hindi ocd booklet

Dr. Sumant Khanna Dr. Y.C.Janardhan Reddy

Dr. Suresh Bada Math Dr. Ravi Philiph Rajkumar

Patient information booklet

National Institute of Mental Health and Neuro Sciences

OCD

Dr. Sumant Khanna, MD, PhD, MAMS, MRC Psych Consultant Psychiatrist, New Delhi Former Additional Professor of Psychiatry, NIMHANS, Bangalore

Dr.Y.C.Janardhan Reddy. DPM, MD Additional Professor of Psychiatry NIMHANS, Bangalore Phone:(office) 91-080-26995278 Email:[email protected]

Dr.Suresh Bada Math. MD, DNB, PGDMLE Assistant Professor of Psychiatry NIMHANS, Bangalore Phone:(office) 91-080-26995276 Email:[email protected]

Dr. Ravi Philiph Rajkumar. MD Senior Resident, NIMHANS, Bangalore

1 Copyright NIMHANS, 2008. Bangalore, INDIA

National Institute of Mental Health and Neuro Sciences,

(Deemed University), Bangalore, 560 029 INDIA

OBSESSIVE-COMPULSIVE DISORDER

Patient information brochure

YC Janardhan Reddy Sumant Khanna

Suresh Bada Math Ravi Philip Rajkumar

OCD Clinic, Department of Psychiatry,

National Institute of Mental Health and Neuro Sciences, (Deemed University), Bangalore, 560 029

INDIA 2008

HINDI VERSION

Translated by

Dr. Prashant Tibrewal

1

vks-lh-Mh- D;k gS\

vks-lh-Mh- ,d vke ekufld chekjh gSA igys bls bruk vke ugha le>k tkrk Fkk ijUrq fofHkUu v/;;uksa ls ;g fl) gks x;k gS fd fo’o dh 2&3 tula[;k dHkh u dHkh bl chekjh ls xzflr jg pqdh gSA gkyk¡fd vks-lh-Mh- ,d vke chekjh gS] blls xzflr yksx bldk bykt ugha djokrsA if’peh ns’kksa esa 50 ls de vkSj Hkkjr esa blls Hkh de yksxksa us bl chekjh ds fy, euksfpfdRld ls lEidZ fd;k gSA ;g chekjh lHkh mez ds yksxkas dks gks ldrh gSA rdjhcu 65 yksxksa esa ;g chekjh 25 lky dh mez ds igys gh gks tkrh gS ftuesa ls dqN esa rks ;g 5 lky dh mez ls gh 'kq# gks tkrh gSA 5 ls de yksxksa esa ;g chekjh 35 lky ds ckn gks ldrh gSA lkekU;r% ;g chekjh nksuksa fyaxksa esa leku :i ls ik;h tkrh gS ij ;fn blds y{k.k cpiu vFkok ;qokoLFkk esa 'kq: gks tk, rc ;g yM+fd;ksa dh rqyuk esa yM+dksa esa T;knk ik;h tkrh gSA bl chekjh ds eq[; y{k.k gSa %& vksCls'kUl vkSj daiY'kUlA

tc dqN fopkj] bPNk] 'kadk ;k n`'; ckj&ckj bPNk ds fo#) vkrs gSa] rc mUgsa vksCls'kUl dgk tkrk gSA

bl chekjh ls xzflr vf/kdrj yksx ;g tkurs gSa fd ;g fujk/kkj] vko';drk ls vf/kd vkSj cseryc ds fopkj gSa ij og mu fopkjksa dks jksd ugha ikrs gSaA vksCls'kUl yksxksa esa dkQh ruko vkSj ?kcjkgV iSnk djrs gSa ftlls muds nSfud thou esa cgqr ck/kk iM+rh gSA

tc dksbZ O;fDr fdlh dk;Z dh fujZFkdrk dks tkurs gq, Hkh mls ckj&ckj djus ij foo'k gksrk gS rc mUgs dEiY'kUl dgrs gSaA dEiY'kUl] lkekU;r% vksCls'kUl ds çfrfØ;k Lo:i vFkok mUgsa jksdus ds fy, fd;s tkrs gSaA tSls %& ftl O;fDr dks xUnxh dk vksCls'kUl gS] og ;g lqfuf'pr djus ds fy, fd mlds gkFk lkQ gSa] mUgsa ckj&ckj /kksrk gSA ejht ;g dksf'k'k djrs gSa fd og ckj&ckj gkFk u /kks,a] ij ,slk u djus dh n'kk esa gksus okyh ?kcjkgV ds lkeus varr% og vius ?kqVus Vsd nsrs gSaA

vks-lh-Mh- ds ejht fdlh lEHkkfor nq?kZVuk@[krjs dks Vkyus ds fy, dqN dk;Z ckj&ckj nksgjkrs gSaA mnkgj.k ds rkSj ij %& Q'kZ dks ,d fuf'pr ckj Nwuk rkfd ifjokj tuksa ds lkFk gksus okyh lEHkkfor nq?kZVuk Vy tk,A vf/kdrj ejht ;g tkurs gSa fd muds fØ;k&dyki fujFkZd gSa ij og bu ij fu;a=.k ugha dj ikrs D;ksaafd blls mudh ?kcjkgV@cspSuh de gksrh gS] Hkys gh FkksM+s le; ds fy,A

dqN dEiY'kUl dks ,d fo'ks"k i)fr ls fd;k tkrk gSA O;fDr fo'ks"k fdlh dk;Z dks ,d foLr`r Øec) rjhds ls djus ij foo'k gksrk gS vkSj Ja[kyk VwVus dh n'kk esa iwjh çfØ;k 'kq#vkr ls nksgjkuh iM+rh gS vU;Fkk ?kcjkgV cgqr c<+ tkrh gSA bl dkj.ko'k NksVs&NksVs dkeksa ds fy, cgqr le; yx tkrk gSA

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Copyright NIMHANS, 2008. Bangalore, INDIA

2

fdUgsa vksCls’kUl ugha dgk tkrk gS %&

• lk/kkj.kr% ^^vksCls’kUl** ’kCn dk ç;ksx ^^mls laxhr dk vksCls'kUl gS** ,sls fd;k tkrk gS] ijUrq vks-lh-Mh- ds lUnHkZ esa ge bl ’kCnkFkZ dk ç;ksx ugha dj ldrs gSaA mijksDr mnkgj.k esa vkneh viuh bPNk ls ml dke dks djrk gS vkSj ,slk djus esa mls [kq’kh feyrh gSA

• tc fdlh dks ukSdjh ls fudkyk tkrk gS rc mldk bl ?kVuk dks ysdj fpafrr gksuk LokHkkfod gSA ijUrq bu fopkjksa dks ge csotg ;k csdkj ugha dg ldrs gSaA blh rjg ls] ijh{kk ds igys ?kcjkgV gksuk LokHkkfod gS] gkyk¡fd buls ijs’kkuh gksrh gS ij bUgsa ge fujk/kkj ugha dg ldrsA

lkQ gS fd mijksDr vuqHkoksa dks vksCls’kUl ugha dgk tk ldrk gSA

dqN vke vksCls’kUl

• yksxksa ds Nwus ls ;k okrkoj.k ds phtksa ls xanxh yxus dk Mj

• fu;e ds fo#) fopkj

• nwljksa dks ;k [kqn dks gkfu igq¡pkus dk fopkj

• ’kadk gksuk dh dke Bhd rjhds ls ugha fd;k x;k gSA

• ySafxd fopkj ;k n`’; ckj&ckj vkuk

• xanh xkfy;k¡ cksyus dk Mj

• tku&ysok chekjh gksus dk Mj

• gj pht dks] ,d gh ljhds ls j[kus dk fopkj

dqN vke daIy’kUl %

• ckj&ckj gkFk /kksuk] ugkus ds fy, T;knk le; yxkuk ;k ?kj ds phtksa dks ckj&ckj lkQ djuk

• phtksa dks ,d ljhds ls j[kuk

• rkyk] xSl vkSj cÙkh ds cVu vkSj bysfDVªdy phtksa dks ckj&ckj ij[kuk

• [kqn ds diM+s dks ckj&ckj Mkyuk vkSj fudkyuk

• ckj&ckj ,d vad rd fxurh djus jguk

• dqN phtksa dks ,d gh jhfr esa Nwuk

• dqN dke ckj&ckj djukA tSls & njokts ls ckgj tkdj ykSVuk

• ckj&ckj nwljksa ls vk’oklu ek¡xuk ¼[kkldj cPpksa esa fn[kkÃ nsrk gS½

xanxh dk Mj vkSj /kksus ;k lkQ djus ds daIy’kUl %

3

;g lcls vke vksCls’kUl gksrk gSA bl vksCls’kUl esa jkst ds dke djus esa] xanxh yxus dk Mj yxk jgrk gSA tSls & njokts dh dqaMh Nwuk] uhps fxjs gq, phtksa dks Nwuk] nwljksa ds Nq, gq, iSlksa ds uksV dks Nwuk ;k fdlh dpjs ds fMCcs ds fudV ls tkukA bu lHkh dkeksa dks djus ls xanxh yxus dk Mj yxk jgrk gSA ;g Mj cgqr T;knk vkSj jhfr;k¡ cgqr yEcs le; rd jgrs gSaA mnkgj.k % gkFk /kksus esa dÃ ?kaVs yx ldrs gSa] ftlls gkFk fNy ldrs gSaA yksx bl chekjh esa ?kj dks lkQ djus esa dÃ ?kaVsa yxk ldrs gSa ;k ugkus ds igys ckj&ckj ugkus dh txg dks lkQ djrs jgrs gSaA

dqN yksxksa dks ;g Mj yxk jgrk gS fd muls ;k nwljksa ls QSykÃ xÃ xanxh vkSj xans dhVk.kq] mUgsa ;k nwljksa dks gkfu igq¡pk ldrs gSaA bl dkj.k og [kqn ugkus rd ;k iwjs ?kj dks lkQ djus rd ¼esgekuksa ds tkus ds ckn½ nwljksa dks ugha Nwrs gSaA gkFk /kksus ds dk;Z esa dHkh&dHkh yach jhfr;ksa dk bLrseky fd;k tkrk gSA tSls & gkFkksa dks ,d ljh[ks ls eyuk ;k ,d gh ljh[ks ls ugkukA tc bl jhfr dks ugha ekuk tkrk gS] rc cspSuh vkSj ?kcjkgV T;knk c<+rh gS vkSj nksckjk ls ogh dke ’kq#vkr ls djuk iM+rk gS tc rd larqf"V ugha feyrh ;k tc rd og Fkd ugha tkrsA

’kadk vkSj tk¡pus&ij[kus ds vksCls’kUl vkSj daIy’kUl

ftu yksxksa dks ;g vksCls’kUl gksrs gSa] muds eu esa ckj&ckj ;g ’kadk iSnk gksrh gS fd muds Bhd ls u tk¡pus&ij[kus ls dqN cqjk gksus okyk gSA lEHkkfor gknls dks Vkyus ds fy, ckj&ckj ejht tk¡prs&ij[krs gSa & tcfd og tkurs gSa fd og lEHkor% lPpkÃ esa ugha cny ldrk gSA mnkgj.k & ’kadk gksuk dh] xSl can ugha fd;k x;k gS] ftlds otg ls vkx yx ldrh gSA vke mnkgj.k gS & ckj&ckj njoktksa dh dqafM;ksa] xSl ds cVu vkSj bysfDVªd phtksa dks tk¡pukA vU; mnkgj.k & ckj&ckj :i;ksa dks fxuuk] ,d gh dke dks ckj&ckj xyfr;ksa ds fy, ij[kuk ¼[kkldj cPpksa esa fn[kkÃ nsrk gS½A ijarq ckj&ckj tk¡pus ds ckn Hkh ;g yksx larq"V ugha gksrs gSaA dHkh&dHkh ;g nwljksa ls vk’oklu ek¡xrs gSa fd mUgksaus dksÃ [krjs okyh xyrh ugha dh gSA tu lk/kkj.k dks ;g yksx vkylh vkSj dkepksj yxrs gSA ftu cPpksa dks ckj&ckj tk¡pus dk daIy’kUl gksrk gS] og i<+kÃ esa detksj ekus tkrs gSaA vxj bu yksxksa ls iwNk tk, fd ^^vki dc larq"V gksaxs fd njoktk can fd;k x;k gS\** dkQh yksx ;g tokc nsaxas fd og dHkh Hkh bl ekeys esa larq"V ugha gks ldrs gSaA dqN ejht tk¡pus&ij[kus ds le; dks de djus ds fy, dqN rjhds viukrs gSaA lcls vke rjhdk tks viuk;k tkrk gS & fxurh djds tk¡pus&ij[kus dh ckjh dks de djukA ;g ejht dÃ ckj fxurh djus dh jhfr dh vknr yxk ysrs gSa] tSls vPNs vkSj cqjs Ja[kyk ds vadksa dks ekuukA

phtksa dks ,d rjhds ls ;k ,d gh Ja[kyk esa j[kus dh vko’;drk

ftu yksxksa esa ;g vksCls’kUl jgrk gS] og viuh phtksa dks lkQ&lqFkjk j[kuk ilan djrs gSaA ijarq phtksa dks lkQ&lqFkjk j[kus esa gh mudk vk/ks ls T;knk /;ku yx tkrk gS] ftlds otg ls og nwljs jkstejkZ ds dkeksa dks çkFkfedrk ugha ns ikrs gSaA gj pht dks ,d ljhds ls ;k ,d gh

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Ja[kyk esa j[kuk mudh t:jr cu tkrh gSA vxj phtksa dks mYV&iqYV fd;k tk,] rc mUgsa vçlUurk gksrh gSA tc rd mudh phtksa dks O;ofLFkr txgksa esa ugha j[kk tkrk rc rd mUgsa vthc lk ruko eglwl gksrk gSA

;g yksx [kkus dh est dks rS;kj djus ds fy, ?kaVksa yxkrs gSa ;k rc rd fcLrj yxkrs jgrs gSa tc rd og larq"V ugha gks tkrs gSa fd lkjh phtsaa Bhd txg esa j[kh xÃ gSA

ySafxd vkSj vkØks’ktfud fopkj ds vksCls’kUl %

ftu yksxksa dks ;g vksCls’kUl gksrk gS] mUgsa ckj&ckj ySafxd fopkj ;k n`’; fn[kkÃ nsrk gSA mnkgj.k % ySafxd vksCls’kUl ifjokjokyksa ds çfr ;k Hkxoku ds çfr ySafxd n`’;ksa ds ek/;e ls vk ldrs gSaA vkØks’ktfud vksCls’kUl T;knkrj fdlh pkgusokys ¼ifjokj ds yksx½ dks ekjus dh lksp gksrk gSA tks yksx ySafxd vkSj vkØks’ktfud fopkj ds vksCls’kUl ls ihfM+r gSa] mUgsa i’pkrki vkSj ?kcjkgV eglwl gksrk gSA mUgsa ges’kk ;g Mj yxk jgrk gS fd og dgha vius ySafxd vkSj vkØks’ktfud fopkj dks vly ftanxh esa dj u cSBsA bl otg ls] og ckj&ckj nwljksa ls vk’oklu ek¡xrs jgrs gSa fd og vPNs bUlku gSa vkSj ,slh xanh gjdr ugha dj ldrs gSaA

fxurh djus vkSj ,d pht dks ckj&ckj djus dh daIy’kUl %

ftu cPpksa esa vks-lh-Mh- dh chekjh gksrh gS vkSj og csotg phtksa dh fxurh djus esa ?kaVksa yxkrs gSaA og lM+d esa pyrs gq, yksxksa dh] f[kM+dh ds fxzy dh] Q’kZ ds VkbYl dh fxurh djrs jgrs gSaA dqN cPps dke ’kq: djus ds igys ;k lekIr djus ds ,d vad rd fxurh djrs gSaA fdlh Hkh txg dks ikj djus ds fy,] lhf<+;ksa dh fxurh djuk] og vko’;d le>rs gSaA ftu yksxksa dks ,d gh pht dks ckj&ckj djus ds daIy’kUl gksrs gSa] og ,d gh dke dks ckj&ckj nksgjkrs gSaA tSls & dqlhZ ds bnZ&fxnZ xksy&xksy ?kweuk ;k dqN vad rd pDdj dkVuk vkSj fQj dqlhZ ij cSBukA

,d gh pht ds ckjs esa ckj&ckj lkspuk %

ftu yksxksa dks ;g vksCls’kUl gksrk gS] og csotg vkSj cseryc dh phtksa esa viuh le; xokars gSaA og tkurs gSa fd ;g fopkj csotg gS ijarq og mUgsa jksd ugha ikrs gSaA ;g lksp yacs le; rd pyrh gS vkSj ejht dks vius gh ç’uksa dk gy ugha fey ikrk gSA vke phtksa ij Hkh og ’kadk djrs jgrs gSaA ;g lksp ;k ’kadk fnu esa fd;s x;s fdlh dk;Z ;k fdlh ds lkFk dh xÃ ckrphr ij gks ldrk gSA

phtksa dks tek djuk %

tc yksx iqjkus diM+s] crZu ;k dkxt vius Hkfo"; ds bLrseky ds fy, j[krs gSa] rc mls [kkl ugha ekuk tkrk gSA ijarq ftu yksxksa dks vks-lh-Mh- dh chekjh gksrh gS] og T;knk gn rd phtksa dks tek djrs gSaA ?kj okys vkSj nksLr vDlj ;g f’kdk;r djrs gSa fd ejht us vius dejs esa csotg vkSj cseryc dh phtksa dks tek fd;k gSA bu ejhtksa dks viuh phtksa dks ckj&ckj ij[kus vkSj tk¡pus dh vknr gksrh gS] ftlls og vius

5

vki dks vk’oklu ns lds fd mudh lkjh phtsa lqjf{kr gSaA vxj dksÃ mUgsa bu phtksa dks Qsdus dh lykg ns] rc mUgsa cgqr T;knk ?kcjkgV eglwl gksrh gSA

vks-lh-Mh- gksus ds dkj.k %

vks-lh-Mh- gksus dk lgh dkj.k vHkh rd Kkr ugha gSA ijarq oSKkfud i<+kÃ;ksa us vks-lh-Mh- ds lEHkkfor dkj.kksa dks nqfu;k ds lkeus is’k fd;k gSA bu dkj.kksa dks oSKkfud vkSj euksoSKkfud dkj.kksa esa ck¡Vk tk ldrk gS

v½ oSKkfud dkj.k

vkt dh fLFkfr esa ;g Li"V :i ls crk;k tk ldrk gS fd vks-lh-Mh- gksus ds oSKkfud dkj.k gSa vkSj ;g gekjs efLr"d esa ik, x, dqN dSfedy rRoksa esa cnyko vkus dh otg ls gks ldrk gSA ;g cnyko gekjs efLr"d esa ik, x, U;wjksVªkUlfeVlZ esa gksrk gS] ftudh enn ls lwpuk gekjs fnekx ds jxksa rd ig¡qprh gSA ftu yksxksa esa vks-lh-Mh- dh chekjh ikÃ tkrh gS] muesa fljksVksfuu uked ,d U;wjksVªkUlfeVj dh deh gksrh gSA bl ckr dk lcls cM+k lcwr gS oks nokÃ;k¡ tks ^fljksVksfuu* dks çHkkfor djrh gSaA ;g nokÃ;k¡ gekjs fnekx esa ^fljksVksfuu* dh ek=k dks c<+krs gSa & ftlls vks-lh-Mh- ds y{k.k de gksrs tkrs gSaA

vks-lh-Mh- dk jxksa dh vkSj chekfj;ksa ds lkFk gksuk mlds oSKkfud mn~Hko dh iqf"V djrs gSaA ftu yksxksa dks ^,ulsQsySfVl*] ^fVd fMl~vkWMZj* vkSj ^dksfj;k* tSlh chekfj;k¡ gksrh gSa] mUgsa vks-lh-Mh- gksus dh T;knk lEHkkouk gSA efLr"d dh ,e-vkj-vkÃ- vkSj ih-Ã-Vh- LdSu esas ÝUVy yksCl] flaaxqye vkSj csly xSaxfy;ksa esa vfu;ferrk,a ik;h x;h gSaA ,slk lkspk tk jgk gS fd vks-lh-Mh- ds ejhtksa esa efLr"d ds bu rhu Hkkxksa dks tksM+us okys lfdZV esa dqN [kjkch gks tkrh gSA

vktdy ;g ekuk tkrk gS fd vks-lh-Mh- ,d vkuqokaf’kd chekjh gks ldrh gSA rdjhcu 3%&6% ejhtksa ds lxs&lEca/kh ¼ekrk&firk] cgu&HkkÃ vkSj cPps½ esa Hkh ;g chekjh ik;h tkrh gSA vks-lh-Mh- vkSj VwjsV fMlvkMZj ¼jxksa dh ,d chekjh½ dk Hkh vkil esa lEcU/k ik;k x;k gSA vks-lh-Mh- ds ejhtksa ds lxs&laca/kh dks vks-lh-Mh- vkSj VwjsV~ fMl~vkWMZj & nksuksa gksus dh T;knk lEHkkouk gSA oSls gh VwjsV~ fMl~vkWMZj ds ejhtksa ds fj’rsnkjksa dks] vks-lh-Mh- gksus dh T;knk lEHkkouk gSA Kkr jgs fd vks-lh-Mh- ds vkuqokaf’kd gksus ds çek.k dsoy dqN çfr’kr ejhtksa esa gh ns[ks x, gSaA T;knkrj ejhtksa ds fj’rsnkjksa esa ;g ugha ik;h tkrh gSA

ruko dh Hkwfedk %

fdlh Hkh rjg dk ruko [kqn&c&[kqn vks-lh-Mh- dk dkj.k ugha ekuk tk ldrk gSA ijarq jksx&ço.k O;fDr;ksa esa ruko] vks-lh-Mh- pkyw gksus dk eq[; dkj.k cu ldrk gSA ruko] chekjh ds y{k.k ;k gkykr dks T;knk fcxkM+ ldrk gSA dqN vke rukoiw.kZ ?kVuk,¡ tks bl chekjh dks ’kq: dj ldrh gS & djhch yksxksa ls fcNqM+uk] ukSdjh xokuk] dke esa ijs’kkuh eglwl djuk] xHkZorh gksuk vFkok xHkZikrA


6

O;fDrÙo dh Hkwfedk %

dqN yksxksa dk O;fDrÙo dh Hkwfedk ,slk gksrk gS fd og gj dke dks ,d rjhds ls gh djrs gSaA T;knk le; mudk /;ku fu;e vkSj dke djus ds lgh rjhdksa esa yxk jgrk gSA ;g ekuk tkrk gS fd ;g yksx vksClsflo&daIyflo ilZukfyVh fMl~vkWMZj ds f’kdkj gSa & u fd vks-lh-Mh- dsA ftu yksxksa dks ;g ilZukfyVh fMl~vkWMZj gksrk gS] mu yksxksa dks vks-lh-Mh- gksus dh T;knk lEHkkouk gksrk gSA ijarq vks-lh- ilZukfyVh fMl~vkWMZj gksus dk ;g eryc ugha gS fd bu yksxksa dks vks-lh-Mh- Hkh t:j gksxhA T;knkrj ejht tks vks-lh-Mh- ds f’kdkj gksrs gSa] mUgsa vks-lh- ilZukfyVh fMl~vkWMZj ugha gksrk gSA ftu yksxksa esa vkRefo’okl de gksrk gS] tks yksxksa dh vkykspuk ugha >sy ikrs vkSj ftu yksxksa dks ckgj tkus ;k yksxksa ls feyus esa ?kcjkgV eglwl gksrh gS & bu yksxksa dks vks-lh-Mh- gksus dh T;knk lEHkkouk gSA

c½ euksoSKkfud dkj.k %

dÃ lkyksa ls] euksoSKkfud ;g ekurs vk jgs gSa fd ftu yksxksa dks vks-lh-Mh- gksrh gS muds ekrk&firk us mudh ijofj’k vR;f/kd vuq’kklu vkSj dBksjrk ls dh gSA ijarq vc ;g ckr lkQ gS fd vks-lh-Mh- dk ,slk dksÃ dkj.k ugha gksrk gSA cpiu esa euksoSKkfud ruko ;k ijs’kkuh dh otg ls vks-lhMh- ugha gksrh gSA

^yfuZax fFk;ksjh* ds eqrkfcd vksCls’kUl vkSj daIy’kUl nks pj.k esa iSnk gksrs gSaA vksCls’kUl dSls iSnk gksrs gSa & blds iq[rk lcwr ugha gSa D;ksafd ejht vksCls’kUl ds pkyw gksus ls igys dh ?kVukvksa dks ;kn ugha dj ikrs gSaA ijarq ;g HkyhHkkafr fl) gks pqdk gS fd daIy’kUl vkSj Mj Hkkxus dh ço`fÙk] vksCls’kUl dks dk;e j[krh gSA

igys pj.k esa dksÃ lk/kkj.k fopkj vFkok dYiuk fdlh ,slh nq?kZVuk ds lkFk lEcfU/kr gks tkrh gS tks vius vki esa dkQh Mjkouh vkSj ?kcjkgV iSnk djus okyh gksrh gSA QyLo:i og fopkj vkrs gh O;fDr ?kcjk tkrk gSA

nwljs pj.k esa O;fDr bu ?kcjkgV iSnk djus okys fopkjksa@dYiukvksa ls nwj Hkkxus yxrk gSA tSls & bl Mj ls pkdw dk bLrseky u djuk fd eSadgha fdlh dks ekj u cSBw¡A ,sls gj fopkj ?kcjkgV iSnk djrs gSa ftuls Hkkxk ugha tk ldrkA ftlds QyLo:i daIy”kUl iSnk gksrs gSaA

mijksDr nksuksa rjhds ¼nwj Hkkxuk@daIy’kUl½ {kf.kd gh lgh ijarq ?kcjkgV de djrs gSaA QyLo:i ejht dks budh vknr iM+ tkrh gS vkSj mlds fy, bl Ja[kyk dks rksM+ ikuk eqf’dy gks tkrk gSA

vks-lh-Mh- vkSj vU; chekfj;k¡

vDlj vks-lh-Mh- nwljs ekufld chekfj;ksa ds lkFk ik;k tkrk gSA dqN vke chekfj;k¡ tks vks-lh-Mh- ds lkFk ik;h tkrh gSa & ^fMçs’ku*] ^vU; ,aXtkbVh fMl~vkWMZj*] ^fVd fMl~vkWMZj*] ^LdhtksÝsfu;k* vkSj u’ks dh chekjh ¼’kjkc] flxjsV] xkatk bR;kfn½A ,aXtkbVh fMl~vkWMZj tks vks-lh-Mh- ds lkFk

7

ik, tkrs gSa og gSa & iSfud fMl~vkWMZj] Qksfc;k vkSj tujykbTM ,aXtkbVh fMl~vkWMZjA bu vU; chekfj;ksa dks igpkuuk vkSj mudk bykt djuk vko’;d gS] D;ksafd vxj budk bykt ugha fd;k x;k] rks ’kk;n vks-lh-Mh- dk Bhd rjg ls bykt ugha gks ik,xkA vks-lh-Mh- ds lkFk vU; chekfj;ksa dk gksuk] ejht dh gkyr dks vkSj csdkj cuk ldrk gSA ftlls og fcYdqy cscl gks ldrk gSA

vDlj ^fMçs’ku* dh chekjh ejht dks vksCls’kUl vkSj daIy’kUl ls de ijs’kkuh nsrk gSA ftu yksxksa dks vks-lh-Mh- ds lkFk fMçs’ku dh chekjh gksrh gS] mudk eu mnkl jgrk gS vkSj dke djus dh QqrhZ de gks tkrh gSA og phtksa dk etk ugha ys ikrs gSa vkSj [ksy&dwn ds çfr mudh #fp de gks tkrh gSA og vius vki dks] lekt dks vkSj Hkfo"; dks grk’k utj ls ns[krs gSaA og vius gh dkfcfy;r vkSj {kerk dks utjvankt djrs gSaA mUgsa yxrk gS fd thus dk dksÃ eryc ugha gS vkSj dkQh yksx vkRegR;k djus dh lksprs gSaA

ftu ejhtksa dks ^iSfud fMl~vkWMZj* gksrk gS] mUgsa ?kcjkgV ds nkSjs iM+rs gSaA bu nkSjksa esa mUgsa ng’kr eglwl gksrh gSA ejht vius gh /kM+duksa dh rst xfr dks lqu ldrs gSa] mudh lk¡l Qwyus yxrh gS] T;knk ilhuk NwVrk gS] gkFk dk¡irs gSa] isV esa mFky&iqFky eglwl gksrh gS vkSj ejus dk ;k ikxy gksus dk Mj yxk jgrk gSA

ftu ejhtksa dks ^Qksfc;k* dh chekjh gksrh gS] mUgsa fdlh oLrq ;k ?kVuk ds çfr csotg Mj yxk jgrk gSA bldh otg ls og mu ?kVukØeksa ls lEcU/k ugha j[krs gSaaA ftu ejhtksa dks ^vxksjkQksfc;k* dh chekjh gksrh gS] mUgsa ,slh txgksa vkSj ?kVukvksa ls Mj yxk jgrk gS] tgk¡ ls lEHkkfor nkSjs ds le; vklkuh ls cp dj ugha fudy ldrs gSa] ;k vius cpko ds fy, fdlh dks cqyk ugha ldrs gSaA mnkgj.k ds rkSj ij & ?kj ls vdsys tkuk ;k ?kj rd vdsys lQj djuk] tgk¡ HkhM+&HkkM+ T;knk gksrh gS] tSls lCtheaMh] nqdku] Hkjh cl bR;kfnA

ftu ejhtksa dks ^lks’ky Qksfc;k* gksrk gS] og lkekftd txgksa ij ugha tkrs gSa D;ksafd mUgsa Mj yxk jgrk gS fd lHkh yksxksa dk /;ku muij gSA bu yksxksa dks ;g Mj Hkh yxrk gS fd og vutku yksxksas ds lkeus ’keZukd crkZo dj jgs gSaA ftu ejhtksa dks ^tujykbTM ,aXtkbVh fMlvkMZj* gksrk gS og gj oDr ?kcjkrs jgrs gSa vkSj rukoxzflr jgrs gSaA bu yksxksa dks jkstejkZ dh ?kVukvksa vkSj ijs’kkfu;ksa ds ckjs esa yxkrkj ?kcjkgV eglwl gksrh gSA

ftu yksxksa dks ^fLØtksÝsfu;k* dh chekjh gksrh gS] mUgs ^gSY;wflus”kUl* vkSj ^fMY;wtUl* gksrs gSaA mudks ,slh phtksa ij fo’okl gksrk gS] ftUgsa muds nksLr ;k ifjokjokys ugha ekursA mudks dHkh&dHkkj ;g eglwl gksrk gS fd muds lksp] dk;Z vkSj Hkkouk,¡ fdlh vkSj ds dkcw esa gSaA dqN yksx ;g fo’okl djrs gSa fd dksÃ ckgjh rÙo ¼rkdr ;k yksx½ muds eu ds vanj fopkj Mky jgs gSa ;k muds ethZ ds f[kykQ muds fopkjksa dks nwljksa dks n’kkZ jgs gSaA og nwljksa ds dk;Z vkSj uh;r ij lansg djus yxrs gSaA mUgsa vkoktasa lqukÃ nsrh gSa ;k phtsa@yksx fn[kkÃ nsrs gSa & tks nwljs yksxksa dks fn[kkÃ ;k lqukÃ ugha nsrs gSaA tc vks-lh-Mh- fLØtksÝsfu;k ds

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lkFk ikÃ tkrh gS] rc igys vks-lh-Mh- dks igpkuuk vkSj mldk bykt djuk t:jh gks tkrk gS & ugha rks fLØtksÝsfu;k ij dkcw ikuk eqf’dy gks ldrk gSA

rdjhcu 20%&30% vks-lh-Mh- ds ejht ?kcjkgV de djus ds fy, ’kjkc dk lgkjk ysrs gSaA og fu;fer :i ls ’kjkc ihus yxrs gSa vkSj mUgsa bldh yr iM+ tkrh gSA og ’kjkc ij fu;a=.k [kks cSBrs gSa vkSj bls jksduk ;k de djuk muds o’k esa ugha jgrkA jksdus dh n’kk esa mUgsa ?kcjkgV] cspSuh] vfuæk vkSj gkFkksa esa dEiu dh f’kdk;r gksus yxrh gSA

vksClsflo & daIyflo Js.kh dh vU; chekfj;k¡

gkykafd vksCls’kUl vkSj daIy’kUl eq[;r% vks-lh-Mh- esa ns[ks tkrs gSa] mUgsa vU; ekufld chekfj;ksa esa Hkh ik;k tk ldrk gSA bu chekfj;ksa vkSj vks-lh-Mh- esa dqN lekurk,¡ gksrh gSa tSls & y{k.k] dkj.k] bykt dk vlj bR;kfn esa lekurk,¡A

vU; chekfj;ksa esa ckWMh fMlekWfQZd fMl~vkWMZj] VªkbdksfVyksesfu;k] VwjsV~ fluMªkse] [kkus dh chekfj;k¡] vR;f/kd tqvk [ksyus ;k phtksa dks [kjhnus dh chekjh ’kkfey gSaA ;s chekfj;k¡ vks-lh-Mh- ds lkFk vFkok LorU= :i ls ik;h tk ldrh gSA

ckWMh fMlekWfQZd fMl~vkWMZj esa ejht dks ;g fpark yxh jgrh gS fd ’kk;n mldh HkkSfrd :i js[kk] esa dqN deh gSA mnkgj.k % mldh ukd Vs<+h gS] cky irys gSa ;k mldk peM+k [kjkc gSA tjk lh Hkh deh dks og t:jr ls T;knk egÙo nsrs gSaA ;g yksx vkÃus ds lkeus viuh dfe;ksa dks tk¡pus ds fy, T;knk le; yxkrs gSaA og psgjs ij esdvi yxkrs gSa rkfd mudh dfe;k¡ fNi ldsaA viuh dfe;ksa dks Nqikus ds fy, ;s yksx MkDVjksa ds] [kkldj IykfLVd ltZuksa ds] ckj&ckj pDdj yxkrs gSaA

VªkbdksfVyksesfu;k ;k tkucw>dj [kqn ds cky fudkyus dh chekjh esaejht tkucw>dj ckj&ckj [kqn ds ckyksa dks [khaprs gSaA cky [khapus ds igys bu yksxksa dks ruko eglwl gksrk gS vkSj [khap ysus ds ckn [kq’kh ;k jkgr eglwl gksrk gSA ’kjhj ds fdlh Hkh fgLls ls cky [khapk tk ldrk gSA T;knkrj ;g ejht vius lj ds ckyksa dks [khaprs gSaA

ftu ejhtksa dks VwjsV~V fluMªkse gksrk gS] muds ’kjhj ds vax] fcuk mudh bPNk ds fgyrs gSaA tSls lj vkSj dU/ks dk vpkud >Vdk ysuk] vk¡[kksa dk QM+duk bR;kfnA blds vykok] muds bPNk ds fo#) vkoktsa fudyrh gSa( mnkgj.k % ¼xyk lkQ djuk] fpYykuk] fgPpdh vkuk½ vkSj og xanh ckrsa cksy cSBrs gSaA

[kkuk] [kjhnnkjh djuk vkSj dHkh tqvk [ksyuk vke vkSj jkstejkZ dh ftanxh dk ,d fgLlk ekuk tkrk gSA ijarq tc ;gh dk;Z T;knk ek;us esa gksrk gS] yksxksa esa ?kcjkgV iSnk djrk gS vkSj muij dkcw ikuk eqf’dy gks tkrk gS] rc mUgsa ^ÃfVax fMl~vkWMZj*] dEiyflo ckÃax] iSFkksykWftdy xSEcfyax dgk tkrk gSA

vks-lh-Mh- ds fy, nokÃ;k¡ %

1980 rd vks-lh-Mh- ds bykt ds fy, dksÃ Hkh vljnkj nokÃ miyC/k ugha FkhA ijarq mlh le; ls nokÃ;ksa ds ,d oxZ dks bl chekjh esa

9

vljnkj ik;k x;k gS vkSj uÃ nokÃ;k¡ tks bl oxZ esa ’kkfey gSa] og Hkh vljnkj lkfcr gqÃ gSaA bl nokÃ;ksa ds oxZ dks ^fljksVksfuau jh&viVsd bfUgfcVlZ* dgk tkrk gSA gekjs efLr"d esa U;wjksVªkafLeVj uked jlk;u ik;s tkrs gSaA fljksVksfuu ,d rjg dk U;wjksVªkafLeVj gksrk gSA ;g nokÃ;k¡ gekjs efLr"d esa fljksVksfuu dh ek=k dks c<+kus dk dke djrh gSA tks nokÃ;k¡ nwljs U;wjksVªkafLeVj ds Hkkxksa ij dke djrh gSa] tSls Mksikehu ¼,UVh lkbdksfVd nok,sa½] uksj,Mªhusyhu ¼vU; ,UVh&MhçslsUV nokÃ½ ;k xk ck jhlsIVj dkEIysDl ¼flMsfVo fgiuksfVd nokÃ½] og vks-lh-Mh- ds bykt esa vljnkj ugha gksrh gSA vks-lh-Mh- esa ftu nokÃ;ksa dk oxZ bLrseky fd;k tkrk gS & muesa Dyksehçehu uked ,d nokÃ lcls iqjkuh nokÃ gSA uÃ nokÃ;k¡ tks bl oxZ esa “kfey dh xÃ gSa] og gSa & ¶ywvksdlksVhu] ¶ywoksDlksehu] ljVªsfyu] ikWjksDlVhu] bfLlVyksçke vkSj flVyksçkeA igys ;g lkjh nokÃ Hkkjr esa miyC/k ugha FkhaA bu esa ls dksÃ Hkh ,d nokÃ vU; nokÃ;ksa ls vks-lh-Mh- chekjh ds fy, Js"B ugha ekuh tkrh gSA

bu lHkh nokÃ;ksa dks] ,UVh MhçslsUV uked nokÃ;ksa ds ,d cM++s oxZ esa ’kkfey fd;k x;k gSA cgqr le; ls ;g fookn py jgk Fkk fd D;k bu nokÃ;ksa ls fMçs’ku ;k vks-lh-Mh- dk bykt gksrk gS\ T;knkrj oSKkfud bl ckr ij lger gS fd gkykafd ;g nokÃ;k¡ Mhçs”ku esa T;knk vlj fn[kkrh gSa] ;g dkQh gn rd vks-lh-Mh- dk bykt djus esa Hkh lQy jgh gSaA blds ;g ek;us gq, fd vkidks Mhçs’ku gks ;k u gks] ;g nokÃ;k¡ vki dh vks-lh-Mh- ij dke djsaxhA

nokÃ dk pquko mlds lkbM bQSDV~l vkSj ml nokÃ ij MkDVj ds fo’okl ij fuHkZj djrk gSA tks nokÃ;k¡ T;knkrj vks-lh-Mh- chekjh ds bykt ds fy, nh tkrh gSa] og gSa & Dyksfeçehu] ljVªsfyu vkSj ¶ywvkDlVhuA ge bu nokÃ;ksa ij foLrkj ls ppkZ djsaxsA

Dyksfeçehu ,d VªkÃlkbfDyd ,UVh fMçslsaV ekuk tkrk gSA fljksVksfuu {ks= ij mldk vlj çHkko’kkyh gksrk gS] gkykafd og vU; U;wjksVªkafLeVlZ ij Hkh viuk dke djrk gSA ;g nokÃ 150&250 ,e-th- dh ek=k esa] çfrfnu ck¡Vdj fn;k tkrk gSA dqN fo’ks"k ifjfLFkfr esa bl nokÃ dks T;knk ek=k esa fn;k tk ldrk gS ¼300 ,e-th- rd½A nokÃ dh ek=k /khjs&/khjs c<+kÃ tkrh gS] D;ksafd bl nokÃ ds lkbM&bQSDV~l T;knkrj 150 ,e-th- dh ek=k ds ckn fn[kkÃ nsrs gSaA bl nokÃ ds eq[; lkbM&bQSDV~l & eq¡g dk lw[kuk] gkFk&iSj dk¡iuk vkSj dCt gksuk] gksrk gSA dHkh&dHkkj vk¡[kksa dk /kq¡/kykuk vkSj fexhZ vkus dh ¼nokÃ dh T;knk ek=k esa½ lEHkkouk gksrh gSA T;knkrj ;g lkbM&bQSDV~l dkQh rdyhQ nsrh gSA vxj ;g rdyhQ t:jr ls T;knk gks rks mlds fy, vki vius MkWDVj ls lEidZ dj ldrs gSa rkfd og vkids nokÃ dh ek=k dks ;k rks ?kVk ldrs gSa] /khjs&/khjs c<+k ldrs gSa ;k nokÃ cny ldrs gSaA

¶ywvkDLVhu nokÃ fljksVksfuu jh&viVsd {ks= dk ,d [kkl bufgfcVj gSA fMçs’ku ds fy, ;g nokÃ 20 ,e-th- dh ek=k esa nh tkrh gSA ijarq vks-lh-Mh- esa 60 ls 80 ,e-th- dh ek=k esa bl nokÃ dks nsus ls ;g vljnk;d lkfcr gksrh gSA ¶ywvkDLVhu T;knkrj ,d vdsyh xksyh lqcg esa ;k ,d&,d xksyh lqcg vkSj nksigj dks nh tkrh gSA bl nokÃ ds


10

eq[; lkÃM&bQSDV~l gS de uhan vkuk vkSj cspSuh eglwl djukA uhan u vkus dh lkÃM&bQSDV~l dh otg ls ¶ywvkDLVhu nokÃ lqcg esa nh tkrh gSA ’kq#vkr esa tc ;g nokÃ T;knk ek=k esa yh tkrh gS rc dHkh&dHkkj lkÃM&bQSDV~l utj vkrs gSaA

fdrus le; rd nokÃ;k¡ pkyw j[kuh gS & ;g Bhd ls crk;k ugha tk ldrk gSA oSKkfud v/;;uksa us ;g fn[kk;k gS fd nokÃ;k¡ 1 & 2 lky ds fy, vljnk;d gksrh gSA ijarq bykt dc can djuk pkfg,] ;g lkQ crk;k ugha x;k gSA dqN v/;;uksa us ;g crk;k gS fd nokÃ can djus ls 60% ls 80% lEHkkouk gS fd chekjh nksckjk gks ldrh gSA dksÃ Hkh v/;;u] nokÃ;k¡ vkSj fcgsfo;j Fksjsih vkSj nokÃ jksdus ds vlj ij lwpuk ugha nsrh gSA vxj nokÃ;ksa ds lkFk ejht fu;a=.k esa gS] rc MkWDVj /khjs&/khjs nokÃ;ksa dks de djds] jksd ldrk gSA nokÃ jksdus ds ckn ;g ns[kuk t:jh gS fd D;k chekjh ds y{k.k nksckjk çdV gksrs gSa fd ughaA vxj chekjh ds y{k.k nksckjk çdV ugha gksrs gSaA rc nokÃ;k¡ ysus dh t:jr ugha iM+rh gSA ijarq vxj chekjh ds y{k.k nksckjk çdV gksrs gSa] rc nokÃ;k¡ ’kq: djuh iM+rh gSaA ;g nqHkkZX;iw.kZ ckr gS fd vks-lh-Mh- ,d yacs vjls dh chekjh gS vkSj bldk bykt yacs le; rd fd;k tkrk gSA bl lUnHkZ esa mldh rqyuk e/kqesg ;k mPp jDrpki ls dh tk ldrh gSA ijUrq chekjh ds fu;a=.k esa vkus ds ckn] nokÃ dh ek=k de dh tk ldrh gSA

nokÃ /khjs&/khjs 1&3 eghus ds le; esa de dh tkrh gSA bykt ds 6 eghus ls 1 lky ds ckn] vxj chekjh fu;a=.k esa gS] rc nokÃ dh ek=k 60% rd de dh tkrh gSA

nqHkkZX;iw.kZ ckr ;g gS fd dkQh Qhlnh ejht ¼rdjhcu 40%½ ,d gh nokÃ ds ysus ls Bhd ugha gks ikrs gSaA vxj nokÃ ds lkFk fcgsfo;j Fksjsih Hkh bLrseky fd;k tkrk gS] rc flQZ 20%—30% ejhtksa dks ,d ls T;knk nokÃ;ksa dh t:jr iM+rh gSA bu ejhtksa ds fy, nwljh nokÃ;k¡ nsus dk mik; fd;k tkrk gS & tSls Dyksukftike] yhFkh;e] bR;kfnA vki ds MkWDVj vkidks bu nokÃ;ksa ds ckjs esa T;knk tkudkjh ns ldrs gSa] vxj bl rjg dk bykt t:jh yxsA

gekjs yk[k dksf’k’kksa ds ckotwn FkksM+s&cgqr ejht bykt ls Bhd ugha gks ikrs gSaA bu ejhtksa ds fy, lkbdksltZjh ,d vkf[kjh fodYi ekuk tkrk gSA bl rjg ds bykt ds dsUæ vkt Hkkjr esa miyC/k ugha gSaA ijarq tc budh vko’;drk iM+sxh] rc ’kk;n bu dsUæksa dks LFkkfir fd;k tk,xkA

vks-lh-Mh- chekjh ds fy, fcgsfo;j Fksjsih %

fcgsfo;j Fksjsih D;k gksrk gS\

fcgsfo;j Fksjsih ,d bykt lewg gksrk gS ftlls cqjs vkpj.k vPNs vkpj.k esa cnys tk ldrs gSaA vks-lh-Mh- ds y{k.k & vkCls’kUl vkSj daIy’kUl dks cqjs vkpj.k ds vUrxZr ekuk tkrk gS D;ksafd og vkneh ds jkstejkZ ds dkedkt esa ck/kk Mkyrs gSa vkSj muls dkQh rdyhQ eglwl gksrh gSA fcgsfo;j Fksjsih bu vkCls’kUl vkSj daIy’kUl ls NqVdkjk fnykus esa enn djrk gS & ftlls ejhtksa dks de rdyhQ eglwl gksrh gSA

11

vks-lh-Mh- ds bykt esa fcgsfo;j Fksjsih dh dÃ rduhdsa bLrseky dh tkrh gSaA bu esa ls ^,Dlikstj vkSj fjLikWUl fçosU’ku* ¼?kcjkgV iSnk djus okyh fLFkfr@pht ls ifjfpr djuk vkSj ejht ds ¼ml fLFkfr esa½ dh x;h çfrfØ;k dks jksduk½ dkQh ç;ksx dh tkrh gSs vkSj vljnk;d Hkh ekuh tkrh gSA ;g 60% & 80% vks-lh-Mh- ds ejhtksa esa vljnk;d gksrh gSA

fcgsfo;j Fksjsih D;ksa bLrseky dh tkrh gS\

ge tkurs gSa fd T;knkrj ejht nksuksa vkCls’kUl vkSj daIy’kUl ls ihfM+r gksrs gSaA daIy’kUl ?kcjkgV ;k rdyhQ de djus ds fy, fd, tkrs gSa vkSj bl rjg vksCls’kUl ds lkFk laidZ j[krs gSaA FkksM+s nsj ds fy, gh lgh] ijarq daIy’kUl ?kcjkgV de djus esa enn djrh gSA blfy, og vknr cu tkrh gS vkSj vksCls’kUl ds tokc esa og vDlj bLrseky dh tkrh gSA le; ds lkFk] tks daIy’kUl ?kcjkgV de djus ds fy, dh tkrh Fkh] ogh daIy’kUl ?kcjkgV dh tM+ cu tkrh gSA lgt ’kCnksa esa & vksCls’kUl daIy’kUl dks iSnk djrh gS vkSj D;ksafd daIy’kUl vksCls’kUl ls iSnk gqÃ ?kcjkgV dks de djrh gS] og dk;e jgrh gS vkSj ,d etcwr Ja[kyk cukrh gS] ftls rksM+uk eqf’dy gks tkrk gSA

^^,Dlikstj vkSj fjLikWUl fçosU’ku** dh rduhd] tks Hkkoukvksa ds ^gkWfcpq, ’ku* uked fl)kar ij dk;e gS og bl Ja[kyk dks rksM+ ldrk gSA ^gkWfcpq, ’ku* dk eryc D;k gS\ ;g ,d vke fl)kar ij vk/kkfjr gSA blesa ;g ekuk tkrk gS fd csotg Mj vkSj vkpj.k] Mj ;k ?kcjkgV iSnk djusokyh pht dks ckj&ckj fn[kkus ls xk;c gks tkrh gSA ckj&ckj vkSj yacs le; rd Mj iSnk djusokyh pht dks fn[kkus ls balku dks mldh vknr gks tkrh gS ;k ?kcjkgV vkSj cspSuh dh vknr ml gn rd gks tkrh gS] tc rd ogh nnZukd pht Mj iSnk djus dh {kerk [kks nsrk gSA ijarq ftu ejhtksa dks vks-lh-Mh- gksrk gS] og vius Mj vkSj ?kcjkgV dks de djus ds fy, daIy’kUl dk lg;ksx ysrs gSa ;k mu lkjh phtksa ls nwj jgrs gSa tks lEHkor% vksCls’kUl dks iSnk dj ldrh gSaA blds fo#) fcgsfo;j Fksjsih esa ejht dks ;g çksRlkgu fn;k tkrk gS fd og /khjs&/khjs Mj iSnk djusokyh ?kVukvksa dk lkeuk djs vkSj viuh cspSuh ls tw>sA ejht ls ;g Hkh dgk tkrk gS fd og Mj iSnk djusokyh ?kVukvksa ls nwj ugha jgs vkSj daIy’kUl dh lgk;rk u ysA daIy’kUl dh lgk;rk u ysus ls vksCls’kUl ls tqM+h gqÃ ?kcjkgV /khjs&/khjs de gks tkrh gSA tc ejht dks ?kcjkgV dh vknr iM+ tkrh gS rc vksCls’kUl vkSj daIy’kUl /khjs&/khjs de gks tkrs gSaA

mnkgj.k % dqN ejht xanxh ds Mj ls ckj&ckj gkFk /kksrs gSa] [kkldj tc Hkh njoktksa dh dqafM;ksa dks Nwrs gSa & fcgsfo;j Fksjsih esa bu ejhtksa dks ckj&ckj njoktkas dh dqafM;ksa dks Nwus dk çksRlkgu fn;k tkrk gS ijarq fcuk gkFk /kks,A bl rjg djus ls] ejht dh ?kcjkgV T;knk c<+rh gSA ijarq /khjs&/khjs le; ds lkFk] [kqn&c&[kqn ;g ?kcjkgV de gks tkrh gS vkSj ejht dks mldh vknr iM+ tkrh gSA vxj ejht gkFk /kksrk gS] rc ?kcjkgV rqjar de gks tkrh gS] ijarq mls ?kcjkgV dh vknr ugha iM+rh gSA

12

bl otg ls] xanxh dk Mj dk;e jgrk gS vkSj ejht dks xanxh ds Mj ls fuiVus ds fy, yacs vkSj ekufld ncko iSnk djus okys daIy’kUl dh lgk;rk ysuh iM+rh gSA bl etcwr Ja[kyk dks rksM+us ds fy, ,d gh rjhdk gS & ,Dlikstj ¼[kqn ml fLFkfr dk lkeuk djuk] ijarq gkFk u /kksuk½A ckj&ckj ^,Dlikstj* ls xanxh dk Mj /khjs&/khjs NwV tkrk gS vkSj bl otg ls gkFk&/kksus dk daIy’kUl Hkh NwV tkrk gSA

chekjh ds y{k.k dh tk¡p vkSj bykt %

1½ igys] lHkh vksCls’kUl vkSj daIy’kUl dks /;ku ls vkSj foLrkj ls fy[kuk pkfg,A

2½ blds ckn] og lkjh pht vkSj fLFkfr tks vksCls’kUl vkSj daIy’kUl iSnk djrh gSa] mUgsa igpkudj ,d ?kVrs gq, Øe esa Åij ls uhps fy[kuk pkfg,A lcls uhps] lcls de ?kcjkgV iSnk djusokyh fLFkfr vkSj lcls Åij lcls T;knk ?kcjkgV iSnk djusokyh fLFkfrA

3½ Øec) rjhds ls fd, tkus okys daIy’kUl dks jksdus ds fy,] mu lkjh fLFkfr;ksa vkSj phtksa ds ckjs esa tkudkjh gkfly dh tkrh gS] ftlls ejht nwj jgrk gSA mnkgj.k %& ejht lkekftd ’kkSpky; bLrseky djus esa drjkrk gS D;ksafd og vius gkFk vkSj diM+s dks T;knk ugha /kksuk pkgrk gSA phtsa vkSj fLFkfr dh rjg] dqN fopkj vkSj n`’;] ?kcjkgV ;k cspSuh iSnk dj ldrh gSa vkSj ejht bu ifjfLFkfr;ksa esa iM+us ls Mjrk gSA mnkgj.k %& Hkxoku dh rLohj ns[kdj ;k eafnj tkus ls] Hkxoku ds çfr eu esa xans fopkj iSnk gksukA bu fopkjksa ls NqVdkjk ikus ds fy,] ejht cgqr ckj eafnj tkuk ;k çkFkZuk djuk jksd nsrk gSA

4½ dqN ejhtksa dks] vksCls’kUl vkSj daIy’kUl flQZ ?kj esa jgrs le; eglwl gksrk gSA bl tkudkjh dks gkfly djuk t:jh gks tkrk gS D;ksafd bl fLFkfr esa bykt iwjh rjg ?kj esa gh gksrk gS vkSj ?kjokyksa dk lg;ksx cgqr egÙoiw.kZ gks tkrk gSA

5½ varr% dqN ejhtksa ds daIy’kUl ?kjokyksa ds vkpj.k ls T;knk dk;e jgrs gSaA bl fLFkfr eas] bykt djrs le; ?kjokyksa dk lg;ksx fy;k tkrk gSA

igys ls gh ;g tku ysuk t:jh gS fd bykt rdyhQ iSnk djrk gSA vxj ejht var esa lqdwu gkfly djuk pkgrk gS] rc ejht dks rdyhQ >syus ds fy, rS;kj gksuk pkfg,A fdl xfr ls ejht vius gh HkkoukRed çfrfØ;kvksa ls ifjfpr gksrk gS] ;g gj ejht esa leku ugha gksrk gSA dqN vkpj.k ^,Dlikstj* ds dqN le; ¼30 feuV½ esa gh urhtk fn[kkrs gSa] ijarq dqN vU; vkpj.k dks yacs ^,Dlikstj* dh t:jr gksrh gS ¼2&3 ?kaVs½] ftlls ?kcjkgV de gksrh gSA T;knkrj ifjfLFkfr;ksa esa daIy’kUl igys de gksrs gSa] ijarq vksCls’kUl de gksus esa T;knk le; yxkrs gSaA dkQh vksCls’kUl ^,Dlikstj vkSj jsLikWUl fçosU’ku* ds 10 ls 12 ?kaVs ds ckn urhtk fn[kkrs gSaA vPNs ifj.kke ds fy, Bhd gksus dk n`<+ ladYi vkSj ’kq:vkrh nkSj esa gksus okyh ijs’kkuh ls tw>us dh {kerk gksuk vko’;d gSA

vks-lh-Mh- ds bykt esa ifjokj dh Hkwfedk

13

gekjk vuqHko ;g dgrk gS fd ifjokj dk lg;ksx vks-lh-Mh- ds bykt esa dkQh egÙoiw.kZ Hkwfedk fuHkkrk gSA T;knkrj vks-lh-Mh- iwjs ifjokj dks çHkkfor djrk gSA vks-lh-Mh- ds otg ls ifjokj esa T;knk ruko iSnk gks ldrk gS] ftlls ifr&iRuh ds chp esa vucu ;k fMokslZ gks ldrk gSA dqN ifjokj] vius cPpksa ;k thou&lkFkh ds chekjh ds fy, [kqn dks ftEesnkj ekurs gSaA tc dHkh nksLr vkSj fj’rsnkj ijke’kZ nsrs gSa fd ejht chekj ugha gS & flQZ cqjs oDr ls xqtj jgk gS vkSj T;knk fu;a=.k vkSj /;ku j[kus ls ejht dh ijs’kkuh nwj gks ldrh gS( rc ifjokj dks T;knk nq[k vkSj “keZ eglwl gks ldrk gSA ifjokj esa ges’kk ;g ’kadk jgrh gS fd D;k ejht ds daIy’kUl muds chekjh dk gh ,d Hkkx gS ;k og mudk /;ku vkdf"kZr djus ds fy, tkucw>dj dj jgs gSaA gj ifjokj eq[;r% rhu rjg ls vks-lh-Mh- ls tw>rk gS % lg;ksx ls] vkØks’k ls vkSj dqN lg;ksx ;k vkØks’k ls ¼bu ifjokjksa dks ^fLIyV Qsfeyh* dgk tkrk gS½A

lg;ksxh ifjokj T;knkrj ejht ds çfr t:jr ls T;knk mRlkg] NwV ;k n[kyvankth fn[kkrs gSaA ifjokj ds lnL; feydj ejht dks daIy’kUl djus esa enn djrs gSa] rkfd ?kj esa Nk;k ruko ?kV tk,A ;g ejht ds bykt esa gkfu igq¡pkrk gS vkSj ?kj esa ruko iSnk djrk gSA blds foijhr vkØks’ktud ifjokj] ejht ds ijs’kkfu;ksa esa ’kkfey ugha gksrs gSaA og dBksj] vyx&vyx] çfrdwy] vkykspd vkSj ltk esa ;dhu djus okys gksrs gSaA ifjokj ds lnL;ksa ds chp esa xqLlk vkSj yM+kÃ vkSj dHkh&dHkkj fgalk vke ckr gksrh gSA fLIyV Qsfeyh esa] dqN yksx t:jr ls mRlkg trkrs gSa vkSj ckdh ds yksx vkykspd] çfrdwy vkSj dBksj gksrs gSaA Åij fn, x, rhu rjg ds ifjokj ds vkpj.k vks-lh-Mh- ds bykt ds fy, ljkguh; ugha ekus tkrs gSaA blfy, vks-lh-Mh- ds bykt esa ifjokj okyksa dk ’kkfey gksuk t:jh ekuk tkrk gS] [kkldj fcgsfo;j Fksjsih djus esa vkSj nokÃ nsrs le;] fuxjkuh j[kus esaaA

lPph ?kVuk,¡ % dqN mnkgj.k

• ,d 25 lky dh x`g.kh dks mlds ifr vkSj lkl&llqj vLirky ys vk,] bl ijs’kkuh ds lkFk fd og vius gkFk /kksus ds fy, ?kaVksa yxkrh FkhA tk¡p&iM+rky djus ij ejht us ;g crk;k fd og Mjrh Fkh fd mlds gkFk lkQ&lqFkjs ugha gSa vkSj bl otg ls og ckj&ckj viuk gkFk /kksrh Fkh] rkfd mlds gkFk lkQ gksaA og nwljksa ds Nq, x, njoktksa dh dqafM;k¡] f[kM+fd;k¡] ckYVh vkSj ex ugha Nwrh FkhA og nwljksa ds bLrseky dh x;h ’kkSpky; esa Hkh ugha tkrh FkhA nk¡rksa dks ek¡tus ds fy, 30 feuV yxkrh D;ksafd og Mjrh Fkh fd mlds nk¡r lkQ ugha gSaA bl LoPNrk ds tquwu dh otg ls] og gj ml pht dks] tks mlds fglkc ls xank Fkk] mldks Nwus ds ckn viuk gkFk /kksus ds fy, 20&30 feuV yxkrh FkhA ¼mnkgj.k % njoktksa dh dqafM;k¡] [kkus dh est] da?kh] lkcqu dk fMCck½A og gj ckj ugkus ds igys ckFk:e] ckYVh] ex o uy ,oa lkcqu dks rdjhcu ,d ls nks ?kaVs rd /kksrh FkhA mlds ckn og ugkus ds fy, vkSj nks ?kaVs yxkrh FkhA mldk Mj fd og iwjh rjg LoPN ugha gS] mls ckj&ckj lkcqu yxkus ds fy, etcwj djrk Fkk vkSj bl otg ls og


14

ugkdj ckgj vkus rd iwjh rjg Fkd tkrh FkhA mldh iwjh ftanxh vkSj jkst ds dke iwjh rjg LoPNrk ds fopkjksa esa chrrs Fks vkSj mls nwljs dke djus dk cgqr de le; feyrk FkkA vktdy] mldk lkQ jgus dk vksCls’kUl bl gn rd igq¡p x;k gS fd og vius ifr dks dksÃ Hkh dke djus ls igys gkFk /kksus ds fy, etcwj djrh gSA mls ;g ,glkl gS fd mlds lQkÃ ds fopkj csdkj vkSj vko’;drk ls vf/kd gSaA ijarq og T;knk ?kcjkgV dh otg ls bu fopkjksa ij dkcw ugha ik ldrh FkhA

• 30 lky dh mez ds ,d vkneh cSad esa dSf’k;j dk dke djrs FksA mUgs ;g ’kadk Fkh fd xzkgd dks iSls nsus ds igys] mUgksauas iSlksa dks Bhd rjg ls fxuk ugha gSA mudh ’kadk ;g Fkh fd ’kk;n mUgksaus xzkgd dks de ;k T;knk iSls ns fn, gSaA vxj T;knk iSls ns fn, x, rc mUgsa ftEesnkj Bgjk;k tkrk vkSj vxj de iSls fn, x, rc xzkgd muij fpYykrsA ;g ’kd muds dke djus esa ck/kk Mkyrh FkhA gj eghus ds igys g¶rs esa T;knk ijs’kkuh gksrh Fkh] tc cgqr lkjs xzkgd ml ij fpYykrs FksA muds cSad eSustj us Hkh muds dke djus ds rjhds ij psrkouh nh vkSj bl otg ls og vkfQl esa g¡lh ds ik= cu x,A blls mUgsa ’kfeZUnxh vkSj nq[k eglwl gksrk FkkA tk¡p iM+rky djus ds ckn] mUgksaus ;g cryk;k fd jkr dks lksus ds igys] og vius ?kj ds njoktksa dh dqafM;k¡ Hkh ckj&ckj tk¡prs Fks] rdjhcu 10&15 ckjA og bysfDVªd dh phtksa dks Hkh ckj&ckj tk¡prs Fks] ;g tkuus ds fy, fd og Bhd rjg ls can fd;k x;k gS fd ughaA ;g tk¡pus vkSj fxurh djus ds fu;e cspSuh vkSj ?kcjkgV iSnk djrh Fkh D;ksafd mUgsa irk Fkk fd og t:jr ls T;knk csdkj dh ’kadk FkhA

• MkWDVj us 16 lky ds Nk= dks ;g dgdj bykt ds fy, Hkstk fd og dHkh Hkh Ldwy oDr ij ugha igq¡prk Fkk] D;ksafd T;knk oDr Ldwy tkus dh rS;kjh esa yxkrk FkkA mlds ekrk&firk ;g dgrs Fks fd og vius est ij ;k cSx esa j[kh x;h fdrkcksa ds j[kus ds rjhds ls dHkh Hkh larq"V ugha FkkA og gj lqcg Ldwy ls lEcfU/kr lHkh phtksa dks ckj&ckj j[kus ds fy, 3 ?kaVs yxkrk Fkk] ftlds dkj.k mls ges’kk nsj gks tkrh FkhA mlds ?kjokys mls tYnh djus ds fy, tcjnLrh djrs FksA vxj dksÃ mldh phtksa dks Nwrk] rc og cgqr T;knk nq[kh gks tkrk FkkA ?kjokyksa us ;g Hkh crk;k gS fd og jkr dks lksus ls igys] fcLrj cukus ds fy, rdjhcu ,d ?kaVk yxkrk FkkA phtksa dks lgh rjhds ls j[kus dk tquwu mls i<+kÃ] gkse&odZ vkSj Ldwy ds ckdh dke ds fy, cgqr de le; nsrk FkkA bldh otg ls og i<+kÃ esa detksj gksrk x;k vkSj mlds f’k{kd mlds i<+kÃ esa detksj gksus ij Mk¡Vrs FksA

• 23 lky ds ,d d`f"k oSKkfud dks vkSjrksa dks ns[kus ij ckj&ckj muds uaxs gksus dk n`’; vkrk FkkA viuh ek¡] cgu vkSj NksVh yM+fd;ksa dks ns[kus ij Hkh mUgsa ;g n`’; vkrk FkkA ;g csotg vkSj okg~;kr fopkj muds eu esa cgqr ?kcjkgV vkSj i’pkrki iSnk djrs FksA blds otg ls mUgsa fMçs’ku vkSj vkRegR;k ds [;ky vkus yxsA

15

og vkSjrksa ls utj fNikrs Fks ¼viuh gh ek¡ vkSj cgu ls Hkh½ vkSj T;knk vdsys jgus yxsA tgk¡ vkSjrksa ls feyus dh laHkkouk gksrh Fkh] mu lkekftd dk;ZØeksa esa mUgksaus tkuk can dj fn;kA mUgksaus bu n`’;ksa ls NqVdkjk ikus ds fy,] eu gh eu esa çkFkZuk “kq: dj fn;k] ijarq og uaxs n`’;ksa ij dkcw ugha ik ldsA muds ?kjokys mUgsa fMçs’ku vkSj vkRegR;k djus dh dksf’k’k ij vLirky ys vk,A

• ,d 26 lky dh MkWDVj dks] nwljksa dks ekjus dk fopkj vkrk FkkA ;g lksp muesa T;knk ?kcjkgV vkSj iNrkok iSnk djrk Fkk D;ksafd ;g lksp muds [kq’k fetkt O;fDrÙo ls fcYdqy foijhr FkkA ;g lksp muesa rc T;knk gksrk Fkk] tc og viuh 3 lky dh csVh ds lkFk gksrh FkhA mUgsa ;g Mj yxk jgrk Fkk fd og vius gh csVh dks pkdw ls ekj MkysaxhA bl otg ls mUgsa tku&cw>dj vius ?kj ls lkjs pkdqvksa dks Qsduk iM+kA mudk ;g Mj fd og viuh gh csVh dks pkdw ls ekj Mkysaxh] bruk T;knk c<+ x;k fd og ckj&ckj fdlh u fdlh cgkus ls viuh csVh dks vius ekrk&firk ds ?kj Hkstrh FkhA mUgksaus ekufld MkWDVjksa dh lykg rc yh tc mudh yk[k dksf’k’kksa ds ckotwn ;g lksp muds dkcw esa ugha vk;h vkSj ;g lksp muds dke esa ck/kk Mkyus yxhA

• 20 lky dk bUthfu;fjax dk Nk=] 2 lky ls fujFkZd fopkjksa ls ijs’kku gksdj vLirky vk;k FkkA og dgrk Fkk fd mls ckj&ckj ;g fopkj vkrs Fks fd vxj mlds firkth ej x, & rc D;k gksxk] ;k firkth ds ekSr ds ckn D;k ifjorZu vk,xk] ?kj dh vkenuh esa D;k ifjorZu vk,xk bR;kfnA ;g lkjs fopkj ,d ds ckn ,d mlds eu esa ,d Ja[kyk esa vkrs Fks] ftlds vkf[kj esa iqu% firkth dk eR;q dk nq%[kn fopkj vkrk FkkA ejht dks ;g tkudkjh Fkh fd NksVh&eksVh chekfj;ksa ds vykok muds firkth iwjh rjg LoLFk FksA ejht dks ;dhu Fkk fd ;g fopkj okg~;kr Fks] ijarq og muij dkcw ugha ik ldrk FkkA

• 24 lky ds fdlku dks ;g ijs’kkuh Fkh fd mUgsa cqtqxZ yksxksa vkSj Hkxoku dks dkslus vkSj x¡ns xkyh nsus ds fopkj vkrs FksA ;g fopkj cqtqxZ yksxksa dks ns[kus ij] Hkxoku ds rLohj ns[kus ;k eafnj ds ikl xqtjus ij vkrs FksA ;g fopkj muesa T;knk ?kcjkgV iSnk djrs Fks D;ksafd og Hkxoku dks vkSj cqtqxZ yksxksa dks cgqr ekurs FksA bu fopkjksa dks jksdus ds fy, og vius gksBksa dks dlds idM+us dh dksf’k’k djrs Fks D;ksafd mUgsa Mj yxrk Fkk fd dgha og xkyh u cd nsaaA ijarq og lQy ugha gksrs FksA mUgksaus cqtqxZ yksxksa ls ckr djuk vkSj eafnj tkuk NksM+ fn;kA og ekufld MkWDVj ds ikl blfy, vk, D;ksafd ;g fopkj muds lgu’kfDr ds ckgj gks x;s FksA

• 27 lky dk iq:"k] rLohjsa [khapus dk dke djrk FkkA og vLirky blfy, vk;k D;ksafd mls ckj&ckj fnu esa gqÃ ?kVukvksa ds n`’; fn[kkÃ nsrs FksA mlds nwljksa ds lkFk ckrphr djus dk n`’; bR;kfnA ;g n`’; mls [kq’kh ugha nsrk Fkk vkSj og mls csdkj ekurk FkkA


16

mlus buij dkcw ikus dh dksf’k’k dh] vius vki dks ;g crk;k fd mls buij fopkj ugha djuk pkfg,A ijarq og lQy ugha gqvk vkSj ;g n`’; ckj&ckj vkrs jgsA

• 22 lky dk flD;wjVh xkMZ ;g ijs’kkuh ysdj vk;k Fkk fd mls [kjkc fopkj vkrs FksA mls ckj&ckj fdlh [krjs ds ckjs esa fopkj vkrs Fks tks mlus i<+k Fkk ;k ftls mlus jsfM;ks ij lquk FkkA ;g fopkj ckj&ckj vkrs Fks] fcuk fdlh otg ds] tcfd og [krjk [kkl ugha gksrk FkkA og bu fopkjksa dks jksdus dh dksf’k’k djrk Fkk & vius Hkfo"; vkSj vU; ?kVukvksa ds ckjs esa lkspdjA ijarq okil] dqN gh le; esa] ;g fopkj mls ijs’kku djus vk tkrs FksA

Obsessive-compulsive disorder (OCD) is a common and disabling mental disorder. It is twice as common as schizophrenia and bipolar disorder. OCD is largely underdiagnosed and inadequately treated. OCD mostly presents for the first time in adolescence and can thus incapacitate a person throughout his/her life. Despite its relatively early age at onset, only a minority of sufferers receive treatment early in the course of illness. OCD also has its relative share of stigma, resulting in long delays in treatment. This is compounded by the fact that most medical professionals are unfamiliar with its clinical characteristics resulting in delay in diagnosis and appropriate treatment. Considerable progress has occurred in the last two decades in the treatment and understand-ing of this common psychiatric illness. Serotonin reuptake inhibitors and cognitive behavior therapy, both have improved the outcome of this illness, which was otherwise considered difficult to treat. There is also significant advance in the understanding of the neurobiology of OCD with respect to neural correlates of obsessional behavior, genetics and immunol-ogy. However, despite the advances in understanding the neurobiology and the cognitive factors in the causation of OCD and availability of effective treatments, about 40% to 60% of the patients do not show satisfactory improvement. This shows that there is still much to be understood The OCD clinic was started on the 24 of June, 1997 by Dr. Sumanth Khanna and Dr. YC Janardhan Reddy, with the objective of providing clinical services, training mental health professionals and conducting research. The OCD clinic at NIMHANS is very popular and caters to around 120 to 150 new patients per year and follows up close to 1000 patients in a year. Patients are often referred from across the country for management of resistant OCD. The specialty OCD clinic is also known for its research activities and have published many international articles. Research activities are focused on phenomenology, course and out-come studies, family studies, genetics, neuroimaging, and neuropsychological studies. This specialty clinic held an international symposium on Nov 10 & 11, 2007 in commemoration of completion of a decade of specialty OCD services at the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore

hindi ocd booklet

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