Jurnal Psikiatri Surabaya

Front Matter

2024-04-24T13:04:57+00:00

Front matter

Back Matter

2024-04-24T13:10:56+00:00

Back Matter

Reduced Right Hippocampal Volume on MRI and Correlation with Major Depressive Disorder

2023-06-15T09:18:41+00:00

Introductions: Many studies have shown in the field of psychiatry results in specific changes in brain anatomy and function associated with measurable clinical outcomes. One of the biggest difficulties in diagnosing and treating psychiatric disorders is that human behavior involves complex mechanisms when compared to experimental animals. Case: 25-year-old female, diagnosed with Major Depressive Disorder (MDD) 6 months ago at a General Hospital in Malang, Indonesia. The patient felt depressed, had trouble sleeping, and had attempted suicide. MRI of the hippocampus was performed at the power of 3 Tesla magnetic strength (PHILIPS INGENIA 3.0T). MRI data processing and hippocampal volumetric analysis were performed using the volBrain HIPS software. Discussion: The left hippocampus volume was larger than the right volume, with a history of the patient never doing exercise or exercising regularly. In general, the hippocampus can be asymmetrical on both sides and larger on the right side. Although asymmetry in the hippocampus is normal, but there are no studies that say the volume of the left hippocampus is larger than the volume of the right hippocampus in a normal people. Conclusions: a person with depression should be screened and planned for early treatment. In the field of radiology, psychoradiology plays an important role in the main clinical situation in guiding decisions, especially treatment planning, as well as monitoring the results of care carried out in patients with psychiatric disorders.

Graves Disease Presenting Psychosis: a Case Report

2023-03-21T09:25:36+00:00

Introductions: Graves' disease is the most common cause of hyperthyroidism. Neuropsychiatric manifestations may occur in thyroid disease. As the premier clinical manifestation of Graves disease, psychosis is highly uncommon; it was reported in 1% of cases. The major neuropsychiatric manifestations of hyperthyroidism are acute psychosis, dementia, apathy, agitation, mania, delusional behavior, and hallucinations, especially in older people. Psychosis is highly rare as the first clinical symptom of a grave disease. Case: A 48-year-old female with grave disease symptoms had been taken to the emergency department with psychotic manifestations. She had a three-month history of increasing irritability, increasing irrational talking, staying awake most of the night, muttering, night-time wandering, and poor personal hygiene. She was admitted to the hospital, and the laboratory investigations showed an elevated FT4 and a decreased thyroid-stimulating hormone (TSH). The patient was started on propanolol 3 x 10 mg, propylthiouracil 3 x 50 mg tab, risperidone 2x2mg, trihexylphenidil 2x2mg, lorazepam 1x2mg, and Zyprexa injection once, which showed improvement in psychotic symptoms. Conclusion: Graves' disease can present with neuropsychiatric manifestations such as psychosis, mania, or a combination of both. A detailed medical history and physical and psychiatric evaluation are necessary for diagnosing and giving adequate treatment. A detailed clinical evaluation, including thyroid function tests, could be recommended for all patients who showed psychotic symptoms. More research is needed to comprehend the pathophysiology underlying psychosis due to Graves' disease, so that it is expected that the management can be carried out properly.

Bipolar Disorder with History of Physical Abuse and Comorbid Polycythemia Vera: a Case Report

2023-04-13T14:29:37+00:00

Introductions: Based on a 2015 United Nations Children's Fund (UNICEF) report, violence against children is widespread in Indonesia; 40% of 13–15-year-old children reported being physically assaulted at least once a year, 26% reported being physically abused by a parent or caregiver, and 50% reported being bullied at school. Case: A 23-year-old female patient, Hindu, Balinese, unmarried, and unemployed, came alone to the psychiatric polyclinic of Wangaya Hospital. From history taking, there was dizziness, anhedonia, impaired attention, reduced self-esteem and confidence, guilt and uselessness, reference ideas, somatic delusions, relationship mood, logorrhea and flight of ideas, a history of mixed-type insomnia, and excessive energy. In a general examination, there were icteric sclera and palpable enlargement of the spleen (Schuffner 4). Neurological examination within normal limits. Discussion: The patient has bipolar disorder, caused by a traumatic experience in childhood. The patient was found to have a history of repeated treatment; she was initially diagnosed with bipolar disorder and received Depakote 250 mg and Clobazam 10 mg. Then, the patient came for treatment again at Wangaya Hospital on August 30, 2021, because of a headache and was diagnosed with bipolar affective disorder, with the current episode being moderately depressive with somatic symptoms. Conclusion: Traumatic childhood events are a risk factor for bipolar disorder. In addition to poor clinical presentation, the early onset of bipolar disorder is also an aggravating factor for symptom recurrence. Polycythemia vera can be a complicating factor in the recovery and relapse of bipolar disorder.

Urinary Incontinence Associated with Sertraline use in a Young SSRI-Naí¯ve Female Patient: a Case Report

2023-06-14T09:45:49+00:00

Introductions: Urinary incontinence is a side effect of several antidepressants, especially those in the SSRI and SNRI groups. Sertraline, a popular SSRI effective against a wide range of mental disorders, is one such drug with a clear association with a new onset of UI. Case: A 20-year-old Indonesian Chinese woman, presenting with mixed anxiety and depressive symptoms, was initially treated with sertraline 50 mg. She experienced an acute onset of urinary urgency and a loss of bladder control. These symptoms resolved upon discontinuation of sertraline. She was then given 10 mg of fluoxetine, and she noted that the urinary problems did not return. The medication was gradually tapered up to 40 mg/day with no remarkable adverse events. Discussions: Sertraline tends to stimulate micturition through effects on M3 muscarinic receptors on the bladder's detrusor muscle and inhibition of the dopamine transporter in the central nervous system. On the other hand, fluoxetine acts antagonistically on 5-HT2C, inhibiting the voiding reflex and promoting urinary continence. Therefore, though both are SSRIs, sertraline and fluoxetine may exhibit different, clinically meaningful effects. Conclusions: Clinicians need to have a greater awareness of urinary incontinence as a side effect of sertraline, as it impacts patients' adherence and quality of life. When possible, switching to fluoxetine is recommended for patients with urinary problems in the event of sertraline use.

Ketamine Usage Effectivity on Treatment-Resistant Depression Diagnosed Patients: a Scoping Review

2022-12-19T11:03:10+00:00

Introductions: In Indonesia, a median of 6.1% of people diagnosed with depression disorder are people over 15 years old. Only 9% of that amount underwent medical treatment, while the rest, 91%, did not undergo treatment for their depressive conditions. Inadequate and inappropriate treatment of depression will lead to Treatment-Resistant Depression (TRD). Using ketamine as a pharmacotherapy opens up new possibilities for TRD treatments. Methods: This study uses a retrospective observational study design with a systematic review approach, in which all variable data were collected from previous studies aimed at measuring the effectiveness of ketamine pharmacological therapy in patients diagnosed with treatment-resistant depression (TRD) using placebo as a benchmark of the effectiveness of ketamine in reduced clinical symptoms of TRD using secondary data in the form of study results and analyzes from published studies of the effectiveness of ketamine therapy. Results: Administration of ketamine at doses of 0.4 mg/kg and 0.5 mg/kg is more effective as an antidepressant compared to placebo in adults and is effective in the elderly at doses above 0.2 mg/kg with a maximal effect at 24 hours post-administration and disappeared by about 7 days post-administration. Conclusions: The administration of ketamine therapy is more effective at reducing depressive symptoms in diagnosed patients (TRD) than the use of placebo and repeated administration of ketamine can increase the likelihood that TRD sufferers respond to therapy and experience remission.

Adolescent Premarital Sexual Behavior: A Narrative Review of Challenges, and the Vital Role of Comprehensive Sex Education in Promoting Health and Well-being in Islamic Countries

2024-01-15T13:23:06+00:00

Introduction: Adolescents, comprising 1.2 billion globally, face unique challenges during the transformative phase of sexual maturation. This review emphasizes the prevalence of premarital sexual behavior among adolescents, with a focus on Southeast Asia, Indonesia, and Arab nations. The vulnerable nature of this age group is underscored, considering the risks of unsafe abortions, unintended pregnancies, and sexually transmitted diseases. Objective: The primary objective is to offer a comprehensive understanding of premarital sexual behavior in adolescents. By synthesizing recent developments and key findings, this review aims to inform specialists and non-specialists, foster societal dialogue, and serve as a resource for scholars and practitioners interested in adolescent sexual health. Methods: Utilizing PubMed and Google Scholar, an extensive literature search spanning 2018 to 2023 focused on keywords such as "adolescent AND sex” The inclusion criteria involved articles directly aligned with the review's scope, leading to the identification of 20 relevant articles. Results: Factors influencing adolescent sexual behavior, and the impact of cultural, religious, and societal norms were explored. The importance of sex education, particularly comprehensive sexuality education, in addressing premarital sexual behavior emerged as a critical theme. The impact on adolescent health, both physical and mental, was also highlighted. Conclusions: Premarital sexual behavior among adolescents is a complex issue influenced by various internal and external factors. Comprehensive sexuality education, incorporating cultural and religious teachings, is crucial in promoting healthy decision-making and preventing negative consequences. The review emphasizes the need for ongoing discussions, further research, and improved sexual health education globally.

Obsessive Compulsive Disorder (OCD) During the COVID-19 Pandemic

2021-12-29T04:39:40+00:00

Introduction: The COVID-19 pandemic, present in Indonesia for 17 months, has significantly impacted mental health, especially in individuals with obsessive-compulsive disorder (OCD). Studies in Europe reported a 17.9% to 60.3% increase in OCD symptom severity. Notably, no research in Indonesia has explored the pandemic's effects on OCD patients. Lockdown measures in Indonesia may exacerbate symptoms, but some OCD patients benefit, finding relief from societal stigmatization and the opportunity to advise others on infection prevention. This review aims to examine the impact of the COVID-19 pandemic on OCD patients in Indonesia and discuss potential management strategies. Methods: We conducted a comprehensive literature search, identifying studies, articles, and reports relevant to the effects of the COVID-19 pandemic on OCD patients in Indonesia. These sources were critically evaluated to provide a comprehensive overview. Results: This review reveals that the pandemic poses unique challenges to OCD patients in Indonesia. Lockdown measures may worsen symptoms, although some patients find relief from societal stigmatization. OCD patients can play a valuable role in advising others on infection prevention. Telemedicine, especially CBT, and medication adherence tools are crucial for effective management. Conclusion: The COVID-19 pandemic affects OCD patients in Indonesia in various ways. It is essential to recognize how lockdown measures impact symptom severity and the opportunities for patients to contribute positively to society. Telemedicine and medication adherence tools are valuable for managing OCD during the pandemic. Addressing the needs of OCD patients and implementing effective strategies for their care during COVID-19 is essential in Indonesia.

Acceptance and Commitment Therapy (Act) in Psychotic Patient

2022-12-13T15:39:52+00:00

Introductions: Psychosis is a condition of severe mental disorder characterised by the presence of disability in assessing reality. Schizophrenia is the most common psychotic disorder. It is also associated with long-term disability. ACT is one of the newest psychological interventions for psychotic patients. This paper aims to describe ACT as the newest psychotherapy intervention and its advantages for psychotic patients. Review: The management of psychosis is a combination of the use of antipsychotics, psychotherapy, and psychosocial therapy. ACT is one of the newest psychological interventions for psychotic patients that aims to increase the patient's psychological flexibility through six core processes of therapy: acceptance, cognitive defusion, being present, self as context, value, and committed action. ACT does not target symptom reduction. Therapists help patients recognise and reduce unnecessary struggles with psychological content so that patients can develop an accepting attitude and be able to move towards the values they hold. Conclusions: The use of third-wave behavioural therapy based on mindfulness and acceptance showed good results in patients with psychotic disorders. ACT aims to help individuals accept things that are beyond their control and commit to actions that can improve their lives. Research on the clinical adaptation of ACT for psychosis has shown good initial results in reducing distress due to psychotic symptoms, better regulation of emotions, and reducing relapsing rates.

The Relationship between Self-Regulated Learning (SRL) and Cognitive Function with The Performance of qEEG Examination in First Year Medical Students

2023-10-16T09:57:33+00:00

Introductions: Medical students are required to lifelong learning. Electroencephalog-raphy is a neuroscience tool that can be used to record brain wave activity related to a person's cognitive function. Objective: This study was conducted to see the relationship between self-regulated learning and cognitive function with quantitative electroencepha-logram (qEEG) parameters. Methods: This study used an observa-tional analytic approach to assess self-regulated learning and cog-nitive function using the MSLQ and MoCA-INA questionnaires. qEEG recording to see brain wave activity was done when the eyes were open and closed and seen in alpha and beta waves. The sam-ple of this study amounted to 32 respondents who were willing to carry out each research procedure. Results: The study findings reveal a significant correlation between SRL and qEEG parameters. In the open-eye condition, such a correla-tion exists in the frontal and central regions with regard to alpha waves (P = 0.046 and P = 0.047). In contrast, in the closed-eye condition, it exists in the occipital, central, and parietal regions with alpha waves (P = 0.005, P = 0.021, and P = 0.049) and the central region with beta waves (P = 0.030). There is a significant correla-tion between cognitive function and qEEG parameters observed in both open and closed-eye conditions within the frontal region beta waves (P = 0.024, P = 0.044, and P = 0.021). Conclusions: There is a relationship between SRL and cognitive function with alpha and beta wave activity on qEEG recording.

Relationship Between Stress Level and Academic Grade in Medical Students of Universitas Airlangga

2023-09-08T09:12:14+00:00

Introduction: Medical students have higher psychological pressure compared to students from other majors. Excessive levels of stress can cause physical and mental problems, lower self-esteem, and interfere with academic achievement. Stress has a significant correlation with academic grades. Objective: This study aims to determine the relationship between stress levels and academic scores Methods: This research is an observational analytic study with a cross-sectional design to analyze the relationship between perceived stress scale and academic scores. Perceived Stress Scale were used to determine stress level and spearman correlation were used to correlate stress level with GPA Results: No variable with a Spearman correlation coefficient above 0.2 was found, so it can be seen that none of the variables has a correlation with GPA. But income per capita has a significant p-value. Discussion: The stress level score with the GPA score has a Spearman correlation of -0.089. The correlation shows an insignificant relationship. This shows that the level of stress shown through the Perceived Stress Scale does not have a significant effect on the academic scores of Airlangga University medical students. Sohail's research (2013) found similar results where most students with stress still passed the exam but there were a small number of students with severe stress who failed. This is different from the results of Kumar et al. (2014) who found that stress levels have a negative effect on academic performance. Conclusion: In this study, no correlation was found between stress levels and academic scores.

Relationship Between Personality and Relapse of Breast Cancer Patients at The Oncology Polyclinic Dr. Soetomo Academic General Hospital Surabaya

2021-07-26T13:25:38+00:00

Introductions: Breast cancer is a major health problem that affects the lives of millions of women. Some patients have tried treatment, but cancer recurrence is still present. It is suspected that growth factors play a role in the occurrence of relapse. However, until now, it has been controversial. Finding out whether there is a relation between personality and the incidence of relapse in breast cancer and comparing the personalities of patients with relapsed breast cancer with those with non-relapsed breast cancer. Methods: Analytical research is an observational case-control study. The number of respondents is 56 patients who meet the criteria. It consists of 28 relapsed patients and 28 non-relapsed patients. The research was conducted at the Oncology Polyclinic of Dr. Soetomo General Hospital. Using an instrument to measure personality types that have been validated, namely the OCEAN”Big Five Questionnaire Inventory 44 and Demographic Questionnaire. Results: There is no relationship between personality and the incidence of relapse in breast cancer (p > 0.05). The type of personality in relapse with the most neuroticism (29%) and non-relapse with the most openness (32%), extraversion (36%). Conclusions: The incidence of relapse in breast cancer is not only caused by personality factors; it is possible that other factors play a role. However, the personality of neuroticism is quite prominent in relapse patients.

The Correlation Between the Level of Depression and Religious Coping Among Medical Students Class of 2020 Universitas Airlangga

2023-06-19T11:05:03+00:00

Introduction: Medical students are at risk of developing depression due to their demanding workload and high expectations, which can impact their academic performance and cognitive function. To prevent severe complications, students must prioritize resources for mental health support, namely religious coping as a coping mechanism. Objective: The aim of this study is proof the correlation between depression levels and religious coping in medical students class of 2020 Universitas Airlangga Methods: This research is an observational analytic study with a cross-sectional design, and random sampling was used as a sampling method, totaling to 90 subjects. Variables used were religious coping and level of depression. The data was then analysed and prevalence, correlation coefficient and p-value were acquired. The research result would be considered significant if p <0.05. Result: Out of 90 students, 32 people (35.6%) are found to have a PHQ score more than 10, indicating depression. Severity was found mostly have moderate depression, which consisted of 12 people (13.3%). For religious coping, 84 people (93.3%) use positive religious coping, and 6 people (6.7%) use negative religious coping. The level of depression correlates with religious coping with a Pearson correlation of -0.450, indicating a negative correlation with a p-value less than 0.001. Conclusion: The prevalence of depression among medical students class of 2020 Universitas Airlangga is 35.6%. Level of depression in found to significantly correlates with religious coping with an opposing direction of correlation.

Characteristics of Neuropsychiatric Systemic Lupus Erythematous in Dr. Sardjito General Hospital

2023-10-12T15:54:40+00:00

Introductions: Systemic lupus erythematosus (SLE) is one of the diseases that affects the system organs. Neuropsychiatric SLE (NPSLE) refers to the display of SLE involving both neurologic and psychiatric conditions. Methods: This retrospective study used inpatient and outpatient data from patients diagnosed with unspecified SLE and also included psychiatric manifestations between 2017 and 2021. Results: The patients' age range was from under 10 to over 70 years old, and the average age was 31.49 years old. The highest percentage was between 31 and 40 years old, which was 27%. Out of 100 patients, 61 received the majority of their care from the internist. The highest percentage of psychiatric disorders was unspecified depressive disorder, with 17%. The second-largest proportion was other specified neurotic disorders, which was 11%. Additionally, 10% of the patients experienced a mild cognitive illness. Based on gender, women had a higher proportion compared to men. Conclusions: Our study showed that there were 100 NPSLE cases over five years, and the highest percentages were depressive disorder, neurotic symptoms, and mild cognitive disorder.

Effect of Psychotic Symptoms on Suicide Event in Patient with Severe Depression at Sanglah General Hospital

2023-09-15T09:29:24+00:00

Introductions: WHO states that the suicide rate in the world is still high; most of them had a previous depressive episode. In depressed patients with psychotic symptoms, psychomotor disturbances were more severe, feelings of guilt were higher, and there was an increase in suicidal ideation and attempts. Several studies have tried to find out whether there is an influence between psychotic symptoms and the incidence of suicide in patients with depressive disorders. However, the number of available studies is still limited and controversial. The purpose of this study was to determine the effect of psychotic symptoms on the incidence of suicide in patients with major depressive disorders. Methods: This is an observational analysis with a case-control approach. The sample was obtained from the Udayana Psychiatric Resident Duty Report in 2019 in a purposeful manner that already met the inclusion and exclusion criteria. Test the hypothesis using chi-square and logistic regression. Results: A total of 70 samples were used in this study. Chi-squared showed there was a relationship between psychotic symptoms and the incidence of suicide in patients with major depression (p = 0.016). Logistic regression showed that a history of drinking alcohol (OR 55.058; CI 2.975-1018.8; p = 0.007) and psychotic symptoms (OR 9.237; CI 1.86-45.875; p = 0.007) were shown to affect the incidence of suicide in patients with major depressive disorders. Conclusion: There is an effect of psychotic symptoms on the incidence of depression in patients with major depressive disorders.

Relationship Between Childhood Maltreatment With Levels of Depression On Street Children in Surabaya

2023-10-27T14:54:56+00:00

Introductions: Childhood maltreatment is any form of violence or neglect that occurs against children under the age of 18. Street children are a group that is vulnerable to violence because their activities, for which they spend a lot of time on the streets, make it easier for them to experience violence from both adults and fellow students. One of the impacts can cause mental health disorders, one of which is depression. Objective: Analyze the relationship between childhood maltreatment and levels of depression in street children in Surabaya. Methods: A cross-sectional analytical study was conducted on 43 street children from Surabaya City, East Java, Indonesia. Subjects were selected through two stages, namely using the Children's Depression Inventory (CDI) and the International Child Abuse Screening Tool for Children (ICAST-C) to assess depression and childhood maltreatment. Data analysis using chi-square. Results: The results of the study showed that of the 43 respondents, 18 children experienced childhood maltreatment and 31 children experienced moderate depression. The results of the analysis of the relationship between childhood maltreatment and depression levels showed a p-value of 0.481. Conclusion: Childhood maltreatment is not related to the level of depression in street children in Surabaya.