,6 – 3,9. O Û˘ÓÔÏÈÎfi˜·ÚÈıÌfi˜ ÙˆÓ ÚÔ‚ÏËÌ·ÙÈÎÒÓ ̄ ÚËÛÙÒÓ ÛÙËÓ∫‡ÚÔ ̆ ÔÏÔÁ›˙ÂÙ·È Û 1591~2541 ¿ÙÔÌ·.™‡Ìʈӷ Ì ÙÔ EMCDDA, Ô ÔÚÈÛÌfi˜ ÙÔ˘ÚÔ‚ÏËÌ·ÙÈÎÔ‡ ¯Ú‹ÛÙË ·ÊÔÚ¿ ÙÔ˘˜ ÂÓ-‰ÔÊϤ‚ÈÔ˘˜ ¯Ú‹ÛÙ˜ Ô˘ÛÈÒÓ ‹ ÙÔ˘˜ Ì·-ÎÚÔ¯ÚfiÓÈÔ˘˜ ¯Ú‹ÛÙ˜ ÔȈ‰ÒÓ, ÎÔη˝ÓË˜Î·È ·ÌÊÂÙ·ÌÈÓÒÓ. ∏ οÓÓ·‚Ë Î·È ÙÔ ecstasy‰ÂÓ Û˘ÌÂÚÈÏ·Ì‚¿ÓÔÓÙ·È Û ·˘Ù‹ ÙËÓ Î·-ÙËÁÔÚ›·. ™ÙËÓ ∂˘ÚÒË ˘ÔÏÔÁ›˙ÂÙ·È fiÙÈÌÂٷ͇ ÙˆÓ ·ÙfiÌˆÓ 15-64 ¯ÚfiÓˆÓ Ë ÂÈ-ÎÚ¿ÙËÛË Ù˘ οÓÓ·‚˘ Û fiÏË ÙË ˙ˆ‹ ›-Ó·È ÙÔ˘Ï¿¯ÈÛÙÔÓ 71 ÂηÙÔÌ̇ÚÈ· (22% ÙˆÓ∂˘Úˆ·›ˆÓ ÂÓËϛΈÓ). °È· ÙËÓ ÎÔη˝ÓË ËÂÈÎÚ¿ÙËÛË Û fiÏË ÙË ˙ˆ‹ ·ÊÔÚ¿ ÙÔ˘Ï¿-¯ÈÛÙÔÓ 12 ÂηÙÔÌ̇ÚÈ· (3,6% ÙˆÓ ∂˘Úˆ-·›ˆÓ ÂÓËϛΈÓ). OÈ ‰Â ÚÔ‚ÏËÌ·ÙÈÎÔ› ̄ Ú‹-ÛÙ˜ Ô˘ÛÈÒÓ ˘ÔÏÔÁ›˙ÔÓÙ·È ÌÂٷ͇ ÂÓfi˜Î·È ¤ÍÈ ·ÙfiÌˆÓ ÌÂٷ͇ 1000 ÂÓËϛΈÓ(EMCDDA/ Europe Annual Report 2008).

£ÂˆÚËÙÈ΋ ÚÔÛ¤ÁÁÈÛË Ù˘ Û˘Û¯¤ÙÈ-Û˘ ¢È·Ù·Ú·¯‹˜ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚÂ˜Î·È ¢È·Ù·Ú·¯‹˜ ¯Ú‹Û˘ „˘¯Ô‰Ú·ÛÙÈÎÒÓÔ˘ÛÈÒÓ

∏ ıˆڛ· ÙˆÓ Chilcoat & Breslau (1998),

O‰Ô› Û‡Ó‰ÂÛ˘ ¢È·Ù·Ú·¯‹˜ ÌÂÙ·ÙÚ·˘-Ì·ÙÈÎÔ‡ ÛÙÚ˜ Î·È ¢È·Ù·Ú·¯‹˜ ̄ Ú‹Û˘ „˘-¯Ô‰Ú·ÛÙÈÎÒÓ Ô˘ÛÈÒÓ

™‡Ìʈӷ Ì ÙË ıˆڛ· Ô˘ ·Ó¿Ù˘Í·ÓÔÈ Chilcoat & Breslau (1998), ÙÚÂȘ ÛËÌ·-ÓÙÈΤ˜ Ô‰Ô› Ô˘ Û˘Ó‰¤Ô˘Ó ÙÔ ™‡Ó‰ÚÔÌÔªÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ Î·È ÙË ‰È·Ù·Ú·¯‹¯Ú‹Û˘ Ô˘ÛÈÒÓ ·ÚÔ˘ÛÈ¿˙ÔÓÙ·È ÛÙÔ Û¯Â-‰È¿ÁÚ·Ì· . H ÈÔ ÂÌÊ·Ó‹˜ ÂÍ‹ÁËÛË Â›Ó·ÈË ·˘ÙÔ-›·ÛË Ë ÔÔ›· Ê·›ÓÂÙ·È Ì ÙÔ Û˘ÓÂ-¯¤˜ ‚¤ÏÔ˜ ÛÙÔ Û¯‹Ì·. A˘Ù‹ Ë ÂÍ‹ÁËÛË ‚·-Û›˙ÂÙ·È Î˘Ú›ˆ˜ Û ÎÏÈÓÈΤ˜ ·Ú·ÙËÚ‹ÛÂȘ,˘Ôı¤ÙÂÈ fiÙÈ Ë „˘¯ÔÂÓÂÚÁ¤˜ Ô˘Û›Â˜ ¯ÚË-ÛÈÌÔÔÈÔ‡ÓÙ·È ÁÈ· Ó· ·Ó·ÎÔ˘Ê›ÛÔ˘Ó ÙȘÙÚ·˘Ì·ÙÈΤ˜ ÌӋ̘ Î·È ¿ÏÏ· ›ÔÓ· Û˘-ÌÙÒÌ·Ù· Ù˘ ¢È·Ù·Ú·¯‹˜ ÌÂÙ·ÙÚ·˘Ì·ÙÈ-ÎÔ‡ ÛÙÚ˜ (Brown & Wolte 1994, Stewart2004).

¢‡Ô ÂÓ·ÏÏ·ÎÙÈΤ˜ ÂÍËÁ‹ÛÂÈ̃ ÁÈ· ÙË Û¯¤ÛËÙ˘ ¢È·Ù·Ú·¯‹˜ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚÂ˜Î·È ¢È·Ù·Ú·¯‹˜ ¯Ú‹Û˘ „˘¯Ô‰Ú·ÛÙÈÎÒÓÔ˘ÛÈÒÓ Ê·›ÓÂÙ·È ÛÙÔ Û¯Â‰È¿ÁÚ·ÌÌ· Ì ÙȘ‰È·ÎÂÎÔÌ̤Ó˜ ÁÚ·Ì̤˜. ™ÙȘ ÂÍËÁ‹ÛÂȘ

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·˘Ù¤˜ Ë Î·Ù¿¯ÚËÛË ‹ ÂÍ¿ÚÙËÛË Ô˘ÛÈÒÓ Â›-Ó·È Ô ·ÈÙÈÔÏÔÁÈÎfi˜ ·Ú¿ÁÔÓÙ·˜ Ô˘ Ô‰Ë-Á› ÛÙË ¢È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜.

∆Ô ÌÔÓÙ¤ÏÔ ÙÔ˘ Volpicelli Î·È Û˘ÓÂÚ-Á·ÙÒÓ (2002)

æËÏfi˜ ΛӉ˘ÓÔ˜ Î·È Â˘·ÏˆÙfiÙËÙ·: ™ÙËÓ˘fiıÂÛË Ô˘ ·ÊÔÚ¿ ÙË Û˘ÌÂÚÈÊÔÚ¿ „Ë-ÏÔ‡ ÎÈÓ‰‡ÓÔ˘, Ë ¯Ú‹ÛË Ô˘ÛÈÒÓ ıˆÚ›ٷÈ̤ÚÔ˜ ÌÈ·˜ ÁÂÓÈÎfiÙÂÚ˘ Û˘ÌÂÚÈÊÔÚ¿˜„ËÏÔ‡ Ú›ÛÎÔ˘, .¯. ÙÔ Î˘Ó‹ÁÈ ·Ú¿ÓÔ̈ÓÔ˘ÛÈÒÓ, ÙÔ ÔÔ›Ô ·˘Í¿ÓÂÈ ÙÔ Ú›ÛÎÔ Ù˘ ¤Î-ıÂÛ˘ Û ÙÚ·˘Ì·ÙÈο ÁÂÁÔÓfiÙ· ηÈ, ¤Ì-ÌÂÛ·, ·˘Í¿ÓÂÈ ÙËÓ Èı·ÓfiÙËÙ· ÁÈ· ¢È·Ù·-Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜.™ÙËÓ ˘fi-ıÂÛË Ô˘ ·ÊÔÚ¿ ÙËÓ Â˘·ÏˆÙfiÙËÙ· ıˆ-ÚÂ›Ù·È fiÙÈ ÔÈ ¯Ú‹ÛÙ˜ Ô˘ÛÈÒÓ Â›Ó·È ÈÔ Â˘-¿ÏˆÙÔÈ ÛÙË ¢È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ÛÙÚ˜ ÌÂÙ¿ ·fi ¤ÎıÂÛË Û ÙÚ·˘Ì·ÙÈÎfi ÁÂ-ÁÔÓfi˜. OÈ Volpicelli et al (2002), ̆ ÔÛÙËÚ›-˙Ô˘Ó fiÙÈ ̆ ¿Ú¯Ô˘Ó ÔÏÏÔ› Ì˯·ÓÈÛÌÔ› Ô˘ÌÔÚ› Ó· ·˘Í‹ÛÔ˘Ó ÙËÓ Â˘·ÏˆÙfiÙËÙ· ÙˆÓ¯ÚËÛÙÒÓ ÔÈ ÔÔ›ÔÈ ÌÔÚ› Ó· Û¯ÂÙ›˙ÔÓÙ·ÈÌ ·ÔÙ˘¯›· ·Ó¿Ù˘Í˘ ·ÔÙÂÏÂÛÌ·ÙÈÎÒÓÛÙÚ·ÙËÁÈÎÒÓ ·ÓÙÈÌÂÙÒÈÛ˘ ÙÔ˘ ÛÙÚ˜ ‹·ÏÏ·Á¤˜ ÛÙÔ ÂÁÎÂÊ·ÏÈÎfi Ó¢ÚÔ¯ËÌÈÎfi Û‡-

ÛÙËÌ· ÏfiÁˆ ÂÎÙÂٷ̤Ó˘ ¯Ú‹Û˘ Ô˘-ÛÈÒÓ.E›Ó·È fï˜ Èı·ÓfiÓ Ó· ÌËÓ ˘¿Ú¯ÂÈ¿ÌÂÛË Û˘Û¯¤ÙÈÛË ÌÂٷ͇ Ù˘ ¢È·Ù·Ú·¯‹ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ Î·È Ù˘ ‰È·Ù·Ú·-¯‹˜ ¯Ú‹Û˘ Ô˘ÛÈÒÓ, ·ÏÏ¿ Ë ¢È·Ù·Ú·¯‹ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ Î·È Ë ‰È·Ù·Ú·¯‹¯Ú‹Û˘ Ô˘ÛÈÒÓ Ó· ÔÊ›ÏÂÙ·È Û ¤Ó· ÙÚ›ÙÔ·Ú¿ÁÔÓÙ·. °È· ·Ú¿‰ÂÈÁÌ·, ÔÏϤ˜ ÌÂ-ϤÙ˜ ¤‰ÂÈÍ·Ó fiÙÈ Ë ·ÚÔ˘Û›· Û˘Ó˘¿Ú¯Ô-ÓÙˆÓ ÚÔ‚ÏËÌ¿ÙˆÓ ·˘Í¿ÓÂÈ ÙÔ Ú›ÛÎÔ Ù˘ηٿ¯ÚËÛ˘ Ô˘ÛÈÒÓ (Robins & Prybeck1985) Î·È Ù˘ ¤ÎıÂÛ˘ Û „˘¯ÔÏÔÁÈÎfiÙÚ·‡Ì· Î·È ¢È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ÛÙÚ˜ (Cottler et al 1992,). EÈÚfiÛıÂÙ·,Ë ¢È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ ηÈË Î·Ù¿¯ÚËÛË ‹ ÂÍ¿ÚÙËÛË Ô˘ÛÈÒÓ ÌÔÚ›ӷ ¤¯Ô˘Ó ÎÔÈÓ¿ ÁÂÓÂÙÈο ·›ÙÈ· (Comings etal 1996) ‹ ÎÔÈÓ¿ Ó¢ÚÔÊ˘ÛÈÔÏÔÁÈο Û˘-ÛÙ‹Ì·Ù· (Kosten & Krystal 1986).

H ·Ó¿ÁÎË ÁÈ· «·˘ÙÔıÂڷ›·» :AÚÎÂÙ¤˜ÊÔÚ¤˜ Ë ¯Ú‹ÛË Ô˘ÛÈÒÓ ¤¯ÂÈ Û¯¤ÛË Ì ÙËÛ˘Ó‡·ÚÍË „˘¯È·ÙÚÈÎÒÓ ‰È·Ù·Ú·¯ÒÓ, fiˆ˜ÌÈ· ˘ÔÎÚ˘ÙfiÌÂÓË Ó‡ڈÛË ‹ ÌÈ· Ï·Ó-ı¿ÓÔ˘Û· „‡¯ˆÛË. AÎfiÌ· ˘ÔÛÙËÚ›˙ÂÙ·ÈfiÙÈ ÌÈ· ÚÔ¸¿Ú¯Ô˘Û· „˘¯ÔÏÔÁÈ΋ ÂÈ-

™¯Â‰È¿ÁÚ·ÌÌ· 1 O‰Ô› Û‡Ó‰ÂÛ˘ ÙÔ˘ PTSD Î·È ÙÔ˘ SUD, ¶ËÁ‹ : Chilcoat & Breslau (1998)

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‚¿Ú˘ÓÛË ·›˙ÂÈ ÛËÌ·ÓÙÈÎfi ÚfiÏÔ ÛÙËÓ ÂÎ-‰‹ÏˆÛË ÌÈ·˜ ÂÍ·ÚÙËÙÈ΋˜ Û˘ÌÂÚÈÊÔÚ¿˜.™ÙÔ˘˜ ̄ Ú‹ÛÙ˜ ÔÈÔÂȉÒÓ Û˘Ó·ÓÙ¿Ì ÚÔ-‚Ï‹Ì·Ù· fiˆ˜ ÙÔ ¿Á¯Ô˜, Ë Î·Ù¿ıÏÈ„Ë Î·È·Ú·ÓÔ˚ÎÔ‡ Ù‡Ô˘ Û˘Ó‰ÚÔ̤˜. H ̆ fiıÂÛËÙ˘ ·˘ÙÔıÂڷ›·˜ ‰ÂÓ ·ÊÔÚ¿ ÌÔÓ¿¯·ÂΛÓÔ˘˜ Ô˘ ·ÚÔ˘ÛÈ¿˙Ô˘Ó ‰È·ÁÓÒÛÈ̘„˘¯È·ÙÚÈΤ˜ ‰È·Ù·Ú·¯¤˜ ÙÔ˘ ¿ÍÔÓ· I, Û‡Ì-ʈӷ Ì ÙÔ DSM III-R, ·ÏÏ¿ ÂÂÎÙ›ÓÂÙ·ÈÎ·È Û fiÏÔ˘˜ ÂΛÓÔ˘˜ Ô˘ ̆ ÔʤÚÔ˘Ó „˘-¯ÔÏÔÁÈο ÙfiÛÔ ¤ÓÙÔÓ·, ÒÛÙ ·ÈÛı¿ÓÔÓÙ·ÈfiÙÈ Ù›ÔÙ· ‰ÂÓ ÌÔÚ› Ó· ÙÔ˘˜ ‚ÔËı‹ÛÂÈ.

™‡Ó‰ÚÔÌÔ ÛÙ¤ÚËÛ˘ ÂÓ‰ÔÚÊÈÓÒÓ Î·È·Ó·Ï‹ÚˆÛË:∆Ô ÌÔÓÙ¤ÏÔ ‰›ÓÂÈ ÌÈ· ÂÍ‹ÁËÛËÙÔ˘ ˆ˜ ÙÔ ·ÏÎÔfiÏ Î·ÙÂ˘Ó¿˙ÂÈ Ù· Û˘-ÌÙÒÌ·Ù· Ô˘ ÚÔηÏÔ‡ÓÙ·È ·fi ¤Ó· ÙÚ·˘-Ì·ÙÈÎfi ÁÂÁÔÓfi˜.OÈ Volpicelli et al (2002)·Ó·Ê¤ÚÔ˘Ó fiÙÈ ÌÂÙ¿ ·fi ¤Ó· ÙÚ·˘Ì·ÙÈÎfiÁÂÁÔÓfi˜, ÔÈ ¿ÓıÚˆÔÈ Û˘¯Ó¿ ¯ÚËÛÈÌÔÔÈ-Ô‡Ó ·ÏÎÔfiÏ ÁÈ· Ó· ηÙÂ˘Ó¿ÛÔ˘Ó Ù· Û˘-ÌÙÒÌ·Ù· ÙÔ˘ ¿Á¯Ô˘˜, Ù˘ ‰˘ÛÊÔÚ›·˜ ηÈÙ˘ ηٿıÏȄ˘. TÔ ·ÏÎÔfiÏ Èı·ÓfiÓ Ó· η-ÙÂ˘Ó¿˙ÂÈ Ù· Û˘ÌÙÒÌ·Ù· ·˘Ù¿ ÁÈ·Ù› ·Ó·-ÏËÚÒÓÂÈ ÙËÓ ¤ÏÏÂÈ„Ë ÂÓ‰ÔÚÊÈÓÈ΋˜ ‰Ú·-

™¯Â‰È¿ÁÚ·ÌÌ· 2: ∏ ÚÔÛ¤ÁÁÈÛË Volpicelli (2002), ¶ËÁ‹ : Volpicelli et al (2002:259)

ÛÙËÚÈfiÙËÙ·˜ Ô˘ ·ÎÔÏÔ˘ı› ¤Ó· ÙÚ·˘Ì·-ÙÈÎfi ÁÂÁÔÓfi˜. §›Á· ÏÂÙ¿ ÌÂÙ¿ ÙËÓ ¤ÎıÂÛËÛ ¤Ó· ÙÚ·˘Ì·ÙÈÎfi ÁÂÁÔÓfi˜ ¤¯Ô˘Ì ·‡-ÍËÛË ÙˆÓ ÂȤ‰ˆÓ ÙˆÓ ÂÓ‰ÔÚÊÈÓÒÓ ÛÙÔÓÂÁΤʷÏÔ. K·Ù¿ ÙË ‰È¿ÚÎÂÈ· ÙÔ˘ «ÙÚ·‡-Ì·ÙÔ˜» Ù· ›‰· ÙˆÓ ÂÓ‰ÔÚÊÈÓÒÓ ·-ڷ̤ÓÔ˘Ó ·˘ÍË̤ӷ Î·È ‚ÔËıÔ‡Ó ÛÙÔ Ó·«ÌÔ˘‰È¿ÛÂÈ» Ô „˘¯ÈÎfi˜ Î·È Ê˘ÛÈÎfi˜ fiÓÔ˜Ô˘ ÚÔηÏÂ›Ù·È ·fi ÙÔ ÙÚ·‡Ì·. ŸÙ·Ó ÙÔÁÂÁÔÓfi˜ «ÙÚ·‡Ì·» ÙÂÏÂÈÒÛÂÈ, ÔÈ ÂÓ‰ÔÚÊ›-Ó˜ ÛÙ·‰È·Î¿ ·ӤگÔÓÙ·È ÛÙ· Ê˘ÛÈÔÏÔ-ÁÈο ›‰¿ ÙÔ˘˜, ·˘Ù‹ Ë Ì›ˆÛË ÙˆÓ ÂÓ-‰ÔÚÊ›ÓˆÓ ÌÔÚ› Ó· Ô‰ËÁ‹ÛÂÈ Û ¤Ó· ÛÙÂ-ÚËÙÈÎfi Û‡Ó‰ÚÔÌÔ ÙˆÓ ÂÓ‰ÔÚÊÈÓÒÓ, ÙÔ ÔÔ›ÔÌÔÚ› Ó· ÎÚ·Ù‹ÛÂÈ ·fi ÒÚ˜ ̤¯ÚÈ Î·È Ì¤-Ú˜. A˘Ù‹ Ë ÂÚ›Ô‰Ô˜ ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ ÛÙ¤-ÚËÛ˘ ÙˆÓ ÂÓ‰ÔÚÊÈÓÒÓ ÌÔÚ› Ó· Ô‰ËÁ‹-ÛÂÈ ÛÂ Û˘Ó·ÈÛıËÌ·ÙÈÎfi ‰˘ÛÙÚ¤˜ Î·È Ó· ·˘-Í‹ÛÂÈ ÁÂÓÈο Ù· Û˘ÌÙÒÌ·Ù· ¢È·Ù·Ú·¯‹˜ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜. EÂȉ‹ Ë ¯Ú‹ÛËÙÔ˘ ·ÏÎÔfiÏ ·˘Í¿ÓÂÈ ÙËÓ ÏÂÈÙÔ˘ÚÁ›· ÙˆÓ ÂÓ-‰ÔÚÊÈÓÒÓ, Ë ¯Ú‹ÛË ÙÔ˘ ÌÔÚ› Ó· ·Ó·-ÏËÚÒÓÂÈ ·˘Ù‹ ÙË ÛÙ¤ÚËÛË, ÙÔ ÛÙÂÚËÙÈÎfiÛ‡Ó‰ÚÔÌÔ ÙˆÓ ÂÓ‰ÔÚÊÈÓÒÓ, Î·È ÂÔ̤ӈ˜Ó· ·ÔʇÁÂÈ ÙÔ ÂÈÚfiÛıÂÙÔ ‰˘ÛÙÚ¤˜.A˘ÙfiÙÔ MÔÓÙ¤ÏÔ ¤¯ÂÈ ÛËÌ·ÓÙÈ΋ ÂÊ·ÚÌÔÁ‹ ÁÈ·ÙË ıÂڷ›· Ù˘ ¢È·Ù·Ú·¯‹˜ ÌÂÙ·ÙÚ·˘-Ì·ÙÈÎÔ‡ ÛÙÚ˜ Î·È ·ÏÎÔÔÏÈÛÌÔ‡.

µÈÔ¯ËÌÈΤ˜ ·ÓÙȉڿÛÂȘ ÛÙÔ ÛÙÚ˜. ∏¤ÎıÂÛË Û ¤Ó· ÌË ÂÏÂÁ¯fiÌÂÓÔ ·ÚÓËÙÈÎfi ÁÂ-ÁÔÓfi˜ ÚÔηÏ› ÙË ÁÓˆÛÙ‹ ·ÓÙ›‰Ú·ÛË "Fightor Flight". O Êfi‚Ô˜ ÚÔηÏ› ÙËÓ ¤ÎÎÚÈÛËÙ˘ ÔÚÌfiÓ˘ ÎÔÚÙÈÎÔÙÚÔ›Ó˘ (CRH).ŒÂÈÙ·, Ë CRH ÂÓÂÚÁÔÔÈ› ÙËÓ ¤ÎÎÚÈÛËÙ˘ ÚÔÔÈÔÌÂÏ·ÓÔÎÔÚÙ›Ó˘ (POMC), ÌÈ·˜ÔÚÌfiÓ˘ Ô˘ ¯ˆÚ›˙ÂÙ·È Û ‰È¿ÊÔÚ· Û˘-ÛÙ·ÙÈο (ÛÙÔȯ›·). ∞˘Ù¿ Ù· ÛÙÔȯ›· Â-ÚÈÏ·Ì‚¿ÓÔ˘Ó ÙËÓ ÔÚÌfiÓË ·‰ÚÂÓÔÎÔÚÙÈÎÔ-ÙÚÔ›ÓË (ACTH), Ë ÔÔ›· ·˘Í¿ÓÂÈ ÙË ‰È¤-ÁÂÚÛË Î·È ·Ú¿ÁÂÈ ÙËÓ ·ÓÙ›‰Ú·ÛË "Fight orFlight" Î·È ÙËÓ ‚ËÙ·-ÂÓ‰ÔÚÊ›ÓË, Ë ÔÔ›·¤¯ÂÈ Î·Ù¢ӷÛÙÈ΋ ›‰Ú·ÛË Î·È ÂÔ̤ӈ˜ÌÂÈÒÓÂÈ ÙÔ Û˘Ó·ÈÛıËÌ·ÙÈÎfi Î·È Ê˘ÛÈÎfi fiÓÔ.

∂ÌÂÚÈο ‰Â‰Ô̤ӷ

∏ ˘fiıÂÛË fiÙÈ Ë ¢È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘-Ì·ÙÈÎÔ‡ ÛÙÚ˜ Î·È Ë ‰È·Ù·Ú·¯‹ ηٿ-¯ÚËÛ˘ „˘¯Ô‰Ú·ÛÙÈÎÒÓ Ô˘ÛÈÒÓ Û˘Û¯ÂÙ›-˙ÔÓÙ·È, ¿Ú¯ÈÛ ӷ ÂÚÂ˘Ó¿Ù·È ·fi ÙË ‰Âη-ÂÙ›· ÙÔ˘ 1980 Î·È ÎÏÈÓÈΤ˜ ·Ó·ÊÔÚ¤˜ ¤‰ÂÈ-Í·Ó fiÙÈ ·ÛıÂÓ›˜ Ì ‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘-

Ì·ÙÈÎÔ‡ ÛÙÚ˜ Î·È ÂÍ¿ÚÙËÛË ·fi Ô˘Û›Â˜,›¯·Ó ÁÚËÁÔÚfiÙÂÚ· ˘ÔÙÚÔ‹ ÛÙË ¯Ú‹ÛË·ÏÎÔfiÏ ‹ / Î·È ˘ÔÙÚÔ‹ Û fiÙÈ ·ÊÔÚ¿ ÙÔÙÚ·‡Ì· ÙÔ˘˜. ™ÙË ÔÚ›· Ê¿ÓËΠfiÙÈ ÔÈ·ÛıÂÓ›˜ ·ÓÙÈÏ·Ì‚¿ÓÔÓÙ·Ó ÙȘ ‰˘Ô ‰È·Ù·-Ú·¯¤˜ ÙÔ˘˜ ˆ˜ ÏÂÈÙÔ˘ÚÁÈο Û˘Û¯ÂÙÈ˙fiÌÂ-Ó˜ Î·È ÂÓÙÔ›ÛÙËΠfiÙÈ fiÙ·Ó Ë ÌÈ· ‰È·Ù·-Ú·¯‹ ‚ÂÏÙȈÓfiÙ·Ó, ‚ÂÏÙȈÓfiÙ·Ó Î·È Ë ¿ÏÏË·Ú¿ÏÏËÏ·. ( Brown et al 1995).

∏ Û˘Ó‡·ÚÍË ÙˆÓ ‰˘Ô ‰È·Ù·Ú·¯ÒÓ Ê¿-ÓËΠ۠ÂȉËÌÈÔÏÔÁÈΤ˜ Î·È ÎÏÈÓÈΤ˜ ÌÂ-ϤÙ˜. (Brown et al 1995, Brown et al 1998).∞ÚÁfiÙÂÚ· ÂÓÙÔ›ÛÙËÎ·Ó ·Ó¿ÌÂÛ· Û ¿ÙÔÌ·Ì ‰È¿ÁÓˆÛË ÂÍ¿ÚÙËÛ˘ ·fi ÙÔ ·ÏÎÔfiÏÔÛÔÛÙ¿ 10,3% ÛÙÔ˘˜ ¿ÓÙÚ˜ Î·È 26,2%ÛÙȘ Á˘Ó·›Î˜ Ó· ¤¯Ô˘Ó ÈÛÙÔÚÈÎfi ‰È·Ù·Ú·-¯‹˜ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ (Kessler et al1998). ∞ÎfiÌ· ÈÔ „ËÏ¿ ÔÛÔÛÙ¿ Û˘ÓÙÚ¤-¯Ô˘Û·˜ ‰È·Ù·Ú·¯‹˜ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ÛÙÚ˜ Î·È ¯Ú‹Û˘ Ô˘ÛÈÒÓ Ô˘ Î˘Ì·›ÓÔ-ÓÙ·È ·fi 25% ¤ˆ˜ 55% ‚Ú¤ıËÎ·Ó Û ÌÂ-ϤÙ˜ ÙˆÓ (Brown et al 1995 , Brown et al1998). ªÂÙ¤ÂÈÙ· ÂÚ¢Ó˜ ¤‰ÂÈÍ·Ó ˆ˜˘¿Ú¯ÂÈ ÈÛ¯˘Ú‹ Û˘Û¯¤ÙÈÛË ÌÂٷ͇ ÂÍ¿Ú-ÙËÛ˘ ·fi ÙËÓ ÎÔη˝ÓË, ÙÚ·‡Ì·ÙÔ˜ Î·È ‰È·-Ù·Ú·¯‹˜ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜. ¶ÔÛÔ-ÛÙ¿ 21-22% ÙˆÓ ¯ÚËÛÙÒÓ ÎÔη˝Ó˘ ÏË-ÚÔ‡Û ٷ ÎÚÈÙ‹ÚÈ· ÁÈ· ‰È·Ù·Ú·¯‹ ÌÂÙ·-ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ (Back et al 2000, Najavitset al 2003). ∆· ÔÛÔÛÙ¿ Û˘ÓÓÔÛËÚfiÙËÙ·˜Î·Ù¿¯ÚËÛ˘ / ÂÍ¿ÚÙËÛ˘ ·ÏÎÔfiÏ ·Ó¿ÌÂÛ·Û ‚ÂÙÂÚ¿ÓÔ˘˜ Ì ‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘-Ì·ÙÈÎÔ‡ ÛÙÚ˜ Î˘Ì·›ÓÔÓÙ·È ·fi 64-84% ηÈÁÈ· ηٿ¯ÚËÛË / ÂÍ¿ÚÙËÛË Ô˘ÛÈÒÓ ·fi 40-44%. (Keane et al 1988, Escobar et al 1983).∂ÈϤÔÓ ÙÂÎÌËÚ›ˆÛË ÁÈ· ÙËÓ ‡·ÚÍË Û˘-Û¯¤ÙÈÛ˘ ÙˆÓ ‰˘Ô ‰È·Ù·Ú·¯ÒÓ Û˘Ó·ÓÙÔ‡ÌÂÛÙË ‚È‚ÏÈÔÁÚ·Ê›· ·fi ‰È¿ÊÔÚ˜ ËÁ¤˜(Chilcout and Breslau 1998, Kilpatrick et al2000, Stewart et al, 2004 Î·È Coffey et al,2007). ∂ÈÚfiÛıÂÙ· Ê·ÈÓÂÙ·È fiÙÈ Ë Û˘-ÌÂÚÈÊÔÚ¿ ¯Ú‹Û˘ Ô˘ÛÈÒÓ Î·È ÂȉÈο ÙÔ˘·ÏÎÔfiÏ Î·È ÙˆÓ Ó·ÚΈÙÈÎÒÓ ÌÂÛÔÏ·‚Ô‡ÓÛÙË Û¯¤ÛË ÌÂٷ͇ PTSD Î·È ÙÔ˘ ÂȤ‰Ô˘˘Á›·˜. (Flood et al. 2009). µ¤‚·È· ÂÓÙÔ-›ÛÙËÎ·Ó Î·È ¤Ú¢Ó˜ Ì ·ÓÙ›ıÂÙ· ·ÔÙÂ-ϤÛÌ·Ù·, ÔÈ Ôԛ˜ ‰Â›¯ÓÔ˘Ó fiÙÈ Ë Â‚‰Ô-Ì·‰È·›· ¯Ú‹ÛË ·ÏÎÔfiÏ ·fi ÙÔ˘˜ ‚ÂÙÂÚ¿-ÓÔ˘˜ ‹Ù·Ó Ô˘ÛÈ·ÛÙÈο ¯·ÌËÏfiÙÂÚË ·fi·˘Ù‹ ÙÔ˘ ÁÂÓÈÎÔ‡ ÏËı˘ÛÌÔ‡ (DenVeldeet al 2002).

ÙfiÌÔ˜ 11, Ù‡¯Ô˜ 3Vol 11, No 3

K˘Úȷο NÔÛËÏ¢ÙÈο XÚÔÓÈο 2010Cyprus Nursing Chronicles 2010

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™Â Û¯¤ÛË Ì ÙÔ ·Ó Ë ‰È·Ù·Ú·¯‹ ÌÂÙ·-ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ ÚÔËÁÂ›Ù·È Ù˘ ‰È·Ù·-Ú·¯‹˜ ̄ Ú‹Û˘ „˘¯Ô‰Ú·ÛÙÈÎÒÓ Ô˘ÛÈÒÓ ·-Ú·ÙËÚÂ›Ù·È Û¯ÂÙÈ΋ ‰È·ÊˆÓ›· ÌÂٷ͇ ÙˆÓ¢ÚËÌ¿ÙˆÓ. ™˘Ó·ÓÙԇ̠ÌÂϤÙ˜ ÔÈ Ôԛ˜‰ÂÓ ‰Â›¯ÓÔ˘Ó ÔÈ· ·fi ÙȘ ‰‡Ô ‰È·Ù·Ú·¯¤˜ÚÔËÁ›ٷÈ. (Davis et al 1999) Î·È Â˘Ú‹Ì·Ù·fiÙÈ Ë ˘¿Ú¯Ô˘Û· ‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·-ÙÈÎÔ‡ ÛÙÚ˜ ·˘Í¿ÓÂÈ ÙÔ Ú›ÛÎÔ ÁÈ· ÛËÌ·-ÓÙÈ΋ ηٿ¯ÚËÛË ‹ ÂÍ¿ÚÙËÛË Ô˘ÛÈÒÓ. (Kessleret al 1995, Breslau et al 1997, Chilcoat &Breslau 1998). ∂›Û˘ ·ÓÙ›ıÂÙ· ·ÔÙÂϤ-ÛÌ·Ù· ÂÚ¢ÓÒÓ fiÙÈ Ë ¤Ó·ÚÍË Ù˘ ¯Ú‹ÛË˜Ô˘ÛÈÒÓ ÚÔËÁÂ›Ù·È Ù˘ ‰È·Ù·Ú·¯‹˜ ÌÂÙ·-ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ (Cottler et al 1992,Stewart et al 2004 ).

∏ ˘fiıÂÛË fiÙÈ Ë ‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘-Ì·ÙÈÎÔ‡ ÛÙÚ˜ Î·È Ë Û¯¤ÛË ÙÔ˘ Ì ÙËÓ ̄ Ú‹ÛË„˘¯Ô‰Ú·ÛÙÈÎÒÓ Ô˘ÛÈÒÓ – Â›Ó·È Á˘Ó·ÈΛ·˘fiıÂÛË Û˘Ó·ÓÙ¿ ÌÂÚÈ΋ ̆ ÔÛÙ‹ÚÈÍË ·ÊÔ‡¤Ó· ÔÛÔÛÙfi ·fi 30% ̤¯ÚÈ 57% ÙˆÓ Á˘-Ó·ÈÎÒÓ Ì ‰È·Ù·Ú·¯‹ ¯Ú‹Û˘ „˘¯Ô‰Ú·-ÛÙÈÎÒÓ Ô˘ÛÈÒÓ ÏËÚÔ‡Ó Ù· ÎÚÈÙ‹ÚÈ· ÁÈ·‰È¿ÁÓˆÛË PTSD. (Brown et al 1995, Najavitset al 1997, Volpicelli et al 2002). π‰È·›ÙÂÚ·Á˘Ó·›Î˜ ‚ÂÙÂÚ¿ÓÔÈ ·ÚÔ˘ÛÈ¿˙Ô˘Ó ÌÂÁ¿ÏË›وÛË (Û˘¯ÓfiÙËÙ·) ‰È·Ù·Ú·¯‹˜ ÌÂÙ·-ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ Û ۯ¤ÛË Ì ÛÂÍÔ˘·-ÏÈÎfi ÙÚ·‡Ì· ( Davis et al 1999). ∂›Û˘ʿÓËΠfiÙÈ Ë Û˘Û¯¤ÙÈÛË Ù˘ ‰È·Ù·Ú·¯‹ ÌÂ-Ù·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ Î·È ÙÔ˘ ·ÏÎÔÔÏÈÛÌÔ‡Â›Ó·È ÈÛ¯˘ÚfiÙÂÚË ÛÙȘ Á˘Ó·›Î˜. ( Volpicelliet al 2002).

OÈ ÌÂϤÙ˜ ÁÈ· ÙËÓ Èı·ÓfiÙËÙ· ÎÔÈÓ‹˜·ÈÙÈÔÏÔÁ›·˜ Ù˘ ‰È·Ù·Ú·¯‹˜ ÌÂÙ·ÙÚ·˘Ì·-ÙÈÎÔ‡ ÛÙÚ˜ Î·È ¯Ú‹Û˘ „˘¯Ô‰Ú·ÛÙÈÎÒÓÔ˘ÛÈÒÓ ¤‰ÂÈÍ·Ó Î¿ÔÈ· Û¯¤ÛË ·Ó¿ÌÂÛ· ÛÙȘ‰‡Ô ‰È·Ù·Ú·¯¤˜. ∂ÓÙÔ›˙ÔÓÙ·È ÛËÌ·ÓÙÈΤ˜·ÈÙÈÔÏÔÁÈΤ˜ ̆ Ôı¤ÛÂȘ, fiˆ˜ Ë ̄ Ú‹ÛË Ô˘-ÛÈÒÓ ˆ˜ ̤ıÔ‰Ô˜ ·˘ÙÔ-›·Û˘ ÙˆÓ Û˘-ÌÙˆÌ¿ÙˆÓ Ù˘ ‰È·Ù·Ú·¯‹˜ ÌÂÙ·ÙÚ·˘Ì·-ÙÈÎÔ‡ ÛÙÚ˜, ÙÔ ̆ „ËÏfi Ú›ÛÎÔ Ô˘ ¤¯Ô˘Ó ÔȯڋÛÙ˜ Ô˘ÛÈÒÓ ÛÙËÓ ¤ÎıÂÛË Û ÙÚ·˘Ì·-ÙÈο ÁÂÁÔÓfiÙ· Î·È ÙËÓ ̆ „ËÏ‹ ¢·ÏˆÙfiÙËÙ·ÙˆÓ ¯ÚËÛÙÒÓ ÛÙË ‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘-Ì·ÙÈÎÔ‡ ÛÙÚ˜ ÌÂÙ¿ ·fi ÌÈ· ÙÚ·˘Ì·ÙÈ΋ÂÌÂÈÚ›· (Chilcoat & Breslau 1998). ™˘-ÁÎÚ›ÛÂȘ ÌÂٷ͇ ÙˆÓ ·ÙfiÌˆÓ ÌÂ Î·È ¯ˆÚ›˜‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ ¤‰ÂÈ-Í·Ó fiÙÈ Ù· ¿ÙÔÌ· Ì ‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘-Ì·ÙÈÎÔ‡ ÛÙÚ˜ ¤¯Ô˘Ó ÛËÌ·ÓÙÈο ˘„ËÏfi-ÙÂÚ· ÔÛÔÛÙ¿ ¤ÎıÂÛ˘ Û ÙÚ·˘Ì·ÙÈο ÁÂ-

ÁÔÓfiÙ·, ÌÈÎÚfiÙÂÚË ËÏÈΛ· ÚÒÙ˘ ›ıÂ-Û˘ - ¤ÎıÂÛ˘, ÈÔ ÛÔ‚·Ú‹ Û˘Ìو̷ÙÔ-ÏÔÁ›· Î·È „ËÏfiÙÂÚ· ÔÛÔÛÙ¿ Û˘Ìو̿-ÙˆÓ ÙÔ˘ ¿ÍÔÓ· I Î·È ¿ÍÔÓ· II ‰È·ÁÓÒÛˆÓ.T· ·ÔÙÂϤÛÌ·Ù· ‰Â›¯ÓÔ˘Ó ̆ „ËÏ‹ Û˘¯Ófi-ÙËÙ· Ù˘ ‰È·Ù·Ú·¯‹˜ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ÛÙÚ˜ ÌÂٷ͇ ÙˆÓ ÂÍ·ÚÙËÌ¤ÓˆÓ ·ÙfïÓÛÙËÓ ÎÔη˝ÓË. (Chilcoat & Breslau 1998).™Â ‰ÈÂıÓ‹ ‰Â›ÁÌ·Ù· Á˘Ó·ÈÎÒÓ ̄ ÚËÛÙÒÓ ÛÎÏË-ÚÒÓ Ó·ÚΈÙÈÎÒÓ (ÎÔη˝Ó˘) ÙÔ 66,7% ·Ó¿-ÊÂÚ ÂÌÂÈÚ›· ÔÏÔÎÏËڈ̤ÓÔ˘ ‚È·ÛÌÔ‡.(Kessler at al 1995).

∏ ·ÈÙÈÔÏÔÁÈ΋ ̆ fiıÂÛË ˆ˜ ÔÈ ̄ Ú‹ÛÙÂ˜Ô˘ÛÈÒÓ ¤¯Ô˘Ó ̆ „ËÏfi Ú›ÛÎÔ Û ¤ÎıÂÛË ÙÚ·˘-Ì·ÙÈÎÒÓ ÁÂÁÔÓfiÙˆÓ ‰ÂÓ ·Ô‰Â›¯ıËΠۤÚÂ˘Ó¿ ÙˆÓ Stewart et al (2004), ·˘Ù‹ ˤÚ¢ӷ ̆ ÔÛÙËÚ›˙ÂÈ ÙËÓ ̆ fiıÂÛË Ù˘ ·˘ÙÔ-›·Û˘ ·ÏÏ¿ ·Ú¤¯ÂÈ ÂÏ¿¯ÈÛÙ˜ ·Ô‰Â›ÍÂȘÒÛÙ ӷ ·ÔÙÂÏ› ÂÓ·ÏÏ·ÎÙÈ΋ Ô‰fi Û˘-Û¯¤ÙÈÛ˘ Ù˘ ‰È·Ù·Ú·¯‹˜ ÌÂÙ·ÙÚ·˘Ì·ÙÈ-ÎÔ‡ ÛÙÚ˜ Î·È ‰È·Ù·Ú·¯‹˜ Ô˘ÛÈÒÓ. ∏ ¤Ú¢ӷ·¤‰ÂÈÍ fiÙÈ ÔÈ ÙÚ·˘Ì·ÙÈΤ˜ ÂÌÂÈڛ˜ ÛÙËÓ·Ô˘Û›· Ù˘ ‰È·Ù·Ú·¯‹˜ ÌÂÙ·ÙÚ·˘Ì·ÙÈ-ÎÔ‡ ÛÙÚ˜ ‰ÂÓ Û¯ÂÙ›˙ÔÓÙ·Ó Ì ηٿ¯ÚËÛË‹ ÂÍ¿ÚÙËÛË Ô˘ÛÈÒÓ. ∂ÈϤˆÓ ÙÔ Â‡ÚËÌ·fiÙÈ ÔÈ ·ÌÂÚÈηÓÔ› ‚ÂÙÂÚ¿ÓÔÈ ÙÔ˘ µÈÂÙÓ¿Ì›¯·Ó Ù· ›‰È· ›‰· ÛÔ‚·ÚfiÙËÙ·˜ ‰È·-Ù·Ú·¯‹˜ ¯Ú‹Û˘ Ô˘ÛÈÒÓ Â›Ù ÂÎÙ¤ıËηÓ›Ù fi¯È Û ̿¯Ë (McFall et al 1990), ÂÓÈ-Û¯‡Ô˘Ó Ù· ÈÔ ¿Óˆ.

∏ ¤Ú¢ӷ Á‡Úˆ ·fi Ù· ÂÚÈ‚·ÏÏÔÓÙÈ-Τ˜ ÂÈÚÚÔ¤˜ Û˘Ì›ÙÔ˘Ó ÛÙË ‰È·Ù·Ú·¯‹ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜, ÛÙËÓ ÂÍ¿ÚÙËÛË·fi ÙÔ ·ÏÎÔfiÏ Î·È ÛÙËÓ ÂÍ¿ÚÙËÛË ·fi Ù·Ó·ÚΈÙÈο. º¿ÓËΠfiÙÈ ¤Ó· ÔÛÔÛÙfi 15,3%ÁÂÓÂÙÈÎÒÓ ÂÈÚÚÔÒÓ ‹Ù·Ó ÈηÓfi ÁÈ· ÙË ‰È·-Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜, ÙËÓ ÂÍ¿Ú-ÙËÛË ·fi ÙÔ ·ÏÎÔfiÏ Î·È ÙËÓ ÂÍ¿ÚÙËÛË ·fiÙ· Ó·ÚΈÙÈο Î·È ¤Ó· 20% ÁÂÓÂÙÈÎÒÓ ÂÈÚ-ÚÔÒÓ Û˘ÁÎÂÎÚÈ̤ӷ ÁÈ· ÙË ‰È·Ù·Ú·¯‹ ÌÂ-Ù·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜. EÈÚfiÛıÂÙ·, ηÈÁÈ· ÙȘ ÙÚ›˜ ‰È·Ù·Ú·¯¤˜ ˘¿Ú¯Ô˘Ó ͯˆ-ÚÈÛÙÔ› ÂÚÈ‚·ÏÏÔÓÙÈÎÔ› ·Ú¿ÁÔÓÙ˜, ÎÔÈ-ÓÔ› ·ÏÏ¿ Î·È Û˘ÁÎÂÎÚÈ̤ÓÔÈ ÁÈ· οı ʷÈ-ÓfiÙ˘Ô. ∏ ÂÍ¿ÚÙËÛË ·fi ÙÔ ·ÏÎÔfiÏ Î·È ËÂÍ¿ÚÙËÛË ·fi Ù· Ó·ÚΈÙÈο ¤¯Ô˘Ó ͯˆ-ÚÈÛÙ¿ ·ÈÙÈÔÏÔÁÈο ÛÙÔȯ›· ·ÏÏ¿ Î·È ÎÔÈÓ¤˜ÛËÌ·ÓÙÈΤ˜ ÁÂÓÂÙÈΤ˜ Î·È ÂÚÈ‚·ÏÏÔÓÙÈΤ˜Û˘ÓÂÈÛÊÔÚ¤˜. ( Xian et al 2000).

∞ÎfiÌË Ì›· ·Ú¿ÌÂÙÚÔ˜ Ô˘ ¤¯ÂÈ ÌÂÏÂ-ÙËı› Â›Ó·È Ë Û¯¤ÛË ÛÔ‚·ÚfiÙËÙ·˜ ηٿ-

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¯ÚËÛ˘ Ô˘ÛÈÒÓ Ì ÙÔ ÙÚ·‡Ì· Î·È ÙË ‰È·-Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ fiÔ˘ Ê¿-ÓËΠfiÙÈ ÙÔ ‚›·ÈÔ ÙÚ·‡Ì· Î·È Ë „˘¯ÔÏÔÁÈ΋‰˘ÛÊÔÚ›· ÛÙË ˙ˆ‹ ÙˆÓ ¯ÚËÛÙÒÓ Ô˘ÛÈÒÓÛ¯ÂÙ›˙ÂÙ·È Ì ÙË ÛÔ‚·ÚfiÙËÙ· Ù˘ ÂÍ¿ÚÙË-Û˘ ·fi Ô˘Û›Â˜. H ÂÌÊ¿ÓÈÛË Û˘Ìو̿-ÙˆÓ PTSD, ·ÚÔ˘ÛÈ¿˙ÂÈ ÈÛ¯˘Ú‹ Û˘Û¯¤ÙÈÛËÌ ÙË ÛÔ‚·ÚfiÙËÙ· Ù˘ ¯Ú‹Û˘ Ô˘ÛÈÒÓ. HÛ¯¤ÛË ·˘Ù‹ ‰Â›¯ÓÂÈ fiÙÈ Ë „˘¯ÔÏÔÁÈ΋ ‰˘-ÛÊÔÚ›· ÏfiÁˆ ÙÚ·‡Ì·ÙÔ˜ ÌÔÚ› Ó· ›ӷȷڿÁÔÓÙ·˜ ÁÈ· ÛÔ‚·Ú‹ ¯Ú‹ÛË Ô˘ÛÈÒÓ.(Clark et al 2001). ∏ ¯ÚfiÓÈ· ¯Ú‹ÛË Ô˘ÛÈÒÓÌÂÈÒÓÂÈ ÙȘ ·ÚÓËÙÈΤ˜ Û˘Ó·ÈÛıËÌ·ÙÈΤ˜ ·ÓÙÈ-‰Ú¿ÛÂȘ Ô˘ Û˘Ó‰¤ÔÓÙ·È Ì ÙÔ ÙÚ·‡Ì· ·˘-Í¿ÓÔÓÙ·˜ ÙȘ Èı·ÓfiÙËÙ˜ ÁÈ· ÌÂÏÏÔÓÙÈ΋¯Ú‹ÛË Ô˘ÛÈÒÓ. H ÌË ·ÓÙÈÌÂÙÒÈÛË ÙÔ˘ Û˘Ó-‰ÚfiÌÔ˘ ÌÔÚ› Ó· ·˘Í‹ÛÂÈ ÙË ÛÔ‚·ÚfiÙËÙ·Ù˘ ̄ Ú‹Û˘ Ì ÙËÓ ¿ÚÔ‰Ô ÙÔ˘ ̄ ÚfiÓÔ˘ ηÈÓ· Ô‰ËÁ‹ÛÂÈ Û ¯ÂÈÚfiÙÂÚ· ·ÔÙÂϤÛÌ·Ù·ıÂڷ›·˜ ÁÈ· ̄ Ú‹ÛË Ô˘ÛÈÒÓ (Ouimette etal 1998,).

™˘ÌÂÚ¿ÛÌ·Ù·∏ ÌÂϤÙË ·˘Ù‹ Û¯ÂÙ›˙ÂÙ·È ¿ÌÂÛ· Ì ÙËÓ

ηٷÏÏËÏfiÙËÙ· Î·È ÙËÓ ·ÔÙÂÏÂÛÌ·ÙÈÎfi-ÙËÙ· ÙˆÓ ıÂڷ¢ÙÈÎÒÓ ÚÔÁÚ·ÌÌ¿ÙˆÓ ÁÈ·¿ÙÔÌ· Ì ÂÍ¿ÚÙËÛË ·fi „˘¯Ô‰Ú·ÛÙÈΤ˜Ô˘Û›Â˜ .

∏ ˘fiıÂÛË fiÙÈ Ù· ¿ÙÔÌ· Ì ‰È·Ù·Ú·¯‹ÂÍ¿ÚÙËÛ˘ ·fi „˘¯Ô‰Ú·ÛÙÈΤ˜ Ô˘Û›Â˜ ηÈÛ˘ÓÔ‰‹ ‰È·Ù·Ú·¯‹ ÌÂÙ·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜‰ÂÓ ¤¯Ô˘Ó „ËÏfi ‰Â›ÎÙË ÂÈÙ˘¯›·˜ ÛÙËÓ ıÂ-ڷ¢ÙÈ΋ ÔÚ›·, Èı·ÓfiÓ Ó· Û¯ÂÙ›˙ÂÙ·È

Î·È Ì ÙÔ fiÙÈ Ù· ÚÔÁÚ¿ÌÌ·Ù· Ô˘ ÙÔ˘˜·Ú¤¯ÔÓÙ·È ‰ÂÓ Â›Ó·È Î·Ù¿ÏÏËÏ· ÁÈ· ·˘-ÙÔ‡˜. ∞Ó Ë ̆ fiıÂÛË ·˘Ù‹ Â›Ó·È ÛˆÛÙ‹ ÙfiÙÂÛÙ· ¿ÙÔÌ· ·˘Ù¿ ı· Ú¤ÂÈ Ó· ·Ú¤¯ÔÓÙ·ÈÚÔÁÚ¿ÌÌ·Ù· ۯ‰ȷṲ̂ӷ ¤ÙÛÈ Ô˘ Ó··ÓÙÈÌÂÙˆ›˙Ô˘Ó Î·È ÙȘ ‰‡Ô ‰È·Ù·Ú·¯¤˜.

∏ ¡ÔÛËÏ¢ÙÈ΋ ˆ˜ ÂÈÛÙ‹ÌË Î·È ÔÈ ¡Ô-ÛËÏÂ˘Ù¤˜ ̂ ˜ ·ÁÁÂÏ̷ٛ˜, ÂȉÂÈÎÓ‡Ô˘ÓÌÂÁ¿ÏÔ ÂӉȷʤÚÔÓ ÁÈ· ÙËÓ ·ÔÙÂÏÂÛÌ·-ÙÈÎfiÙËÙ· ÙˆÓ ıÂڷ¢ÙÈÎÒÓ ÚÔÁÚ·ÌÌ¿-ÙˆÓ Ô˘ ·Ú¤¯Ô˘Ó ÛÙÔ˘˜ ıÂڷ¢Ô̤ÓÔ˘˜.™ÙÔÓ ÙÔ̤· ÙˆÓ ÙÔÍÈÎÔÂÍ·ÚÙ‹ÛÂˆÓ Â›Ó·È‚·ÛÈÎfi, fiˆ˜ Î·È Û fiÏÔ˘˜ ÙÔ˘˜ ÙÔÌ›˜, ÔıÂڷ¢fiÌÂÓÔ˜ Ó· Ï·Ì‚¿ÓÂÈ ÙËÓ Î·Ï‡ÙÂÚˉ˘Ó·Ù‹ ÊÚÔÓÙ›‰·, ÙÔ Î·Ù·ÏÏËÏfiÙÂÚÔ ‰Ë-Ï·‰‹ ıÂڷ¢ÙÈÎfi ÚfiÁÚ·ÌÌ· ÁÈ· ·˘-ÙfiÓ.∂›Ó·È ÊÈÏÔÛÔÊ›· Ù˘ ¡ÔÛËÏ¢ÙÈ΋˜ ∂È-ÛÙ‹Ì˘ Ë ÂÛÙ›·ÛË ÛÙÔÓ ¿ÓıÚˆÔ Î·È ÛÙȘ·Ó¿ÁΘ ÙÔ˘. ∂›Ó·È ›Û˘ ·Ú¯‹ Ù˘ ¡Ô-ÛËÏ¢ÙÈ΋˜ ∂ÈÛÙ‹Ì˘ Ë Î·Ï‡ÙÂÚË ‰˘Ó·Ù‹ÊÚÔÓÙ›‰· ÁÈ· οı ¿ÓıÚˆÔ. ™ÙËÓ ÂÚ›-ÙˆÛË ·˘Ù‹ "ÊÚÔÓÙ›‰·" Â›Ó·È Ë ÛˆÛÙ‹ ·ÍÈÔ-ÏfiÁËÛË ÙÔ˘ ·ÙfiÌÔ˘ ÁÈ· ÙËÓ Èı·ÓfiÙËÙ·‡·Ú͢ Û˘ÓÓÔÛËÚfiÙËÙ·˜, ÁÂÁÔÓfi˜ Ô˘ı· Û˘Ì‚¿ÏÂÈ ÛÙËÓ ·ÚÔ¯‹ ÙÔ˘ ηٿÏÏË-ÏÔ˘ ıÂڷ¢ÙÈÎfi ÚÔÁÚ¿ÌÌ·ÙÔ˜

∂ÈÚfiÛıÂÙ·, ÂÂȉ‹ Ë ‰È·Ù·Ú·¯‹ ÌÂ-Ù·ÙÚ·˘Ì·ÙÈÎÔ‡ ÛÙÚ˜ Â›Ó·È ÌÈ· ‰È·Ù·Ú·¯‹Ë ÔÔ›· Û˘¯Ó¿ ·Ú·Ì¤ÓÂÈ ·‰È¿ÁÓˆÛÙË Î·È‰ËÌÈÔ˘ÚÁ› ÛÔ‚·Ú¤˜ ‰˘ÛÎÔϛ˜ ÛÙ· ¿ÙÔÌ·,ÚÔÙ›ÓÂÙ·È Ó· ‰ÈÂÚ¢ÓËı› ÂÚÈÛÛfiÙÂÚÔÙÔ ı¤Ì· ·˘Ùfi ÛÙ· ΢Úȷο ‰Â‰Ô̤ӷ.

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