8f= wg/Tg zfSo, Pd8L
P;f]l;o6 k|f]km];/≤ jl/i7 gzf, :gfo" tyf dgf]/f]u ljz]if1
BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
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tfOjfgsf]
tfOk]Odf ;DkGg Pl;ofnL dgf]lrlsT;sx?sf]
bf]>f] ljZj e]nf (Second World Congress of Asian
Psychiatry)df o; n]vssf t˚{af6
k|:t't …dfOu|]g lz/bb{df dfgl;s ;d:ofÚ (Psychiatric manifestations/
associations in migraine headache) / …alx/Ë
;]jfdf cGo lrlsT;f ljefuaf6 k7fOPsf lj/fdLx?df dfgl;s ;d:ofÚ (Psychiatric
morbidity profiles of referred clinic patients) zf]wkqx?sf
nflu g]kfnnfO{ …;jf]{Ts[i6
k|:t'ltsf] k'/:sf/’
ldNof] . tL zf]wkqx?sf
cfwf/df g]kfnL dgf]/f]uLx?sf] cj:yf / dfgl;s ;d:ofdf pkrf/sf] cfjZostfaf/] oxf“
5n˚n cufl8 a9fOG5 .
lbglbg} cf]5\Øfgdf
lk;fa ug]{ gfg'sf] ;d:of xf];\ jf a'9fkfdf
:d/0f zlSt sd x'“b} uPsf afh]n] x'“b}
gePsf] s'/fdf z+sf u/]/ cl• ln“bf,
cs:dft\ >Ldfg laTbf dlxgf}+ lg/f; x'g]
sfsLsf] cj:yf xf];\ jf ;fyLx?sf] nxnx}df nfu]/ /lS;, g;f jf uf“hf ;]jg ug]{
efO{sf] ;d:of, ljgf sf/0f dg{ nfu]“ egL cflQg] ;fyL xf];\ jf s]lx ;d:of kbf{ d'5f{ kg]{
sfG5L, a]nfa]nf ˚'lt{ u/]/ dSv kg]{ wSs' nufpg]
l5d]sL xf];\ jf cgf}7f] larf/ / Jojxf/ ug]{ gft]bf/ jf s}of}+ lrlsT;s b]vfp“bf
klg /f]u gv'l§P/ 6fpsf],
k]6 b'Vg] jf s'g} cGo
zfl//Ls nIf0fn] cflht efph" xf];\ jf x'g;S5, Pp6} s'/f dgdf
clgolGqt ?kdf af/Daf/ bf]xf]l/P/ lg“b x/fd x'g] cfÎg}
cj:yf Û xfdLdWo]
slQnfO{ o:tf ;d:of s'g} dfgl;s /f]un] x'G5 eGbf lrQ a'‰nf Û
s]lx
u/L cGo :jf:Yosld{ jf cGo JolStaf6 dfgl;s ;d:of eGg] gfd dfq ;'Gbf klg w]/}nfO{
kRb}g . of] o:tf] dfG5], o;nfO{ p;nfO{ klg o:tf] xf]nf / Û p;nfO{ To:tf] kf]
ePsf] t xf];} gePsf] jf To:t} ePsf] jf v':s]sf] t x}g lg Û o:tf cleJolStx?
xfd|f jf:tljstf x'g\ . o:tf ;d:ofaf/] w]/}nfO{ yfxf gx'g;S5 . slQnfO{ l/; p7\nf
. xtf]T;fxL, lg/f; jf 56\kl6 xf]nf s;}nfO{ . sltnfO{ nf]snfh / cK7]/f] x'gyfN5,
c?nfO{ yfxf xf]nf eGg] csf]{ lrGtf ylkG5 . ;DalGwt ljz]if1nfO{ e]6\g] ;Nnfx g}
cfp“bf klg lxlRsrfP/ a;]sf x'g;S5g\ . o:tf
;d:ofdf zfl//Ls nIf0fx?sf] xfjL ePsf] cj:yfdf t ´g\ w]/}nfO{ ljZjf;} ug{ ufx|f]
k5{ ls p;nfO{ klg s'g} vfnsf] dgf]/f]un] ;tfO/x]5 Û c´ sltko /f]udf cf˚"nfO{
e}/x]sf] ;d:ofsf] k§f] gx'g' nIf0fs} ?kdf /xG5 eGbf ´g\ sltnfO{ lrQ a'‰nf Û
jf:tjdf,
;+;f/sf] s'g}
klg ;dfhdf !%–#% k|ltzt dflg;nfO{ s'g} g s'g} / em08} @ k|ltztnfO{ uDeL/ vfnsf]
dgf]/f]u x'g] b]lvG5 . o;n] s'g} ;dfh, efiff, ;+:s[lt, e"uf]n, lnË, ;Dk|bfo, k]zf, ju{ s;}s;}nfO{ c5'6f]
5f8]sf] 5}g . ljsnf+u agfP/ w]/} dflg;nfO{ ;tfpg] ljZjsf !) k|d'v ljdf/Lx?df %
/f]ux? dgdl:tis;“u ;DalGwt 5g\ . pbfl;g (Depression), cflQg] (anxiety),
nfu"kbfy{ / g;fsf] b'Jo{;g, l;hf]k|m]lgof, 5f/]/f]u, ;':t dgl:ylt, Bipolar affective disorder, zf/Ll/s ?kdf k|i6 gx'g] nIf0fx?sf]
ljdf/L (somatoform disorders),
lx:6]l/of, tgfjhGo nufot afNofj:yf jf lszf]/fj:yfsf dfgl;s ;d:ofx?sf]
df/ w]/} b]lvG5 . ;dli6df eGbf, dgf]/f]ux? zf/Ll/s /f]ux? h:t} eofjx ?kdf JofKt
5g\
nIf0f
/ k|s[lt cg';f/ JolStsf] Jojxf/, ;f]rfO, cg'ej
nufotsf dfgl;s lqmofsnfkx?df c;/ ug]{ cfwf/df xfn;Dd s/La kf“r–5–;o
yl/ dgf]/f]ux?sf] pNn]v kfOG5 . yl/yl/ ?k ePklg oL ;d:ofx? cGo zfl//Ls /f]ux?
h:t} x'g\M tL ;fdflhs, dgf]j}1flgs tTjx?af6
k|efljt ePklg xfd|f dl:tiss} u8\a8Ln] pTkGg x'G5g\ .
zfl//Ls
k|lqmofdf u8\a8L, zfl//Ls k|lqmofk|ltsf] ;+j]bgfdf kl/jt{g jf cGo sf/0fx?n]
ubf{ sltko dfgl;s ;d:ofx?df yl/yl/ zfl//Ls l;sfotx? x'g]
u5{g\ . w]/} vfnsf dgf]/f]ux?df ef]s, lgGb|f, of}g, lb;flk;fj, dfl;s wd{ h:tf
zfl//Ls k|lqmofx?df u8\a8L b]lvg;S5g\ . To:t}, zfl//Ls /f]usf ljleGg nIf0fx?,
h:t}– zf/Ll/s kL8f jf b'vfO x'g] -h:t}–
6fpsf]], 9f8 jf cGo efudf b'Vg]_, jfs\jfsL nfUg], k]6 9':; km'Ng]≤ v'§f
emd\emd\ x'g]≤ lr;f] x'g], z/L/df sdhf]/L x'g], kl;gf–kl;gf
x'g] jf cfkm"nfO{ 7"nf] /f]u
ePsf] ;lDemg] jf cfºgf] z/L/sf] s'g} efudf sld sdhf]/L ePsf] 7fGg], d'6'
9's\9's\ x'g],
;f; ˚'Ng], 3f“6L v;\v;fpg], ;'Sg],
ef/L x'g], sfDg], a]xf]; x'g]
cflb OToflb klg dgf]/f]ux?df b]lvg;S5g\ . o:tf zf/Ll/s nIf0fx?sf] sf/0f lj/fdL
cToflws a]r}g /xG5g\ . cfºgf] sfd sfjf{xL ug{ c;dy{ x'gk'U5g\ . oL nIf0fx?sf]
sf/s /f]usf] lg?k0f / pkrf/df w]/} ;do, ;DklQ / dfgl;s k|oTg vlr{g' k/]sf] x'G5
. yl/yl/ ljifosf lrlsT;sx?sxf“ wfO/x]sf x'G5g\ . dlxgf}+, aiff}{+;Dd klg ofjt\
hf“r–k8tfn, ;j]{If0f ubf{ klg lrQ a'‰bf] pQ/ kfpg ;ls/x]sf x'“b}gg\ . Psflt/
lrlsT;sx? la/fdLnfO{ s]xL gePsf] lhls/ ul//x]sf x'G5g\, la/fdLsf] cToflws lrGtf
/ ;/f]sf/ b]v]/ lrlsT;s klg a]r}g x'g;S5g\ eg] csf]{lt/ nfv sf]l;;sf]
afjh"b cfkm"nfO{ ;~rf] gx“'bf la/fdL sfon ePsf x'G5g\ . o:tf
la/fdLx?sf] cfwf/df y'k|} k}+;fd'vL lSnlgs / gl;{Ë xf]dx? km:6fp“5g\ . o;/L
w]/} dflg;x? zf/Ll/s /f]u ljgf klg yl/yl/ zf/Ll/s l;sfot lnP/ af“lr/x]sf x'G5g\
. dfgl;s ;d:ofaf/] c1fgtf, cGwljZjf;, lje]b JofKt 5Ù
kof{Kt dfgl;s :jf:Yo ;]jf pknJw 5}g . ´g\ o:tf zfl//Ls nIf0fx? ePkl5 t
dfgl;s ;d:ofu|:t dflg;x? cfÎgf ;d:ofaf/] cNdlng'
c:jfefljs 5}g .jL=kL= sf]O/fnf :jf:Yo lj1fg k|lti7fgsf] dfgl;s /f]u ljefudf
ePsf oL cWoogx?df o:tf dgf]/f]uLx? lgSs} nfdf] ;dokl5 dfq dfgl;s :jf:Yo ;]jfsf]
kx'“rdf k'u]sf] oyfy{ b]lvPsf] 5 .
pbf;Lg, zfl//Ls /f]u ljgf klg zfl//Ls l;sfot x'g]
dgf]/f]u (somatoform disorders), cflQg] h:tf dgf]/f]u
ePklg pgLx? dgf]lrlsT;s / ;DalGwt ljz]if1sf] ;]jf lng c´} klg lxlRsrfO/x]sf
b]lvG5g\ . ;do;“u;“u} s]lx cg's"n kl/jt{g ePklg c´} klg w]/} o:tf lj/fdLx?
pkrf/df l9nfOsf sf/0f cfTdxTof / cGo hl6ntfsf] l;sf/ eO/x]sf b]lvG5g\ .
ca cfP/ l;4 e};s]sf] 5M dgf]/f]u h;nfO{ klg x'g;S5Ù
ljljw nIf0fx? lnP/ b]vf kg]{ dgf]/f]ux? pkrf/n] 7Ls x'G5g\Ù
;lx / pko'St pkrf/n] ;a} vfn]
dgf]/f]udf ˚fObf x'G5Ù
/f]usf] k|s[lt x]/L bjfO, dgf]j}1flgs, ljh'nLsf]
;]s jf cGo t/Lsfx? pkof]uL x'G5g\Ù
lj/fdL, kl/jf/ / cf˚Gt ;DalGwt ;a}sf] k|of;df dgf]/f]uLx? c? h:t} pkof]uL /
;Ddfghgs hLjg af“Rg ;S5g\ . xfn xfd|f] b]zdf klg pkrf/ ;]jf 7fp“7fp“df pknJw 5
. To;}n], ;TotYo dx;'; u/L dfgl;s ;d:ofsf]
klg ;lx pkrf/ pkef]u u/]/ :jf:Yo nfe ug{lt/ pGd'v
xf]cf}+ .