Jurnal Psikiatri Surabaya

Current Severe Depressive Episode in Bipolar II Disorder with Anxious Distress and Post-traumatic Stress-Disorder with Derealization: a Case Report

Muhammad Alim Jaya, Andi Jihan Nashila Haris, Andi Karlina Syahrir — Fri, 01 Nov 2024 00:00:00 +0700

Introduction: Bipolar II disorder experiences more frequent episodes of depression and is sometimes comorbid with post-traumatic stress disorder (PTSD). However, there is no clear method to distinguish between depression induced by bipolar disorder and PTSD. Through this case, we aim to examine the features of the patient’s bipolar disorder and PTSD from the depressive episodes. Case: A 23-year-old Indonesian woman came with the chief complaint of unexplainable discomfort that had been experienced almost daily for the past two weeks. The patient also complained that she was often lonely. Patients did not get adequate parenting from her parents, so patients have unfavorable relationships with her family. In addition, patients previously experienced sexual harassment that caused severe trauma. She was diagnosed with a current severe depressive episode in bipolar II disorder with anxious distress and PTSD. Discussion: Bipolar disorder is frequently comorbid with PTSD. She was given Sertraline 25 mg once daily, Aripiprazole 5 mg twice a day, Clobazam 5 mg once a day at night, Folic acid 400 mcg once a day, and psychotherapy. After four weeks of treatment, there was an improvement in symptoms by a decrease in the HDRS and the HARS scores. Conclusion: In the case presented, bipolar patients have major complaints related to somatic symptoms accompanied by a history of experiencing severe traumatic events. Thus, bipolar patients do not always come with the chief complaint of mood swings. Furthermore, these complaints improved with the combination of anti-psychotic, anti-depressant, anti-anxiety, and psychotherapy.

Neuropsychiatric Symptoms in Corticosteroid Induced Systemic Lupus Erythematosus (Sle) Patients: a Case Report

Tri Ratnawati — Fri, 01 Nov 2024 00:00:00 +0700

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease with an unknown etiology and various clinical manifestations, course, and prognosis. Classes of medication used in the management of SLE include non-biological immunosuppressives, corticosteroids, biologic therapy, and immunoglobulins. The effect of using corticosteroids in the management of SLE still evokes debate regarding the emergence of mental health disorders. Case: A 24-year-old female patient was admitted to the hospital with an initial diagnosis of acute confusional stage, anemia, chronic disease, and systemic lupus erythematosus (SLE). Anticonvulsants, corticosteroids, and packed red blood transfusions had been given to the patient. The course of the disease during the hospitalization the next days, the patient experienced slurred speech, giggling, place and time disorientation, and visual hallucinations. The patient was consulted to a psychiatrist, got atypical antipsychotics and benzodiazepines, and then experienced improvement. Discussion: Patients with moderate SLE, in this case characterized by lupus nephritis, were given corticosteroids. Administration of corticosteroids to SLE patients will increase the risk of developing neuropsychiatric symptoms such as acute confusional state, anxiety, mood disorders, cognitive disorders, and seizures. This can occur due to increased permeability of the blood-brain barrier mediated by pro-inflammatory cytokines, resulting in the formation of autoantibodies against neural antigens, in which phospholipid proteins appear intracranially. Conclusion: Corticosteroid administration in SLE will cause neuropsychiatric symptoms such as slurred speech, giggling to herself, delirium, and visual hallucinations. Further design studies are needed to address the neuropsychiatric effects of corticosteroids in SLE.

Effect of Depression in The Elderly on Glaucoma and Pharmacotherapy Options

Syaiful Anwar, Yulia Fatima Bessing, Erikavitri Yulianti — Fri, 01 Nov 2024 00:00:00 +0700

Introduction: Depression in the elderly is often not detected because elderly people who are depressed show more somatic or cognitive complaints than affective complaints. The relationship between depression and the progression of glaucoma has been studied and taken into consideration in the selection of therapy to be given. Methods: This report is a case report from a patient who has been given an explanation and received consent regarding a psychiatric interview, physical examination and support, interventions, case discussion presentations, and the confidentiality of all patient personal information. Case: Education was carried out on a 72-year-old patient with a Major Depressive Episode without psychotic symptoms who also had glaucoma a few months after complaining of depression. The education provided includes knowledge about depression and its relationship to glaucoma, a management plan in the form of advice for hospitalization in a hospital that has a psychiatrist and an ophthalmologist. Conclusion: Depression in the elderly can affect the progression of glaucoma. The choice of psychopharmacological therapy needs to be adjusted by considering its side effects on the possibility of glaucoma or the risk of aggravating the progression of glaucoma.

Back Matter

Jurnal Psikiatri Surabaya — Fri, 01 Nov 2024 00:00:00 +0700

Back Matter Jurnal Psikiatri Surabaya Vol. 13 No. 2 2024

an Urgent Call for Suicide Prevention in Indonesia: The Clinicians’ Role in Preventing Suicide

Alshafiera Azayyana Mawadhani Sukma, Adi Winata, Ridwan Balatif — Fri, 01 Nov 2024 00:00:00 +0700

Introduction: Since suicide is a complicated matter, multiple sectors must be involved. Globally, there were 703,000 suicide cases in 2019. Over the past three years, there has been a rise in suicide instances in Indonesia. Treating those who are at risk of suicide is difficult since suicide situations, like mental health illnesses, continue to carry stigma. To provide a statistical overview of suicide cases and the role of clinicians in preventing suicide cases. Methods: Searching for statistical data in Indonesia, we used Pubmed with the keyword “statistics”, “suicide”, “Indonesia”. Searching for data regarding risk factors and prevention of suicide, we also used Pubmed with the keywords “risk factor”, “prevention”, “screening”, “suicide”. Results: Globally, in 2019 the average rate of suicide cases was around 9.0 cases per 100,000 population. In Indonesia, exact data regarding the prevalence of suicide cases is still unknown. A person committing suicide can be caused by many factors such as previous mental disorders, relationship conflicts, legal problems, violence, financial problems, social exclusion, and low socioeconomic status. In addition to providing appropriate management, a clinician must provide education and outreach to the public regarding warning signs and risk factors for suicide, restrictions on tools for suicide, screening, and also remind every patient, especially patients with mental disorders, to continue to pray to be given health. Conclusion: A clinician has a role ranging from education and related outreach, screening, and also pharmacological and non-pharmacological management of someone at risk of suicide

Postoperative Depression: Insight, Screening, Diagnosis, and Treatment of Choice

Fri, 01 Nov 2024 00:00:00 +0700

Introduction: Postoperative depression is a condition of depressive effects in patients without symptoms of depressive mood that occurs a few weeks after surgery and persists for at least 2 weeks. It generally possesses the same symptoms as major depressive disorder. Review: Their difference is that surgery is the trigger of depression in postoperative depression cases. Postoperative depression is associated with increased patients’ morbidity and mortality, increased the risk of disease complications, reduced postoperative healing process, prolonged the duration of treatment, and reduced patients’ quality of life. Therefore, mental health conditions should always be assessed on patients after undergoing surgery. Postoperative depression therapy needs to consider the benefits of antidepressants and adequate pain management. Antidepressant considerations also need to consider interactions with other drugs. Psychotherapy and cognitive behavioral therapy are also useful in postoperative depression management. Conclusion: This review is aimed to give insight about postoperative depression, its importance, and how to treat it.

Cabin Fever During Isolation Due to Covid-19: What Should We Do to Overcome it?

Fri, 01 Nov 2024 00:00:00 +0700

Introduction: Cabin fever is described as some combination of irritability, moodiness, and depression due to isolation during COVID-19. Cabin fever may happen to anyone who has to isolate themself at home because of the COVID-19 outbreak. We aim to identify the risk factor, the influence of hormone imbalance on mood changes, and how to deal with cabin fever during isolation due to COVID-19. People who are unable to connect with other people physically, unable to do activities that they used to do, unmotivated due to having no work, and anxious about finances due to lack of income may have a higher risk of cabin fever. Review: Social isolation experienced by people with cabin fever may result in hormonal imbalances that eventually affect their mood. This is due to the stress that comes from prolonged stay-at-home orders, which are thought to disturb the balance of the hormones in a person’s body. Hormones which are able to cause mood changes are cortisol, thyroid, testosterone, estradiol, and progesterone. Cabin fever is not a recognized psychological condition. In this way, there is no standard treatment for cabin fever. Conclusion: Therefore, acceptance, reconciliation with oneself, coexistence and trust (intimate interactions, mindfulness, and positive self-shaping as self-control) are keys to overcome cabin fever.

Evaluation of Anxiety, Depression, and Health-Related Quality of Life in Female and Male Patients With Newly Diagnosed Type 2 Diabetes

Fri, 01 Nov 2024 00:00:00 +0700

Introduction: Depending on the disease’s stage, type 2 diabetes can impact anxiety, depression, and health-related quality of life. This study aimed to compare the health-related quality of life, anxiety, and depression of men and women recently diagnosed with type 2 diabetes to that of healthy controls. Methods: There were 100 newly diagnosed type 2 diabetic patients (50 females and 50 males), as well as 100 healthy controls (50 females and 50 males). Each participant receives three questionnaires: the Short-Form Health Survey (SF-36), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). Results: Compared to controls, patients’ scores on the SF-36 for total, physical, and mental health were lower for both genders. Compared to controls, the female patients’ BAI and BDI scores were greater. Both male and female diabetes patients had a negative correlation between their SF-36 total score and fasting plasma glucose. Additionally, the female patients’ fasting plasma glucose and BDI score showed a positive correlation. Conclusions: In both genders, patients with recently diagnosed type 2 diabetes had a lower health-related quality of life compared to controls. However, the anxiety and depression levels of only female diabetic patients worsened when compared to controls. We suggest considering gender differences in the symptomatology of anxiety and depression among newly diagnosed type 2 diabetic patients to develop more effective ways to manage their condition, such as comprehensive and early intervention.

The Dominant Personality Trait in Type 2 Diabetes Mellitus Patients at Dr. Soetomo General Hospital Surabaya

Fri, 01 Nov 2024 00:00:00 +0700

Introduction: Diabetes mellitus (DM) is a chronic disease characterized by elevated blood sugar levels above the normal range. The global prevalence of DM increased, with over 90% of cases being Type 2 Diabetes Mellitus (T2DM). People attempted various physical therapies, including adopting a healthy lifestyle through dietary adjustments, physical activity, and pharmacological interventions. However, we have not extensively explored non-physical therapies related to personality traits, and the incidence of DM remains high. The Big Five Personality Theory encompasses openness, conscientiousness, extraversion, agreeableness, and neuroticism. Each personality trait is believed to have specific tendencies toward diseases, emphasizing the importance of identifying the dominant personality traits in T2DM patients. This study aims to identify the dominant personality type in T2DM patients based on the Big Five Personality Theory at Dr. Soetomo General Hospital Surabaya. Methods: We employed a cross-sectional approach for data collection, using Big Five personality questionnaires as the primary data sources. Results: Among the 68 T2DM patients who participated in this study at Dr. Soetomo General Hospital Surabaya, from October 2022 to May 2023, the mean age of patients was 51-60 years, with a majority of female participants (63.2%) and male participants (37.8%). The questionnaire results indicated that the dominant personality trait was agreeableness (85.3%). Conclusion: The dominant personality type in T2DM patients, according to the Big Five Personality Theory at Dr. Soetomo General Academic Hospital Surabaya, was agreeableness (85.3%).

The Effect of Administering Omega-3 Supplements on Serum Lipopolysaccharide (LPS) Levels in Schizophrenia Patients Who Are Taking Atypical Antipsychotics in the Psychiatric Hospital of Prof HB Saanin Padang

Sri Mulyanti, Delmi Sulastri, Amel Yanis, Masrul, Rauza Sukma Rita, Ilmiawati — Fri, 01 Nov 2024 00:00:00 +0700

Introduction: Schizophrenia is a severe mental disorder that ranks among the top 10 major contributors to global disability. Schizophrenia is a disorder of brain function in the form of impaired perception, thoughts, feelings, cognitive processes, and behavior. They require long-term atypical antipsychotics for therapy, but they have secondary effects on food intake and cause intestinal dysbiosis, one of which is characterized by increased serum lipolysaccharide (LPS) levels. We aim to examine the impact of omega-3 supplementation on serum LPS levels in schizophrenia patients utilizing atypical antipsychotics. Methods: This research is an experiment with a randomized pretest-posttest control group design and a triple-blind study in Prof. HB Saanin Padang’s psychiatric hospital and the Biomedic Laboratory, Faculty of Medicine, Andalas University, from July 2023 to February 2024. The research sample consisted of 15 individuals who received 1000 mg Omega-3 PUFA (180 mg EPA and 120 mg DHA) daily for 21 days, and another 15 individuals who served as the control group. We checked the serum LPS levels using ELISA in duplicate on days 0 and 22. We analyzed the data using the paired t-test. Results: There was a significant difference in serum LPS levels in schizophrenia patients taking atypical antipsychotics before and after being given omega-3 supplements in the inpatient ward of Prof. HB Saanin Mental Hospital Padang with p = 0.02 (p < 0.05). Conclusion: Omega-3 supplement 1000 mg/day can reduce serum LPS levels in schizophrenia patients who receive atypical antipsychotic therapy.

Relationship of Physical Change and Social Culture with the Risk of Eating Disorder in One of Surabaya High School

Aisyah Alhaura Gibrata, Royke Tony Kalalo , Nining Febriyana, Roedi Irawan — Fri, 01 Nov 2024 00:00:00 +0700

Introduction: Adolescents aged 10 to 19 experience significant growth in various areas. Around 14% of them struggle with mental health, and eating disorders have the highest mortality rate. According to research, screen-related disordered eating affects about 1 in 8 high school students, and sociocultural pressure is positively associated with bulimia-related behaviors. Limited data on physical changes and sociocultural influences on eating disorders exist in Surabaya, Indonesia. The study aims to examine the potential correlation between physical alterations and sociocultural elements and the likelihood of eating disorders in one of Surabaya’s high schools. Methods: This cross-sectional observational analytic study collects primary data using two questionnaire instruments: EAT-26e collected samples from 60 students in SMAN2 Surabaya and SATAQ-4 using random stratified sampling. We used random stratified sampling to collect samples from 60 students in one of Surabaya’s high schools. We used SPSS version 25 to examine the data using the Spearman’s Rho Correlation Coefficient. Results: Physical changes show no significant correlation; in contrast, sociocultural pressure results show a significant correlation with the risk of eating disorders. Peer pressure, family pressure, and media pressure do not significantly influence the subscales of social culture under measurement. Conclusion: In one of Surabaya’s high schools, there is a significant positive correlation between sociocultural factors and the risk of eating disorders; however, there is no significant correlation between physical changes and the risk of eating disorders.

The Relationship Between Coping and Stress Levels in Students from The Class of 2020 at The Faculty of Medicine, Palangka Raya University, During Their Thesis Preparation

Fri, 01 Nov 2024 00:00:00 +0700

Introduction: Academic stress is prevalent among final-year students, with thesis preparation being a significant source of this stress. Coping are essential as they effectively represent the body’s conscious adaptive responses to reduce stress through self-adaptation. This research determines the relationship between coping and stress levels in students from the class of 2020 at the Faculty of Medicine, Palangka Raya University, during their thesis preparation. Methods: The study employs a quantitative analytical observational design with a cross-sectional approach. Simple random sampling was utilized for participant selection. The research instruments comprised coping questionnaires and the Perceived Stress Scale (PSS-10). Data were analyzed using Charles Spearman’s correlation analysis with a confidence interval of 95%. Results: Out of all 96 respondents, 49 individuals (51%) had good coping skills, and 80 individuals (83.3%) experienced moderate stress levels. Notably, among the 49 participants exhibiting good coping, a majority (42 individuals or 85.71%) experienced moderate stress levels. The Charles Spearman test findings revealed a significant value of 0,013 (p < 0.05) with a weak correlation and the opposite direction (r = -0.252). Conclusion: There is a significant relationship between coping and stress levels in students from the class of 2020 at the Faculty of Medicine, Palangka Raya University, during their thesis preparation.

Risk Factors of Agitation Among Schizophrenia Patients in Dr. Amino Gondohutomo Semarang Regional Psychiatric Hospital: A Cross-Sectional Study

Yulia Ratna sofa, Elly Noerhidajati, Sri Woroasih, Intan Tri Hardini — Fri, 01 Nov 2024 00:00:00 +0700

Introduction: Schizophrenia is a severe mental disorder associated with deterioration in the functions of daily life and social functions because it can reduce a person’s quality of life. In the acute phase, many schizophrenic patients have agitated behavior where this behavior will risk injuring themselves and others because of that treatment costs increase. to determine the risk factors for agitation in schizophrenic patients in terms of age, gender, marital status, occupation, genetic history, and presence or absence of stressors. Methods: This research is a descriptive analytic using a cross-sectional design. The population in this study were schizophrenic patients at Dr. Amino Gondohutomo Semarang Regional Psychiatric Hospital. Research subjects will be taken using consecutive sampling techniques that meet the inclusion and exclusion criteria. Data collection used medical record data and the PANNS EC score to determine whether there was agitation. Data analysis included descriptive analysis with frequency and percentage distributions as well as hypothesis testing using the Chi Square test and logistic regression. Results: From the results of the Chi Square test and logistic regression, it was found that the factors of young age, male sex, unmarried, and unemployed were significant for PANSS EC with a prevalence value of 3.40 (1.13 – 10.22), 2.01 (1.14 – 3.56), 2.39 (1.36 – 4.20), and 2.07 (1.12 – 3.83). Conclusion: Factors of young age <40 years, male sex, unmarried, and unemployed are risk factors for the occurrence of agitation in schizophrenic patients at Dr. Amino Gondohutomo Semarang Regional Psychiatric Hospital.

Perception, Attitude, and Treatment Behaviour of The Community Towards Mental Disorders in Banyumas Raya

Fri, 01 Nov 2024 00:00:00 +0700

Introduction: The stigma associated with mental disorders continues to have negative value in Indonesian society, which can influence treatment decisions. This project is aimed at evaluating the public’s perceptions, attitudes, and behavior toward treatment of mental disorders in Banyumas Raya. Methods: This was a quantitative cross-sectional study with 410 respondents who had completed questionnaires on mental health perceptions (Mental Health Knowledge Schedule, MAKS), attitude assessment (the Community Attitudes toward Mental Illness, CAMI), and behavior of choosing traditional treatment or medical treatment in October–November 2022. A descriptive analysis was used, and the relationship was assessed using the chi-square test. Result: Descriptive analysis reveals that 273 (66.6%) respondents live in Banyumas, 167 (40.7%) are senior high school graduates, and 175 (42.7%) have an income of Rp. 1,000,000-Rp. 3,000,000. Bivariate analysis revealed a significant relationship between knowledge and behavior (p<0.05; CI. OR: 0.251). Conclusion: Respondents with a high level of knowledge are more likely to engage in medical behavior.

Identification of Potential Diagnostic Markers for Depressive Disorders using Urinary Biomarkers of N-Methylnicotinamide and Hippuric Acid

Fri, 01 Nov 2024 00:00:00 +0700

Introduction: The diagnostic methodology for depressive disorders, relying on symptom clusters, has inherent limitations in ensuring heterogeneity levels. Consequently, this presents a notable risk of inevitable diagnostic errors in mental health assessments. Therefore, advocating for objective diagnostic approaches through empirical testing in clinical settings becomes crucial for individuals dealing with depressive disorders. This study aims to identify the effectiveness of urine as a diagnostic support for depressive disorders using the N-Methylnicotinamide and Hippuric Acid biomarkers. Methods: This study used 13 urine samples from patients with depressive disorders and 13 normal urine samples. It used ELISA methods with observational analytic and cross-sectional designs. Results: The results showed that the N-methylnicotinamide biomarker had a relationship with depressive disorders with a correlation value of 0.867, while hippuric acid obtained a correlation value of 0.692. Besides, the N-Methylnicotinamide and Hippuric Acid biomarkers showed differences in the urine of depressive disorder and normal patients with significance values of 0.000 and 0.001 for the N-Methylnicotinamide and Hippuric Acid biomarkers, respectively. In addition, the Relative Operating Characteristics curve analysis showed that these two biomarkers had good sensitivity and specificity values in assisting the diagnosis of depressive disorders. N-methylnicotinamide has a sensitivity of 92.3% and a specificity of 100%, while hippuric acid has a sensitivity of 76.9% and a specificity of 84.6%. Conclusions: Significant differences in the biomarkers of N-methylnicotinamide and hippuric acid in the urine of depressed patients compared to normal patients. Therefore, these biomarkers can be the empirical laboratory methods to support the diagnosis of depressive.

Effect Of Cognitive-Behavioral Therapy on Depression in Chronic Kidney Disease Patients Undergoing Hemodialysis

Nur Azizah AS, Khairina , Artaria Tjempakasari, Khadijah Khairul Bariyah — Fri, 01 Nov 2024 00:00:00 +0700

Introduction: Depression is the most common psychiatric disorder suffered by patients with chronic kidney disease who are undergoing hemodialis. Depression can lead to decreased quality of life and increase the economic burden on the health system. CBT is a validated treatment for depression, and there has been no research yet on CBT in patients with chronic kidney disease undergoing hemodialysis in RSUD, Dr. Soetomo Surabaya. To prove the effect of CBT on the improvement of depression in patients with chronic kidney disease undergoing hemodialysis in RSUD, Dr. Soetomo Surabaya. Methods: Experimental study with use of randomized, pretest-posttest control group design. Respondents meeting the criteria were divided by random allocation, treatment by CBT for as many as 17 respondents, and even as much control as 20 respondents. The mean age of the treatment group was 37.24 and the control group was 44.45, with a range of 21–60 years old, who experienced mild and moderate depression without antidepressants. Treatment consists of 4 sessions, 45 minutes each session, once a week. Effectiveness was measured using BDI instruments. Results: There were significant differences in pre- and post-depression scores in the treatment group (p = 0.007), and there were significant differences in depression improvement between the treatment and control groups (p = 0.006). Depression improvement in the treatment group was 64.7% compared to the control group’s 25.0%. Conclusion: CBT can improve mild and moderate depression without antidepressants (NNT = 3) in patients with chronic kidney disease undergoing hemodialysis treatment at RSUD Dr. Soetomo Surabaya.

Front Matter

Jurnal Psikiatri Surabaya — Fri, 01 Nov 2024 00:00:00 +0700

Front Matter Jurnal Psikiatri Surabaya Vol. 13 No. 2 November 2024