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Abstrak :
Orang dengan Schizophrenia ODS adalah individu dengan gangguan jiwa yang mengalami gangguan pada pikiran, emosi dan perilaku. Gejala-gejala yang dialami oleh ODS membuat fungsi peran dan pekerjaan mereka menurun sehingga menjadi tidak produktif dan membutuhkan pertolongan orang lain. Orang yang dapat merawat dan memenuhi kebutuhan ODS disebut dengan caregiver. Caregiver berperan dalam merawat pasien seperti melakukan aktivitas sehari-hari dan mengurusi kebutuhan dasar pasien. Kondisi ini dapat mengakibatkan caregiver burden yaitu beban yang ditanggung oleh individu yang menyediakan bantuan bagi anggota keluarga dengan penyakit kronis ataupun memiliki keterbatasan. Caregiver burden yang kurang dikelola dengan baik akan berdampak pada kehidupan sosial dan psikologis caregiver. Peneliti menggunakan intervensi psikoedukasi untuk mengelola beban pada caregiver orang dengan schiozphrenia. Penelitian ini menggunakan desain pre-post design. Partisipan berjumlah 3 orang dengan status ekonomi sosial menengah ke bawah dan berusia rata-rata 50 tahun. Data kuantitatif didapatkan dengan menggunakan alat ukur Zarit Burden Interview, Hopkins Symptom Checklist-25 dan General Health Questionnaire-12 sedangkan data kualitatif didapatkan dengan wawancara dan observasi selama intervensi berlangsung. Hasil kuantitatif menunjukkan adanya penurunan beban pada caregiver sedangkan data kualitatif menunjukkan bahwa mereka bisa lebih mengerti bagaimana cara untuk mengatasi pasien, mengurangi stres dan bisa merawat diri sebagai bagian diluar tugas mendampingi pasien. ......Schizophrenia disorder is a mental disorder in which the patient experiences a disruption in their mind, emotions, and behaviour. The symptoms that they experience make their role function and their work decrease so that it makes unproductive and need help from other. A caregiver has a responsibility in caring for the daily needs of the patient. This condition can lead into caregiver burden. Less well managed caregiver burden will give effect to the social and psychological life of the caregiver. The researcher used psychoeducational intervention to manage the caregive burden of caregiver. This study used a pre post design. Quantitative data were obtained using Zarit Burden Interview, Hopkins Symptom Checklist 22, and General Health Questionnaire 12, while qualitative data were obtained using interview and observation during the intervention. The quantitative results indicate a decrease burden on the caregiver. Meanwhile, qualitative data show that they can better understand how to cope with patients, to reduce stress, and to take care of themselves as the part of their task besides to take care of their patients.

Abstrak :
Latar Belakang: Skizofrenia merupakan gangguan jiwa berat yang kompleks dengan angka harapan hidup yang rendah karena penyakit kardiovaskular. Orang dengan skizofrenia rentan mengalami sindroma metabolik meskipun tidak mendapat pengobatan antipsikotika. Sebuah penelitian di RSUPN Cipto Mangunkusumo menunjukkan prevalensi sindroma metabolik sebanyak 3,3% sampai 68% yang berhubungan dengan stress oksidatif dan berpotensi menurunkan produksi ATP. Penelitian ini berusaha menjelaskan patofisiologi sindroma metabolik pada skizofrenia dan hubungannya terhadap polimorfisme gen GCLC GAG TNR, stres oksidatif dan aktivitas metabolisme seluler. Metode: Penelitian merupakan penelitian observasional analitik. Subjek sebanyak 25 pasien skizofrenia dan 25 pasien kontrol sehat dilakukan pengambilan fibroblas dan PBMC kemudian dilakukan pengamatan polimorfisme gen GCLC GAG TNR, stres oksidatif (kadar MDA, MnSOD, GSH, GSSG, dan rasio GSH/GSSG), aktivitas metabolisme seluler (kadar ATP), dan parameter sindroma metabolik (lingkar pinggang, Indeks Massa Tubuh (IMT), LDL-c, HDL-c, TG, HbA1C, dan tekanan darah). Hubungan dianalisis dengan uji komparasi atau uji korelasi. Hasil: Terdapat korelasi pada sel fibroblas dengan PBMC yaitu korelasi kuat pada MnSOD (r=0.797) dan korelasi sedang pada GSSG (r=0.581). Didapatkan perbedaan yang bermakna pada kadar stres oksidatif yaitu MDA (p=0.013), GSH (p≤0.001), GSSG (p≤0.001), dan rasio GSH/GSSG (p≤0.001) pada kelompok skizofrenia dan kontrol serta didapatkan hubungan polimorfisme gen GCLC GAG TNR terhadap MDA (p=0.054) dan GSSG (p=0.010) pada kelompok skizofrenia tetapi tidak ditemukan perbedaan kadar ATP dan hubungan antara polimorfisme GCLC GAG TNR terhadap kadar ATP. Pada orang dengan skizofrenia didapatkan lingkar pinggang, IMT, LDL-c, dan HDL-c yang lebih rendah (p=0.025;p=0.003;p=0.022;p=0.010) dan TG yang lebih tinggi (p=0.038) dibandingkan kelompok kontrol. Simpulan: Polimorfisme gen GCLC GAG TNR memiliki hubungan terhadap stres oksidatif tetapi tidak ada hubungan terhadap aktivitas metabolisme seluler. Tidak terdapat perbedaan aktivitas metabolisme seluler pada orang dengan skizofrenia dan tidak ditemukan hubungan antara metabolisme seluler dengan sindroma metabolik. Terjadi perubahan kadar penanda stres oksidatif yang memiliki hubungan terhadap sindroma metabolik pada orang dengan skizofrenia ......Background: Schizophrenia is a complex severe mental disorder with low life expectancy due to cardiovascular disease. People with schizophrenia is prone to metabolic syndrome even if they do not receive antipsychotic. One study in Cipto Mangunkusumo General Hospital showed the prevalence of metabolic syndrome as much as 3.3% to 68% which correlate with oxidative stress and has the potential to reduce ATP production. This study aims to explain the pathophysiology of the metabolic syndrome in schizophrenia and its relationship to the GCLC GAG TNR gene polymorphism, oxidative stress and metabolic activity. Methods: This research is an observational analytic study. Twenty five schizophrenic patients and 25 healthy control patients were admitted to study. Fibroblast and PBMC (peripheral blood mononuclear cell) were taken to measure GCLC GAG TNR gene polymorphism, oxidative stress (levels of MDA, MnSOD, GSH, GSSG, and GSH/GSSG ratio), cellular metabolic activity (ATP levels), and metabolic syndrome parameters (waist circumference, body mass index (BMI), LDL-c, HDL-c, TG, HbA1C, and blood pressure). Relationship between variables were analyzed by comparison test or correlation test. Results: There is a correlation in fibroblast cells with PBMC with a strong correlation in MnSOD (r=0.797) and a moderate correlation in GSSG (r=0.581). There were significant differences in the levels of oxidative stress, namely MDA (p=0.013), GSH (p≤0.001), GSSG (p≤0.001), and GSH/GSSG ratio (p≤0.001) in the schizophrenia and control groups. There was correlation found for the polymorphism of the GCLC GAG TNR gene towards MDA (p=0.054) and GSSG (p=0.010) in the schizophrenia group but found no difference in ATP levels in the schizophrenia and control groups alongside with GCLC GAG TNR polymorphism and ATP levels. In people with schizophrenia, waist circumference, BMI, LDL-c, and HDL-c were lower (p=0.025;p=0.003;p=0.022;p=0.010) and higher TG (p=0.038) than the control group. Conclusion: GCLC GAG TNR gene polymorphism has correlation to oxidative stress but not to cellular metabolic activity. There is no difference in metabolic activity in people with schizophrenia and no relationship between cellular metabolism and the metabolic syndrome. There is alteration of oxidative stress markers which have an association with metabolic syndrome in people with schizophrenia.

Abstrak :
Latar Belakang: Pemulihan kesehatan mental orang dengan gangguan spektrum skizofrenia merupakan faktor penting dalam tatalaksana. Pemulihan kesehatan mental menekankan nilai-nilai humanistik dan pengalaman subjektif, sehingga bersifat sangat individual dan dipengaruhi oleh latar belakang budaya. Salah satu instrumen yang mengukur pemulihan kesehatan mental adalah Recovery Assessment Scale – Domains and Stages (RAS-DS) yang telah divalidasi ke dalam bahasa Indonesia. Namun, pengembangan RAS-DS dilakukan di Australia sesuai dengan persepsi pemulihan kesehatan mental di Australia. Hingga saat ini, belum ada instrumen yang mengukur pemulihan kesehatan mental pada orang dengan gangguan spektrum skizofrenia yang dikembangkan sesuai dengan persepsi pemulihan kesehatan mental di Indonesia. Metode: Penelitian ini merupakan studi kualitatif untuk mendapatkan makna pemulihan kesehatan mental menurut persepsi orang dengan gangguan spektrum skizofrenia di Indonesia, mengembangkan butir-butir SPPS, dan menentukan kesahihan isi SPPS. Pengambilan data kualitatif menggunakan metode focus group discussion (FGD) bersama orang dengan gangguan spektrum skizofrenia (n = 11). Data kualitatif dianalisis menggunakan pendekatan conventional content analysis dengan tipologi thematic survey. Pembentukan butir-butir SPPS dilakukan dengan metode induktif berdasarkan hasil analisis data kualitatif. Uji kesahihan isi dihitung dengan menggunakan content validity index for items (I-CVI) dan content validity index for scales (S-CVI). Uji coba dilakukan kepada subjek (n = 10) untuk menilai durasi pengisian SPPS, tingkat kesulitan SPPS secara keseluruhan, dan butir-butir sulit dalam SPPS. Hasil: Persepsi orang dengan gangguan spektrum skizofrenia di Indonesia mengenai pemulihan kesehatan mental meliputi dimensi sosial, eksistensial, klinis, fungsional, dan fisik. Beberapa persepsi yang unik sesuai dengan situasi sosiokultural di Indonesia adalah aspek keluarga, religi dan spiritualitas, serta stigma. Butir-butir SPPS terdiri dari 40 butir pernyataan yang mencerminkan berbagai dimensi tersebut. SPPS memiliki kesahihan isi yang baik dengan rerata I-CVI sebesar 0,99 dan S-CVI sebesar 0,93. SPPS memiliki tingkat kesulitan mudah dengan rerata durasi waktu pengisian adalah 5,4 menit (rentang 3 – 10 menit). Simpulan: Pemberian layanan pada orang dengan gangguan spektrum skizofrenia perlu mempertimbangkan berbagai dimensi pemulihan kesehatan mental. SPPS dapat digunakan secara rutin sebagai alat bantu untuk mengukur dan memantau pemulihan kesehatan mental secara holistik pada orang dengan gangguan spektrum skizofrenia. ......Background: Mental health recovery of people with schizophrenia spectrum disorders is an essential factor in therapy. Mental health recovery emphasizes humanistic values and subjective experiences, so it is highly individualized and influenced by cultural background. One instrument that measures mental health recovery is the Recovery Assessment Scale – Domains and Stages (RAS-DS), validated in Indonesian. However, the development of RAS-DS in Australia is consistent with the perception of mental health recovery in Australia. To date, no instrument measures mental health recovery in people with schizophrenia spectrum disorders, which has been developed based on the perception of mental health recovery in Indonesia. Therefore, Indonesian Recovery Scale for Patients with Schizophrenia/Skala Pemulihan Pasien Skizofrenia (SPPS) is needed. Methods: This study is a qualitative study to assess the meaning of mental health recovery according to the perceptions of people with schizophrenia spectrum disorders in Indonesia, develop SPPS items, and determine the content validity of SPPS. Qualitative data was collected through focus group discussion (FGD) with people with schizophrenia spectrum disorders (n = 11). Qualitative data were analyzed using a conventional content analysis approach with thematic survey typology. The formation of SPPS items was carried out using an inductive method based on the results of qualitative data analysis. The content validity test is calculated using the content validity index for items (I-CVI) and the content validity index for scales (S-CVI). Trials were conducted on subjects (n = 10) to assess the duration of filling out the SPPS, the overall difficulty level of the SPPS, and the difficult items in the SPPS. Results: Perceptions of mental health recovery of people with schizophrenia spectrum disorders in Indonesia include social, existential, clinical, functional, and physical dimensions. Some perceptions of family, religion, spirituality, and stigma are unique to Indonesia's socio-cultural situation. The SPPS items consist of 40 statements that reflect these various dimensions. SPPS has good content validity with an average I-CVI of 0.99 and an S-CVI of 0.93. SPPS was rated easy to use, with the average duration required to complete the instrument was 5.4 minutes, with a range of 3 – 10 minutes. Conclusion: The provision of services to people with schizophrenia spectrum disorders needs to consider the various dimensions of mental health recovery. SPPS can be used routinely as a tool to measure and monitor holistically mental health recovery in people with schizophrenia spectrum disorders.

Abstrak :
Skizofrenia adalah suatu gangguan jiwa berat yang ditandai dengan penurunan atau ketidakmampuan berkomunikasi, gangguan realitas, serta mengalami kesukaran melakukan aktivitas sehari-hari. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berpengaruh terhadap kejadian gangguan jiwa berat di Yogyakarta. Penelitian ini menggunakan metode cross sectional dengan 1.157 responden dan menggunakan pendekatan regresi logistik. Hasil penelitian ini adalah 4 variabel faktor psikologis, 2 variabel faktor somatik dan 2 variabel faktor sosio ekonomi berpengaruh terhadap kejadian gangguan jiwa berat di Yogyakarta. ...... Schizophrenia is a severe mental disorder characterized by a decrease or an inability to communicate, impaired reality, and had difficulty doing everyday activities. This study aims to identify factors that affect the incidence of schizophrenia in Yogyakarta. This study using cross sectional method and the sample size of 1,157 respondents surveyed, this study used logistic regression. The result, there are 4 variables from psychologic factors, 2 variables from somatic factors, and 2 variables from socio economic factors that are affect the incidence of schizophrenia in Yogyakarta.

Abstrak :
Skizofrenia merupakan salah satu fenomena gangguan jiwa yang banyak dialami oleh masyarakat di Indonesia. Skizofrenia menimbulkan gejala yang berbeda-beda salah satunya gejala positif yaitu perilaku kekerasan. Individu dengan masalah risiko perilaku kekerasan jika tidak segera ditangani dapat membahayakan bagi penderita sendiri, orang lain, dan lingkungan sekitar. Penulisan karya ilmiak akhir ners ini bertujuan untuk menganalisis asuhan keperawatan pada pasien risiko perilaku kekerasan selama 8 hari. Intervensi keperawatan berfokus pada terapi musik bernyanyi selama 30 menit dalam satu hari di ruang Arimbi RSJ Marzoeki Mahdi Bogor. Hasil asuhan keperawatan yang diberikan menunjukan bahwa terdapat penurunan tanda dan gejala risiko perilaku kekerasan. Studi kasus ini diharapkan dapat sebagai gambaran dalam pemberian asuhan keperawatan ners pada Pasien dengan risiko perilaku kekerasan. ......Schizophrenia is a mental disorder phenomenon that is experienced by many people in Indonesia. Schizophrenia causes different symptoms, one of which is positive symptoms, namely violent behavior. Individuals with risk problems for violent behavior if not treated immediately can be dangerous for the sufferer himself, others, and the environment. The purpose of writing this final scientific paper for nurses is to analyze nursing care for patients at risk of violent behavior for 8 days. The nursing intervention focused on singing music therapy for 30 minutes in one day in the Arimbi room of the Marzoeki Mahdi Hospital, Bogor. The results of the nursing care provided showed that there was a decrease in signs and symptoms of the risk of violent behavior. This case study is expected to serve as an illustration in providing nursing care to clients at risk of violent behavior.

Abstrak :
The author reviews the changing diagnostic concepts of schizophrenia and bipolar disorder with a historical perspective to clarify how the current conflict over explanations for psychosis has arisen. That two disorders, schizophrenia and bipolar, known as the Kraepelinian dichotomy, account for the functional psychoses has been a cornerstone of Psychiatry for over 100 years, but is questioned because of substantial similarities and overlap between these two disorders. Literature in the field demonstrates that psychotic patients are frequently misdiagnosed as suffering from the disease called schizophrenia when they suffer from a psychotic mood disorder. Such patients, their families, and their caretakers suffer significant disadvantages from the misdiagnosis. Psychotic patients misdiagnosed with schizophrenia receive substandard care regarding their medications, thus allowing their bipolar conditions to worsen. Other adverse effects are substantial and will be included. Liability for medical malpractice is of critical importance for the mental health professionals who make the majority of the diagnoses of schizophrenia. The concept put forward in this work will have a discipline-altering impact.

Abstrak :
This book provides a wealth of assessment instruments from the world’s experts to help clinicians gather the most important information from their patients. This is the 3rd edition of our highly successful guides to rating scales in schizophrenia, it is a practical and quick reference publication for psychiatrists.