amakuru

Indwara y'akababaro igihe kirekire ni syndrome de stress nyuma y'urupfu rw'uwo ukunda, aho umuntu yumva afite intimba, akababaro gakomeye igihe kirekire kuruta uko byari byitezwe n'imigenzo, umuco, cyangwa idini. Abantu bagera kuri 3 kugeza ku 10 ku ijana bafite uburibwe bwigihe kirekire nyuma yurupfu rusanzwe rwumuntu ukunda, ariko indwara iba nyinshi iyo umwana cyangwa uwo bashakanye apfuye, cyangwa iyo uwo ukunda apfuye muburyo butunguranye. Kwiheba, guhangayika hamwe n’ihungabana nyuma y’ihungabana bigomba gusuzumwa mu isuzuma ry’amavuriro. Ibimenyetso bishingiye ku mitekerereze ya psychotherapi yumubabaro nubuvuzi bwibanze. Ikigamijwe ni ugufasha abarwayi kwemera ko ababo bagiye burundu, kubaho ubuzima bufite intego kandi bushimishije nta nyakwigendera, no gusenya buhoro buhoro ibyo bibuka kuri nyakwigendera.

Urubanza
Umugore wapfakaye w'imyaka 55 yasuye umuganga we nyuma y'amezi 18 umugabo we apfuye umutima utunguranye. Mu gihe umugabo we apfuye, agahinda ke ntikagabanutse na gato. Ntiyashoboraga kureka gutekereza ku mugabo we kandi ntashobora kwizera ko yagiye. Ndetse n'igihe aherutse kwishimira umukobwa we arangije kaminuza, irungu no kwifuza umugabo we ntibyashize. Yahagaritse gusabana nabandi bashakanye kuko byamubabaje cyane kwibuka ko umugabo we atakiri hafi. Yararize asinzira buri joro, atekereza kenshi ku buryo yagombye kuba yarabonye urupfu rwe, n'uburyo yifuzaga ko yapfuye. Yari afite amateka ya diyabete no kurwara inshuro ebyiri zo kwiheba. Isuzumabumenyi ryakozwe ryerekanye ko kwiyongera k'urwego rw'isukari mu maraso no kwiyongera ibiro 4.5 kg (10lb). Nigute akababaro k'umurwayi kagomba gusuzumwa no kuvurwa?

Ikibazo cyamavuriro
Abaganga bavura abarwayi bafite agahinda bafite amahirwe yo gufasha, ariko akenshi bananiwe kuyifata. Bamwe muri aba barwayi bafite ikibazo cy'akababaro igihe kirekire. Agahinda kabo karakwirakwira kandi karakomeye, kandi kumara igihe kirekire kuruta abantu benshi bapfushije ubusanzwe batangira gusubira mubuzima kandi intimba irashira. Abantu bafite ikibazo cyigihe kirekire bafite akababaro barashobora kwerekana ububabare bukabije bwamarangamutima bujyanye nurupfu rwumukunzi wawe, kandi bakagira ikibazo cyo gutekereza ibisobanuro byose bizaza nyuma yuko umuntu yagiye. Bashobora guhura nibibazo mubuzima bwa buri munsi kandi barashobora kugira ibitekerezo byo kwiyahura cyangwa imyitwarire. Abantu bamwe bizera ko urupfu rwumuntu uri hafi yabo bivuze ko ubuzima bwabo bwarangiye, kandi hari bike bashobora kubikoraho. Bashobora kwinangira ubwabo bakibwira ko bagomba guhisha akababaro kabo. Inshuti n'umuryango nabo barababara kuko umurwayi yatekereje kuri nyakwigendera gusa kandi akaba adashishikajwe cyane nubusabane nibikorwa, kandi barashobora kubwira umurwayi "kubyibagirwa" bagakomeza.
Indwara y'akababaro igihe kirekire ni isuzuma rishya, kandi amakuru ajyanye n'ibimenyetso byayo no kuyivura ntaramenyekana cyane. Abaganga b’amavuriro ntibashobora gutozwa kumenya indwara y’akababaro igihe kirekire kandi ntibashobora kumenya uburyo bwo kuvura neza cyangwa inkunga ishingiye ku bimenyetso. Icyorezo cya COVID-19 hamwe n’ubuvanganzo bugenda bwiyongera ku gusuzuma indwara y’akababaro igihe kirekire byongereye ibitekerezo ku buryo abaganga bagomba kumenya no gusubiza akababaro n’ibindi bibazo by’amarangamutima bifitanye isano n’urupfu rw’uwo ukunda.
Mu isubiramo rya 11 ry’imibare mpuzamahanga y’ibarurishamibare ry’indwara n’ibibazo bifitanye isano n’ubuzima (ICD-11) muri 2019, Umuryango w’ubuzima ku isi (OMS) n’ishyirahamwe ry’abanyamerika ryita ku barwayi bo mu mutwe (Ishyirahamwe ry’indwara zo mu mutwe zo muri Amerika)
Mu 2022, Igitabo cya gatanu cy’igitabo cya Diagnostic na Statistical Manual of Disorder Disorders (DSM-5) cyongeyeho ingingo ngenderwaho zo gusuzuma indwara zigihe kirekire. Amagambo yakoreshejwe mbere arimo intimba igoye, guhora abuze ababo, hamwe nihahamuka, indwara, cyangwa intimba idakemutse. Ibimenyetso biranga akababaro kamaze igihe kinini birimo nostalgia ikabije, gutera pine, cyangwa guhiga nyakwigendera, biherekejwe nibindi bigaragarira amaso, bikabije, kandi bikwirakwira.
Ibimenyetso by’indwara y’akababaro igihe kirekire bigomba kumara igihe runaka (months amezi 6 ukurikije ibipimo bya ICD-11 n’amezi 12 ukurikije ibipimo bya DSM-5), bitera umubabaro ukomeye mu mavuriro cyangwa imikorere mibi y’imikorere, kandi bikarenga ku byifuzo by’itsinda ry’umuco, idini, cyangwa imibereho by’umurwayi kubera akababaro. ICD-11 itanga ingero z'ibimenyetso nyamukuru byerekana akababaro k'amarangamutima, nk'akababaro, kwicira urubanza, umujinya, kudashobora kumva amarangamutima meza, kunanirwa mu marangamutima, guhakana cyangwa ingorane zo kwakira urupfu rw'uwo wakundaga, kumva gutakaza igice cyawe, no kugabanya uruhare mu mibereho cyangwa ibindi bikorwa. Ibipimo bya DSM-5 byo kwisuzumisha kubibazo by'akababaro bimara igihe kirekire bisaba byibura bitatu muri bitatu mu bimenyetso umunani bikurikira: ububabare bukabije bw'amarangamutima, gucika intege, kwigunga cyane, gutakaza ubwenge (kwangiza indangamuntu), kutizera, kwirinda ibintu bibibutsa abakunzi bawe bagiye burundu, ingorane zo gusubira mu bikorwa no mu mibanire, no kumva ko ubuzima ari ubusa.
Ubushakashatsi bwerekana ko impuzandengo ya 3% kugeza 10% byabantu bapfuye bapfuye bazize indwara zisanzwe barwaye indwara yigihe kirekire, kandi igipimo cyikubye inshuro nyinshi kubantu bafite mwene wabo bapfa bazize kwiyahura, ubwicanyi, impanuka, impanuka kamere, cyangwa izindi mpamvu zitunguranye zitunguranye. Mu bushakashatsi bw’ubuvuzi bw’imbere n’ubuvuzi bw’ubuzima bwo mu mutwe, igipimo cyatanzwe cyikubye inshuro zirenga ebyiri igipimo cyavuzwe mu bushakashatsi bwavuzwe haruguru. Imbonerahamwe 1 irerekana impamvu zishobora gutera akababaro igihe kirekire nibimenyetso byerekana iyo ndwara.

Kubura umuntu uwo bafitanye isano iteka birashobora guhangayika cyane kandi bigatera urukurikirane rwimpinduka zangiza mumitekerereze n'imibereho aho abapfushije bagomba kumenyera. Agahinda nigisubizo gisanzwe cyurupfu rwumukunzi wawe, ariko ntaburyo bwokubabaza kwisi cyangwa kwemera ukuri kwurupfu. Igihe kirenze, abantu benshi babuze ababo babona uburyo bwo kwemera uku kuri gushya no gukomeza ubuzima bwabo. Mugihe abantu bamenyereye guhinduka mubuzima, akenshi bahindagurika hagati yo guhangana nububabare bwamarangamutima no kubishyira inyuma byigihe gito. Mugihe babikora, ubukana bwintimba buragabanuka, ariko buracyajya bwiyongera rimwe na rimwe kandi rimwe na rimwe bikaza gukomera, cyane cyane kuri anniversaire nibindi bihe byibutsa abantu ba nyakwigendera.
Ku bantu bafite ikibazo cy’akababaro igihe kirekire, ariko, inzira yo kurwanya imihindagurikire y'ikirere irashobora guteshwa agaciro, kandi intimba ikomeza kuba ndende kandi ikwira hose. Kwirinda cyane ibintu bibibutsa ko ababo bagiye burundu, kandi guhindukira ukareba ibintu bitandukanye ni inzitizi zisanzwe, kimwe no kwishinja uburakari n'umujinya, ingorane zo kugenzura amarangamutima, no guhangayika buri gihe. Indwara y'akababaro igihe kirekire ifitanye isano no kwiyongera k'indwara zitandukanye z'umubiri n'iz'ubwenge. Indwara y'akababaro igihe kirekire irashobora guhagarika ubuzima bwumuntu, bikagorana gushiraho cyangwa gukomeza umubano usobanutse, bigira ingaruka kumikorere yabakozi nababigize umwuga, kubyara ibyiyumvo byo kwiheba, nibitekerezo byo kwiyahura.

Ingamba n'ibimenyetso

Amakuru ajyanye nurupfu rwa mwene wabo vuba ningaruka zayo agomba kuba mubice byo gukusanya amateka yubuvuzi. Gushakisha inyandiko z'ubuvuzi ku rupfu rw'uwo ukunda no kubaza uko umurwayi ameze nyuma y'urupfu bishobora gutangiza ikiganiro kijyanye n'agahinda n'inshuro zacyo, igihe bimara, ubukana, gukwirakwira, n'ingaruka ku bushobozi bw'umurwayi bwo gukora. Isuzuma ry’amavuriro rigomba kuba rikubiyemo gusuzuma ibimenyetso by’umurwayi n’amarangamutima nyuma y’urupfu rw’uwo ukunda, ubuzima bwo mu mutwe n’ubuvuzi bwa none ndetse n’ubuvuzi, kunywa inzoga n’ibiyobyabwenge, ibitekerezo by’ubwiyahuzi n’imyitwarire, ubufasha bw’imibereho n’imikorere, amateka y’ubuvuzi, hamwe n’isuzuma ry’imitekerereze. Indwara y'akababaro igihe kirekire igomba kwitabwaho niba amezi atandatu nyuma y'urupfu rw'uwo ukunda, intimba y'umuntu iracyafite ingaruka zikomeye mubuzima bwabo bwa buri munsi.
Hano haribintu byoroshye, byemejwe neza, byatsinzwe nabarwayi biboneka mugupima mugufi kubibazo byigihe kirekire. Icyoroshye cyane ni ingingo eshanu Zibibazo Byakababaro Byibibazo (Brief Grief Questionnaire; Range, 0 to 10, hamwe n amanota menshi muri rusange yerekana ko hakenewe isuzumabumenyi ryigihe kirekire cy’akababaro) Amanota arenze 4 (reba umugereka wongeyeho, uboneka hamwe ninyandiko yuzuye yiyi ngingo kuri NEJM.org). Mubyongeyeho, niba hari ibintu 13 byumubabaro muremure -13-R (Igihe kirekire
Agahinda-13-R; Amanota ya ≥30 yerekana ibimenyetso byindwara yigihe kirekire nkuko byasobanuwe na DSM-5. Icyakora, ibibazo byamavuriro biracyakenewe kugirango hemezwe indwara. Niba ibarura ryibintu 19 byerekana akababaro katoroshye (Ibarura ry’akababaro katoroshye; intera iri hagati ya 0 kugeza kuri 76, hamwe n amanota menshi yerekana ibimenyetso by’akababaro bimaze igihe kirekire.) Amanota ari hejuru ya 25 ashobora kuba ari akababaro gatera ikibazo, kandi igikoresho cyaragaragaye ko gikurikirana impinduka mugihe runaka. Igipimo cya Clinical Global Impression Scale, gipimwa n'abaganga kandi cyibanda ku bimenyetso bifitanye isano n'agahinda, ni inzira yoroshye kandi ifatika yo gusuzuma uburemere bw'akababaro mu gihe runaka.
Ibibazo by’amavuriro n’abarwayi birasabwa gukora isuzuma rya nyuma ry’indwara y’akababaro igihe kirekire, harimo na gahunda yo gusuzuma no kuvura itandukanye (reba Imbonerahamwe ya 2 kugira ngo uyobore amavuriro ku mateka y’urupfu rw’abavandimwe n’inshuti ndetse n’ibazwa ry’amavuriro ku bimenyetso by’indwara y’akababaro igihe kirekire). Gutandukanya itandukaniro ryindwara yigihe kirekire ikubiyemo intimba isanzwe idahwema kimwe nizindi ndwara zisuzumwa. Indwara y'akababaro igihe kirekire irashobora kuba ifitanye isano nizindi mvururu, cyane cyane ihungabana rikomeye, ihungabana ry’ihungabana (PTSD), hamwe n’indwara yo guhangayika; Indwara zishobora kandi guteganya gutangira indwara y’akababaro igihe kirekire, kandi irashobora kongera kwandura indwara y’akababaro igihe kirekire. Ibibazo byabarwayi birashobora kwerekana ibishobora kubaho, harimo nubwiyahuzi. Igipimo kimwe cyasabwe kandi gikoreshwa cyane mubitekerezo byo kwiyahura nimyitwarire nigipimo cyo kwiyahura cya Columbia (kibaza ibibazo nka "Wigeze wifuza ko wapfuye, cyangwa ko wasinzira ntuzigera ubyuka?"). Kandi “Mubyukuri wagize ibitekerezo byo kwiyahura?” ).

Hariho urujijo muri raporo z’itangazamakuru ndetse no mu bakora umwuga w’ubuzima ku bijyanye n’itandukaniro riri hagati y’igihe kirekire cy’akababaro n’akababaro gasanzwe gakomeje. Uru rujijo rurumvikana kuko intimba na nostalgia kumuntu ukunda nyuma yurupfu rwabo birashobora kumara igihe kirekire, kandi kimwe mubimenyetso byerekana uburwayi bwigihe kirekire bwanditswe muri ICD-11 cyangwa DSM-5 burashobora gukomeza. Agahinda gakabije gakunze kubaho kuri anniversaire, iminsi mikuru yumuryango, cyangwa kwibutsa urupfu rwumukunzi wawe. Iyo umurwayi abajijwe ibya nyakwigendera, amarangamutima arashobora kubyuka, harimo amarira.
Abaganga b’amavuriro bagomba kumenya ko intimba zose zidahoraho zerekana ko hasuzumwe indwara y’akababaro igihe kirekire. Mu gihe kirekire cy’akababaro, ibitekerezo n'amarangamutima kuri nyakwigendera hamwe n’akababaro ko mu mutima bifitanye isano n’agahinda birashobora gufata ubwonko, gutsimbarara, gukomera no gukwirakwira ku buryo bibangamira ubushobozi bw’umuntu kugira uruhare mu mibanire n’ibikorwa bifatika, ndetse n’abantu bazi kandi bakunda.

Intego y'ibanze yo kuvura indwara y’akababaro igihe kirekire ni ugufasha abarwayi kwiga kwemera ko ababo bagiye burundu, kugira ngo babeho ubuzima bufite intego kandi bwuzuye nta muntu wapfuye, kandi bareke kwibuka nibitekerezo byumuntu wapfuye bigabanuke. Ibimenyetso bivuye mubigeragezo byinshi byateganijwe ugereranije nitsinda rishinzwe gutabara no kugenzura urutonde (ni ukuvuga, abarwayi bashinzwe kubushake bwo kwitabira ibikorwa cyangwa gushyirwa kurutonde rwabategereje) bishyigikira imikorere yibikorwa byigihe gito, bigamije kuvura indwara zo mumutwe kandi birasaba cyane kuvura abarwayi. Isesengura ryakozwe n’ibigeragezo 22 hamwe n’abitabiriye 2.952 ryerekanye ko ubuvuzi bwa gride bwibanze ku bwenge bwo kuvura bwagize ingaruka ku rugero ruto kandi runini mu kugabanya ibimenyetso by’akababaro (ingano y’ibipimo byapimwe hakoreshejwe Hedges 'G yari 0,65 nyuma yo gutabarwa na 0.9 mu gukurikirana).
Umuti uvura indwara yigihe kirekire wibanda ku gufasha abarwayi kwakira urupfu rwumukunzi wawe no kugarura ubushobozi bwo kubaho ubuzima bufite intego. Intimba igihe kirekire Ubuvuzi ni uburyo bwuzuye bushimangira gutega amatwi witonze kandi bikubiyemo ibiganiro bitera imbaraga, imitekerereze ya psychoeducation, hamwe nuruhererekane rwibikorwa byuburambe muburyo buteganijwe mu masomo 16, rimwe mu cyumweru. Ubuvuzi nubuvuzi bwambere bwakozwe kuburwayi bwigihe kirekire kandi ubu bufite ibimenyetso bifatika. Uburyo bwinshi bwo kumenya-imyitwarire ivura ifata inzira imwe kandi yibanda ku gahinda nayo yerekanye umusaruro.
Ibikorwa byo guhungabana igihe kirekire byibanda ku gufasha abarwayi kumvikana nurupfu rwumuntu ukunda no gukemura inzitizi bahura nazo. Ibikorwa byinshi birimo no gufasha abarwayi kugarura ubushobozi bwabo bwo kubaho neza (nko kuvumbura inyungu zikomeye cyangwa indangagaciro shingiro no gushyigikira uruhare rwabo mubikorwa bifitanye isano). Imbonerahamwe 3 irerekana ibiri hamwe nintego ziyi miti.

Ibigeragezo bitatu byateganijwe byerekana igihe kirekire cyo kuvura indwara z’akababaro ugereranije no kuvura neza indwara yo kwiheba byagaragaje ko igihe kirekire cyo kuvura indwara z’akababaro cyari kinini cyane. Ibisubizo by'ibigeragezo by'indege byagaragaje ko igihe kirekire cyo kuvura indwara z’akababaro cyaruta ubuvuzi bw’abantu kugira ngo umuntu yihebe, kandi ikigereranyo cya mbere cyakurikiyeho cyatoranijwe cyemeje iki cyegeranyo, cyerekana ko ibisubizo by’amavuriro ari 51% mu gihe cyo kuvura indwara z’akababaro. Igipimo cyo gusubiza kwa muganga kubuvuzi bwa muntu cyari 28% (P = 0.02) (igisubizo cyamavuriro cyasobanuwe ngo "cyateye imbere cyane" cyangwa "cyarushijeho kuba cyiza" kuri Clinical Composite Impression Scale). Ikigeragezo cya kabiri cyemeje ibisubizo ku bantu bakuze (bivuze imyaka, imyaka 66), aho 71% by'abarwayi bahabwa imiti myinshi yo kuvura indwara z'akababaro na 32% bahabwa imiti ivura abantu babonye igisubizo ku ivuriro (P <0.001).
Ikigeragezo cya gatatu, ubushakashatsi bwakorewe mu bigo bine by’ibigeragezo, bwagereranije citalopram ya antidepressant na placebo ifatanije n’ubuvuzi bumara igihe kirekire cyangwa kuvura indwara zishingiye ku cyunamo; Ibisubizo byerekanye ko igisubizo cyo kuvura indwara zigihe kirekire zivura hamwe na placebo (83%) cyari hejuru ugereranije n’ubuvuzi bw’ubuvuzi bw’icyunamo buvanze na citalopram (69%) (P = 0.05) na placebo (54%) (P <0.01). Byongeye kandi, nta tandukanyirizo ryakozwe hagati ya citalopram na placebo iyo ikoreshejwe ifatanije nubuvuzi bwibanze bwicyunamo cyangwa kuvura indwara zigihe kirekire. Nyamara, citalopramu hamwe nubuvuzi bwigihe kirekire bwo kuvura indwara byagabanije cyane ibimenyetso byo kwiheba bihuye, mugihe citalopram hamwe nubuvuzi bwibanze bwicyunamo ntabwo.
Umubabaro umaze igihe kirekire Ubuvuzi bwa Disorder bukubiyemo ingamba zagutse zo kuvura zikoreshwa muri PTSD (ishishikariza umurwayi gutunganya urupfu rw'uwo yakundaga no kugabanya kwirinda) mu buryo bwo gufata intimba igihe kirekire nk'indwara yo guhangayika nyuma y'urupfu. Ibikorwa bigizwe kandi no gushimangira umubano, gukorera mu ndangagaciro z'umuntu ku giti cye n'intego z'umuntu ku giti cye, no kongera imyumvire yo guhuza na nyakwigendera. Amakuru amwe yerekana ko kuvura ubwenge-imyitwarire yubuvuzi bwa PTSD bishobora kutagira ingaruka nziza niba bitibanze ku gahinda, kandi ko ingamba zisa na PTSD zishobora gukoreshwa muburyo butandukanye mugukomeza guhungabana. Hariho uburyo bwinshi bwo kuvura bushingiye ku kababaro bukoresha imiti isa n’ubwenge kandi ikagira ingaruka ku bantu no ku matsinda kimwe no guhungabana igihe kirekire mu bana.
Ku bavuzi badashoboye gutanga ubuvuzi bushingiye ku bimenyetso, turasaba ko bohereza abarwayi igihe cyose bishoboka kandi bagakurikirana abarwayi buri cyumweru cyangwa ikindi cyumweru cyose, igihe bibaye ngombwa, bakoresheje ingamba zoroheje zo gutera inkunga zibanda ku gahinda (Imbonerahamwe 4). Ubuvuzi bwa telemedisine hamwe n’abarwayi bayobora ubwabo kuri interineti birashobora kandi kuba inzira nziza yo kunoza uburyo bwo kwivuza, ariko inkunga idahwitse itangwa nabavuzi irakenewe mubushakashatsi bwuburyo bwo kwivuza bwonyine, bushobora kuba ngombwa kugirango habeho ibisubizo byubuvuzi. Ku barwayi badasubiza ibimenyetso bishingiye ku bimenyetso bifatika bivura indwara z’akababaro igihe kirekire, hagomba gukorwa isuzuma kugira ngo hamenyekane uburwayi bw’umubiri cyangwa bwo mu mutwe bushobora gutera ibimenyetso, cyane cyane bushobora gukemurwa neza hakoreshejwe ingamba zigamije, nka PTSD, kwiheba, guhangayika, kubura ibitotsi, no gukoresha ibiyobyabwenge.

Ku barwayi bafite ibimenyetso byoroheje cyangwa batujuje imbibi, kandi bakaba badafite uburyo bwo kwivuza bushingiye ku bimenyetso bifatika by’igihe kirekire, abaganga barashobora gufasha mu gucunga akababaro. Imbonerahamwe 4 irerekana uburyo bworoshye bwo gukoresha ubwo buvuzi.
Gutega amatwi no guhuza intimba nibyingenzi. Psycho-uburezi busobanura ikibazo cyigihe kirekire cyumubabaro, isano ifitanye nintimba rusange, nibishobora gufasha akenshi guha abarwayi amahoro yumutima kandi birashobora kubafasha kumva batigunze kandi bafite ibyiringiro ko ubufasha buhari. Uruhare rw'abagize umuryango cyangwa inshuti magara mu myigire ya psychologiya kubyerekeye indwara y'akababaro igihe kirekire birashobora kunoza ubushobozi bwabo bwo gutera inkunga no kugirira impuhwe uwababaye.
Kumenyesha abarwayi ko intego yacu ari uguteza imbere inzira karemano, kubafasha kwiga kubaho badapfuye, no gukemura ibibazo bibangamira iki gikorwa bishobora gufasha abarwayi kwitabira kwivuza. Abaganga b’amavuriro barashobora gushishikariza abarwayi nimiryango yabo kwakira akababaro nkigisubizo gisanzwe cyurupfu rwumuntu ukunda, kandi ntibagaragaze ko intimba yarangiye. Ni ngombwa ko abarwayi badatinya ko bazasabwa kureka kwivuza bibagirwa, bakomeza cyangwa basize ababo. Abaganga b’amavuriro barashobora gufasha abarwayi kumenya ko kugerageza kumenyera ko uwo ukunda yapfuye bishobora kugabanya akababaro kabo kandi bigatera kumva ko bishimishije gukomeza umubano na nyakwigendera.

Indangarugero
Kugeza ubu nta bushakashatsi buhagije bwa neurobiologique busobanura neza indwara itera akababaro igihe kirekire, nta biyobyabwenge cyangwa ubundi buryo bwo kuvura indwara zifata ubwonko bwerekanwe ko ari ingirakamaro ku bimenyetso by’indwara z’akababaro igihe kirekire mu bigeragezo by’amavuriro, kandi nta biyobyabwenge byapimwe byuzuye. Gusa ubushakashatsi bumwe buteganijwe, buteganijwe, bugenzurwa na placebo bwibiyobyabwenge bwabonetse mubitabo, kandi nkuko byavuzwe haruguru, ubu bushakashatsi ntibwerekanye ko citalopram yagize akamaro mugukomeza ibimenyetso byindwara y’akababaro, ariko iyo ihujwe n’igihe kirekire cyo kuvura indwara z’akababaro, byagize ingaruka zikomeye ku bimenyetso byo kwiheba. Biragaragara ko hakenewe ubushakashatsi bwinshi.
Kugirango umenye imikorere yubuvuzi bwa digitale, birakenewe gukora ibigeragezo hamwe nitsinda rishinzwe kugenzura hamwe nimbaraga zihagije zibarurishamibare. Byongeye kandi, igipimo cyo gusuzuma indwara y’akababaro igihe kirekire ntikiramenyekana neza kubera kutagira ubushakashatsi bumwe bw’ibyorezo by’indwara ndetse no gutandukana kwinshi mu bipimo byo gusuzuma bitewe n’ibihe bitandukanye by’urupfu.