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cseyg;gpupT fy;Kid cseyr; rq;fk;>

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Navithanvelly ADP

csr; Nrhu;T / kdr;Nrhu;T Neha; ( )

fLikahd kdr;Nrhu;T Nehapdhy; ghjpf;fg;gl;lu;fis ePqfs; ; fz;bUg;gPu;fs;. kdr;Nrhu;T kpfg;; gutyhf fhzg;gLk; xU Kf;fpa cs Neha; MFk;. ,J rpy Ntis jw;nfhiyf;Fk; ,l;Lr;nry;Yk;. kdr;Nrhu;tpd; FzFwpfs; nghJthfg; gy;NtW tpjkhd ,ayhikfsha; ntspg; g Lj; j g; g Lfpd; w d. cjhuzkhf gbf;f,ayhik> Ntiy nra;a ,ayhik> ; tpisahl ,ayhik Nghd;wtw;iwf; Fwpg;gplyhk;. md;Gf;Fupa FLk;g cWg;gpdu; my;yJ ez;gu; xUtupd; ,og;G (,otpuf;fk;)> tPL> thry; kw;Wk; nrhj;J ,og;Gf;fs;> fLk; tWik> Ntjid jUfpd;w my;yJ MAl;fhyj;ij Fiwf;fpd;w ehl;gl;l Nkhrkhd Neha;fs;> vjpu;ghu;g;Gfs; epiwNtwhik Nghd;wd kdr;Nrhu;Tf;Fupa kpfg; nghJthd fhuzq; f shFk; . ,ij tpl xUtu; jdJ nrhe; j r%jhaj;jpNyNa kjpg;gpof;ff;$ba my;yJ kw;wtu;fshy; fPoepiyapy; ghu;ffg;glf;$ba epiyikfshd Ntz;lj;jfhj ; ; fu;g;gk;> FLk;gg; gpupT my;yJ tpthfuj;J> Ntiyia ,oj;jy;> Ntiyahy; epw;ghl;lg;gLjy; Nghd;wdTk; kdr; Nrhu; T f; F fhuzkhfyhk; . ,tw; i w tpl gaj; i jAk; > csg;ghjpg;igAk; Vw;gLj;jf;$ba epfo;Tfshd fw;gopg;G>nfhs;is> Ml;flj;jy; Nghd;wdTk; kdr; Nrhu;it Vw;gLj;Jk;. ,Ue;jNghJk;> rpy kdr; Nrhu;T Nehahspfsp;y; mij Vw;gLj;jpapUf;ff;$ba ve;j tpjkhd fhuzq;fisAk; fz;Lgpbf;f ,ayhJ ,Uf;Fk;. ,tu;fspy; kdr;Nrhu;T NehahdJ xUtpjkhd Gwf;fhuzpfSkpd;wp jhdhfNt Vw;gl;bUf;Fk;. rhjhuzkhf xUtUf;F VjhtJ Xu; ,og;G Vw;gl;lhy; mtu; rpwpJ fhyk; ftiyg;gl;Ltpl;L> gpd;G jhdhfNt
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mjpypUe;J kPz;L tpLthu;. mtu; kdr; Nrhu;T Nehahy; ghjpg;GWtjpy;iy. Mdhy; kdr; Nrhu;T Neha; Vw;gl;l xUtu; fpoikf; f zf; f hf> khjf; f zf; f hf kpfTk; ftiyahf ,Ug;ghu;. tho;f;ifapy; vJTNk cjtg;Nghtjpy;iy vd;w tpuf;jpapy; ,Ug;ghu;. nghJthf mtu; jdf;F Njitg;gLk; cjtpfisg; ngw;Wf;nfhs;s Kaw;rpf;f khl;lhu;. vJTNk jdJ epyikia khw;wg; Nghtjpy;iy vd;Nwh> jhd; ,tw;Wf;nfy;yhk; yhaf;fpy;iy vd;Nwh mtu; vz;Zthu;.

kdr; Nrhu;tpd; nghJthd Fzq;Fwpfshtd

ftiyapy; %o;fpapUj;jy;> Nrhfj;jpy; Mo;e;jpUj;jy;. ,yFtpy; mOjy; mbffb mo Ntz; L k; Nghyj; Njhd;Wjy;; njhlu;r;rpahf Nahrpj;jgb ,Uj;jy;(Nahrid) vjpu;fhyj;jpy; ek;gpf;ifap;d;ik (tpuf;jp) jho;T kdg;ghd;ik> jd;dk;gpf;iff; FiwT tho;f;ifapy; re;Njh\kpd;ik (ntWg;G - xd;Wf;Fk; tpUg;gkpy;iy) cjtpaw;wepiy (ifaW epiy) jhd; gpuNahrdkw; w tu; vd; w epidg; G (xd; W f; F k; cjthky; Nghd epiy> kw;wtu;fSf;Fr; Rikahf ,Uj;jy;;.) jdf;Fj;jhNd jPq;F nra;Ak; kdepiy. 4

 ,wg;G gw;wpa> jw;nfhiy gw;wpa vz;zq;fs; (,Ue;;njd;d gpuNahrdk;) epj;jpiu Fog;gk;> epj;jpiuapd;ik grpapd;ik cly; nkypT ghYwtpy; ehl;lkpd;ik ,yFtpy; fisg;giljy;> gytPdkhf ,Uj;jy; (,ayhik) fUj;J}d;wy;> Qhgfrf;jp> vd;gtw;wpy; FiwghL (kwjpf;Fzk;) jiyapb> neQ;R Neh> iffhy; cisT> clk;G KOtJk; vupjy; Nghy czUjy; Nghd;w ehl;gl;l nka;g;ghl;L Kiwg;ghLfs;

FwpgG ;
kdr; N rhu; T NehAilatu; f s; gytpjkhd cly; Kiwg;ghLfisf; $Wtu;. ,e;j Kiwg;ghLfs; mNdfkhd re; j u; g ; g q; f sp y ; > mtu; f sJ kdNeha; fhuzkhfNt Vw;gLfpd;wd vd;gij kwe;Jtpl Ntz;lhk;. 53 taJila mk;gythzUf;F Xu; MW khj fhykhf> mtUila nfhd;whf;w; njhopypy; fLk; Nghl;bAk; gpur;ridAk; Vw;glj; njhlq;fpw;W. Muk;gj;jpy; ,tw;iwr; rkhspj;J te;j mtu;> gpwF gbg;gbahfr; Nrhu;e;J Nghfj; Njhlq; f pdhu; . mtUf; F epj; j piu tutpy; i y grpnaLf; f tpy; i y> tho;f;ifapy; ,Ue;j xU gpbg;Gk; ,y;yhky; NghdJ. Nahrpj;Jf;nfhz;Lk;> ftiyg;gl;Lf;nfhz;Lk; ,Ue;jhu;. 5

rpy Ntisfspy; mtiu mwpahkNyNa mOif mOifahf te;jJ. ,dp vd;d nra;ag; Nghwd;? vd;W jpUk;gj; jpUk;g Nahrpj;jhu;. rpy Ntisfspy; tha;fFs; ; ; K ZKZg; g hu; . vjpu; f hyk; ek; g pf; i faw; w jhAk; > ,Us; k akhdjhAk; ,Ue; j J kdjpy; xU gak; Vw;gl;lgbNa ,Ue;jJ ehsiltpy; mtUf;F jiy tpiwg;G> fz; vupT>if fhy; Fj;JisT vdg; gy mwpFwpfs; N jhd; w pd. jd; D ila Nfhyj; j pYk; > cilfspYk; ftdk; Fiwe;jJ. ehq;fs; mtiu Kjypy; ghu;jjNghJ> mtu; fiye;j ; jiyAlDk;> RUf;fk; epiwe;j new;wpAlDk;> rtuk; nra;hj Kfj;JlDk;> mOf;fhd MilfSlDk; ,Ue;jhu;. fijf;f tpUg;gkpy;yhky;> vjw;Nfh gae;jgb> Nahrpj;jgb ,Ue;jhu;.(fg;gy; fTz;l khjpup) mtuJ tUj;jj;jpd; fLik fhuzkhf mtu; tpLjpapy; mDkjpf;fg;gl;lhu;. kpff;Fiwthd mstpy; kUe;Jfs; nfhLf;fg;gl;ld. Mjuthd cstdj;JizAk;> rhe;jtopKiwg; gapw;rpfSk; Muk;gpf;fg;gl;ld. xU fpoikf;Fs;shfNt mtuJ kdepiyapy; khw;wk; Vw;glj; njhlq;fpw;W. mtu; gioa epiyikf;F thwhu; vd;W kidtp re;Njh\g;gl;lhu;.

kdr; Nrhu;Tila xUtiu vt;thW milahsk; fhzyhk; ?

mtuplk; kdr;Nrhu;Tf;Fupa Fzq;Fwpfs; ,Uf;fp;d;wdth vd;gijf; fz;Lgpbf;fTk;. mit vt;tsT fhykhf ,Uf;fpd;wd? mit mtUila ehshe;j tho;f;ifapy; (tPl;by;> Ntiyapy;> gbg;gpy;) ghjpg;ig Vw;gLj;Jfpd;wdth? xU tUthiaj; Njl Kbahky; nra;fpd;wdth? vd;gjid NehahspaplKk; mtuJ FLk;g cWg;gpdu;fsplKk; tprhupj;Jf;nfhs;sTk;. ve;j epfo;Tfspd; jhf;fj;jpdhy; mtUf;F kdr;Nrhu;T 6

Vw;gl;bUf;fyhk; vd;gjid NehahspaplKk; mtuJ FLk;gj;jpduplKk; tprhupj;J mwpaTk;. kdr; Nrhu;T NehAila rpyu; jhq;fs; ftiyaha; ,Ug;gijNah ek;gpf;ifaw;W ,Ug;gijNah kWf;ff;$Lk;. mtu;fs; vd;d ele;j NghJk;> jq;fs; kdk; ed;whfNt ,Ug;gjhfNt $wpf; nfhs;thu;fs;.mtu;fs; ngUk;ghYk; cly; rhu;ej Kiwg;ghLfisNa (nkag;ghL) $Wthu;fs;. ; kdr;Nrhu;Tila NtW rpyu; Nehapd; fLikapdhy; vJTk; fijf;fhky;> xd;wpuz;L Kiwg;ghLfisf; $WtJld; epd;WtpLtu;.,tu;fs; cz;ikapNyNa jq;fisj; jhq;fNs mopj;Jf;nfhs;Sk; mstpw;F Mgj;Jkpf;ftu;fs;.

NehahspAldhd Kjw; re;jpw;gpd; NghNj> mtu; jw;nfhiy nra;Ak; vz;zj;jpy; ,Uf;fpwhuh? vd;gij fz;lwpaTk;.

mtuplk; gpdtUkhW tpdtyhk; ;

1 ,dp thOwjpiy gpuNahrdkpy;iy vd;W epidf;fpwPu;fsh? 2. ,g;gb ,Uf;fpwij tplr; rhfyhk; vz;L tpUk;GwPq;fsh? 3. VjhtJ nra;J nrj;Jg;Nghdhy; ey;yJ vz;L Nahrpf;fpwPq;fsh? 4. mg;gpb VjhtJ jpl;lq;fs; ,Uf;fh? 5. Ke;jp mg;gpb VNjDk; nra;J ghu;j;jdPq;fsh? Kd;G nra;J nfhz;l jw;nfhiy Kaw;rpiag;gw;wpf; Nfl;lwpaTk;. (,J> ,dp tUq;fhyj;jpy; mtu; jw;nfhiy nra;af;$ba rhj;jpaf;$Wfis vjpu;T $WtJld;> mtu; vt;thwhd Kaw;rpfspy; <Lglf;$Lk; vd;fpd;w xU fzpg;igAk; cq;fSf;F jUk;).
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fLk; kdr; Nrhu;TilNahu; cz;ikahd J}z;Ljy;fs; ,y;yhkNyNa ghu;j;jy;> Nfl;ly;> kzj;jy; Nghd;w GyDzu;Tfis mDgtpf;fyhk;. ,tw;iw khag;GyZzu;Tfs;(Hallucinations) vd miog;Nghk;. ,jid cWjp nra;tjw;fhfg; gpd;tUkhW Nfl;fyhk;.

rpy Ntisfspy; xUtUk; ,y;yhJ ,Uf;Nff;if> MNuh cq;fNshil fijf;fpw khjpup (Fuy;fs;) Nff; f pwjh? ,g;gbahd Fuy;fisf; Nfl;Fk; xUtuplk;> me;jf;Fuy;fs; mtiuj; jw;nfhiy nra;Ak;gb $Wfpd;wdth vdf; Nfl;fTk;. mg;gb ,Ue;jhy;> ;cq;fisj; jw;nfhiy nra;ar; nrhy;Yw me;jf; Fuy;fspd; fl;lisfis cq;fshy; vjpu;f;f Kbfpwjh? vd;W Nfl;fTk;. kdr;Nrhu;Tila rpyu; ,wg;Gld; njhlu;Gila vz;zq;fshy; Fog;gkile;J ,Ug;ghu;fs;. cjhuzkhf> mtu;fs; ,we;jtu;fis fdtpy; fhzyhk;. gpNujthil tPRtJ Nghy czuyhk; my;yJ jq;fsJ clk;G gbg;gbahf mope;J NghtJ Nghy czuyhk;. vq;fs; FLk;gj;jpdJ vy;yh tpjkhd Jujp\;uq;fSf;Fk; ehq;fNs nghWg;G> vq;fs; gps;isfSf;F VNjh elf;fg; NghfpwJ> ehq;fs; ngupa gpio tpl;L tpl;Nlhk;. Nghd;w jtwhd> Mdhy; cWjpAld; Ngzg;gLfpd;w Nghyp ek;gpf;iffis(Delusions) rpy kdr; Nrhu;T NehAilatu;fspy; mtjhdpf;fyhk;. ,t; tifgl;l jtwhd ek;gpf;iffis mtu; nfhz;bUf;fpwhuh vd;gijg;gw;wp> mtu;fsJ FLk;g cWg;gpdu;fisf; Nfl;fTk;. rpy Ntisfspy; ,t;thwhd Nghyp ek;gpf;iffs; mtuJ cly; rk;ke;jkhdjhfTk; ,Uf;fyhk;. 8

cjhuzkhfj; jdf;Fg; Gw;W Neha; te;Jtpl;lJ vd;W ve;jtpj MjhuKk; ,d;wp mtu; ek;gyhk;. Nehahsu;fsplk; khag; GyDzu;tfs;> Nghyp ek;gpf;iffs; vd;gd NkNyhq;fpf; fhzg;gLkplj;J> mtu;fs; cskha Neha;f;Fl;gl;bUf;ff;$ba rhjpjpaf;$Wfs; ,Uf;fpd;wd vd;gijAk; kwe;JtplyhfhJ . rpy Ntisfspy; cskha Neha;fs; kdr; Nrhu;tpd; mwpFwpfSlDk; njhlq;ff;$Lk;;. khwhf ,tu;fs; cskha kdr;Nrhu;T vd miof;fg;gLk;. fLikahd> mtrukhfr; rpfpr;iraspf;fg;glNtz;ba cs Nehapdhy; ghjpg;Gw;Wk; ,Uf;fyhk;. ,t;thwhd epiyfspy; cs kUj;Jt cjtpia cldbahf ehLtJ ed;W.

vt;thW cjtyhk;?

jw; nfhiy nra; Ak; vz;zk; cilatu;fSf; F vt;thW cjtyhk; ? ePq;fs; re;jpf;fpd;w me;j egu; jw;nfhiy nra;af;$batuh vd;W Muha;e;J ghu;f;fTk;. fPo; tUk; tplaq;fspy; VjhtJ xd;W my;yJ gy mtupy; ,Uf;fpd;wjh vdf; fz;lwpaTk;. mg;gb VjhtJ ,Uf;fk; gl;rj;jpy; mtu; jw;nfhiy nra;af;$ba mghak; mjpfsT ,Uf;fpd;wJ vdf; nfhs;syhk;. xUtu; Vw;fdNt jw;nfhiy Kaw;rp xd;wpy; <LglbUe;jhy;> mk;Kaw;rp vt;tsT ghuJ}ukhdjhf ,Ue;jJ vd;W fzpg;gplTk;> Nkw;$wpa tplaq;fspd;

njhFg;igghtpj;J> mtu; ,d;dKk; jw;nfhiy Gupaf;$ba Mgj;jpy; ,Uf;fpwhuh vd;W kjpg;gplTk;.

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jw; n fhiy nra; a f; $ ba mgha mwpFwpfs; kpf mjpfsthd tpuf;jpNahbUj;jy;. jq;fSila ,wg;Gg; gw;wp NeubahfNth> kiwKfkhNth fijj;jy; my;yJ vOJjy;. jw;nfhiy Neuj;jpw;fhf eQ;R> kUe;Jf;Fspirfs;> myup tpijfs; Nghd;wtw;iw itj;jpUj;jy; my;yJ mit ,yFtpy; fpilf;ff;$ba toptiffisg;gw;wpr; rpe;jpj;jy;. Kd;G jw;nfhiy Kaw;rpapy; <Lgl;bUj;jy;. mtu;fSila FLk;g cWg;gpdu;fs; ahuhtJ jw;nfhiy nra;J ,we;jpUj;jy;. ehl;gl;l my;yJ me;jpk fhy Neha; xd;wpdhy; gPbf;fg;gl;bUj;jy;. mtiuj; jLf;fNth> ghJfhf;fNth xUtUk; ,y;yhj xU jdpikahd #o;epiyapypUj;jy;. kJ. Nghijt];J Nghd;wtw;iwg; ghtpj;jy;. cz;ikahf xd;Wk; ,y;yhj NghNj Nfl;ly;> ghu;j;jy;> kzj;jy; Nghd;wd ,Ug;gjhff; $wy; (khag; GyDzu;Tfs;) jq;fs; FLk;g cWg;gpdu;fisNah> jq;fisNah nfhy;yf;$ba tpupthd jpl;lj;ij itj;jpUj;jy;. jw;nfhiy nra;af;$batu;fs; vd;W ePq;fs; ahiuahtJ fUjpdhy;> mtu; ,dp mt;thW nra;akhl;lhu; vd;w xU ek;gpf;if cq;fSf;F tUk; tiuf;Fk; mtuJ tPl;bNyh my; y J nghJthd Xu; ,lj; j pNyh itj; J mtiu mtjhdpj;jy; mtrpak;. mtuJ FLk;gcWg;gpdu;fs;> ez;gu;fs; Nghd;Nwhupd; JizNahL mtiu mtjhdpf;fTk;. mtUf;F ngUk;ghYk; itj;jpa rpfpr;ir 10

Njitg;gLk;. ePq;fs; mtUf;F cstsj;Jiz mspf;fj; njhlq;fyhk;. ,g;gbahdtu;fis> ,ad;wsT tpiuthf mtu;fs; Kd;du; ghu;jJ te;j njhopy;JiwfSf;Nfh my;yJ gbg;gtuhapd; ; ghlrhiyf;Nfh Ngha;> jq;fs; jq;fs; fUkq;fspy; <Lglr; nra;tJ ey;yJ.mtu;fs; kdr;Nrhu;T Nehapd; jhf; f j; j pdhy; j hd; ,g; g b ,Uf; f pwhu; f s; vd; W k; > me;NehapypUe;J kPz;lJk; mtu;fs; gioa epyikf;F jpUk;gp tpLthu;fs; vd;Wk; mtu;fSf;Fk;> mtu;fsJ FLk;gj;jpdUf;Fk; ek;gpf;ifA+l;lTk;. rpj;jputij> fw;gopg;Gg; Nghd;wtw;wpw;F Mshdtu;fs; ,yFtpy; kdr; Nrhu;tile;J> jw;nfhiy nra;J nfhs;syhk;. mJ Nghy Gw;W Neha;> vapl;]; Nghd;w khw;w Kbahj Neha;fs; Vw;gl;l xUtUk; ,yFtpy; ek;gpf;ifapoe;J jw;nfhiy nra;Ak; epyikf;F te;J tplyhk;. ,g;gbahd epyikfspy;> mtiu Xu; mDgtkpf;f cstsj; JizahsUld; njhlu;GgLj;Tk;. mj;Jld; mtUf;Fj; Njitahd FLk;g> r%jha MjuitAk; jpul;bf;nfhLf;fyhk;

kUj;Jtkw;w rpfprirfs; ;
1) csts MNyhrid (Councelling) 2) gpur;ridia fz;lwpe;J jPu;j;jy; (Problem Solving) 3) tho;fifj; jpwd; (life skills) gapw;rpfs; ; 4) rhu;e;j topKiwfs;.(Relaxation) 5) ehshe;j nraw;ghLfis xOq;FgLj;jy;.(Daily Routine)

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kUj;Jt rpfpr;ir
Nehahspiar; Nrhjpj;Jg; ghu;jJr; rpfpr;iraspf;ff;$ba xU ; itj;jpau; ,Ue;jhy;> Nehahspf;F(Imipramine Amitriptyline) my;yJ ,it Nghd;w kdr; Nrhu;tpw;F vjpuhd xU kUe;ijf; nfhLf;fyhk;. kUe;Jfis xU ehisf;Fg; gLf;iff;Fg; Nghf Kjy;> 25mg vd;w mstpypUe;J njhlq;fp> Njit Vw;gbd; Xupuz;L fpoikfspy; gbg;gbahf 100mg tuuapYk; $l;lyhk;. tha; cyu;jy;> ghu;it Fiwjy;> jiy Rw;Wjy; Nghd;wgf;f tpisTfs; ,Uf;fpd;wdth vd;gjid mtjhdpj;Jf;nfhs;sTk;. ,Uja Neha;fs; (gupNrhjidapd; NghJ xOq;fw;w ehbj;Jbg;Gfs;> Nkyjpf ,Uja xypfs; Nghd;wd mtjhdpf;fg;gLk;> fhf;if typg;G> Kd;dPu;r; Rug;gp tPf;fk; (Prostatic Enlargement)> fz;fspy; cau; mKf;fk; (Glaucoma) Nghd;wNeha;fs; ,U;f;Fkhdhy;> Nkw;$wg;gl;l kUe;Jfis vf;fhuzk; nfhz;Lk; nfhLf;f Ntz;lhk;. khwhf Fluoxentine Nghd;w kUe;JfisAk; ghtpf;fyhk;. Fluoxetine Mapd; xU ehisf;F 20mg vd;w mstpy;> fhiyapy; rhg;ghl;bw;Fg; gpwF ghtpf;Fk; gb mwpTWj;jyhk;. ,e;j tifahd Gjpa kUe;Jfspy; fhf;if typg;igj; jtpu Nkw;Fwpg;gpl;l Vida gf;f tpisTfs; Vw;glkhl;lhJ. cskha mwpFwpfs; njd;gLfpd;w nghOJ> kdr; Nrhu;Tf;F vjpuhd kUe;JfSld; Olanzapine, Risperidone Nghd;w kUe;JfisAk; Nru;j;Jg; ghtpf;fNtz;b tuyhk;. kUe;Jfs; %yKk;> cstsj;Jiz %yKk; Fzkilahj kdr; Nrhu;T Neha;fs; VjhtJ cly; Neha; xd;wpd; ntspg;ghlhf ,Uf;fyhk;. ,g;gb Fzkilahj xU Nehahspia xU tpN\l epGzUf;Ff; fhl;lNtz;baJ mtrpakhdJ vd;gjid epidtpy; itj;jpUf;fTk;.

ed;wp : jkpo; rKjhaj;jpy; cseyk;

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