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Abstrak :
Latar Belakang: Skizofrenia merupakan gangguan jiwa yang berpotensi berlangsung dalam jangka waktu yang panjang dengan prognosis yang tidak terlalu baik, sehingga diperlukan tata laksana yang tepat guna memperbaiki keluaran pada pasien-pasien dengan Skizofrenia. Penelitian ini berupaya untuk mencermati pola peresepan dan alasan perubahan terapi pasien-pasien dengan Skizofrenia di Indonesia khususnya di Poli Jiwa Dewasa RSCM dengan merujuk pada Konsensus Penatalaksanaan Gangguan Skizofrenia 2011. Metodologi: Penelitian ini merupakan penelitian deskriptif dengan desain kohort retrospektif yang dilakukan dengan cara mengumpulkan data mengenai pola peresepan sejak awal pasien tersebut mendapatkan terapi farmakologi hingga waktu kunjungan yang ditentukan serta alasan perubahan terapi farmakologi bila terjadi perubahan terapi. Penelitian ini menggunakan data rekam medik pasienpasien dengan Skizofrenia di Poli Jiwa Dewasa RSCM yang melakukan kunjungan pada bulan Juli 2013 hingga jumlah sampel terpenuhi. Hasil: Pada 53 (65,4%) rekam medik digunakan antipsikotik monoterapi pada awal terapi. Untuk pengobatan awal, 79 (97,5%) pasien mendapatkan jenis obat yang rasional dan 75 (92,6%) pasien mendapatkan dosis obat yang rasional. Pada pasien yang awalnya mendapatkan monoterapi, sebanyak 14 (43,8%) pasien kemudian mengalami switching ke antipsikotik lain dan sebanyak 18 (56,3%) pasien kemudian mendapatkan antipsikotik kombinasi. Pada pasien yang awalnya mendapatkan terapi antipsikotik kombinasi, sebanyak 7 (26,9%) pasien kemudian mengalami switching, 4 (15,4%) pasien mendapatkan penambahan jenis obat, 1 (3,8%) pasien mengalami pengurangan jenis obat dan 14 (53,8%) pasien mendapatkan antipsikotik monoterapi. Alasan perubahan terapi terbanyak sulit dianalisis karena sebanyak 441 dari 780 (56.5%) perubahan terapi tidak tercantum alasannya. Simpulan: Penggunaan kombinasi antipsikotik pada awal pengobatan pasien dengan Skizofrenia masih didapatkan di Poli Jiwa Dewasa walaupun tidak direkomendasikan oleh panduan tata laksana yang ada. Ketidaklengkapan pencatatan rekam medik menjadikan analisis rasionalitas terapi dan alasan perubahan terapi sulit dilakukan. ...... Background: Schizophrenia is a mental disorder that could potentially progress to a long term disorder with a not very good prognosis, so it requires an adequate treatment in order to improve the outcome. This study aims to examine the prescribing pattern and the reason of therapy changing of patients with Schizophrenia in Indonesia especially in Poli Jiwa Dewasa RSCM regarding the Konsensus Penatalaksanaan Gangguan Skizofrenia 2011. Methodology: This study is a descriptive study with retrospective cohort design that conducted by collecting data on prescribing pattern since the beginning of patients pharmacological treatment until the determined time of visit and the reason of therapy changing. This study uses the medical record data of patients with Schizophrenia in Poli Jiwa Dewasa RSCM who visited in July 2013 until the number of samples provided. Result: In the beginning of Schizophrenia treatment, monotherapy was used in 53 (65,4%) medical records. For the initial treatment, 79 (97,5%) patients received the rational drug and 75 (92,6%) patients received the rational drug dosage. In patients who received monotherapy as initial treatment, 14 (43,8%) patients underwent switching to another antipsychotic and 18 (56,3%) patients received antipsychotic combination. In patients who received antipsychotic combination as initial treatment, 7 (26,9%) patients underwent switching to another antipsychotic, 4 (15,4%) patients received added number of antipsychotic,1 (3,8%) patient received reduced number of antipsychotic and 14 (53,8%) patients received monotherapy. The analysis of reason of therapy changing was difficult to conduct since there was no reason of therapy changing written in 441 of 780 (56.5%) antipsychotic treatment changing. Conclusion: Antipsychotic combination as initial treatment in patient with Schizophrenia is still found in Poli Jiwa Dewasa eventhough the use of antipsychotic combination is not recommended by the available guidelines. Incomplete documentation in medical record makes the treatment rationality analysis difficult.

Abstrak :
[ABSTRAK
Gangguan bipolar dikenal memiliki kaitan dengan berbagai komorbiditas klinis yang memengaruhi pekerjaan, kehidupan berkeluarga, dan fungsi interpersonal. Duapertiga pasien dengan gangguan bipolar memiliki komorbid yang akan memperburuk luaran gangguan bipolar dan dapat menganggu penatalaksanaan terhadap penyakitnya. Belum ada penelitian yang menggambarkan frekuensi komorbiditas fisik yang terjadi pada penderita bipolar di Indonesia. Rumah Sakit Dr. H. Marzoeki Mahdi sebagai rumah sakit jiwa tertua di Indonesia juga belum memiliki data mengenai jenis dan frekuensi komorbid fisik, mengingat bahwa rumah sakit ini juga menangani rawat inap umum di samping rawat inap psikiatri Metode: Penelitian menggunakan rancangan potong lintang pada 100 orang dengan Gangguan Bipolar di Poliklinik Jiwa Dewasa dan Bangsal Psikiatri R.S. Dr. H. Marzoeki Mahdi Bogor. Penelitian ini menggunakan instrument Structured Clinical Interview For the DSM-IV Axis I Disorders untuk menentukan Gangguan Bipolar, dan kriteria diagnostik sepuluh komorbid fisik yang mengacu pada kriteria diagnostik masing-masing komorbid fisik. Hasil: Pada penelitian ini didapatkan adanya hubungan bermakna antara umur dengan terjadinya komorbid fisik yaitu p= 0.001(p di bawah 0.005). Pada analisis tambahan didapatkan adanya hubungan bermakna antara pemberian obat polifarmasi/monoterapi dengan terjadinya komobid fisik terbanyak yakni hipertensi (nilai p= 0,0001). Pada sepuluh komorbid fisik yang dinilai, migrain, hipertensi dan dermatitis merupakan yang paling banyak. Simpulan Hipertensi, migrain dan dermatitis merupakan tiga besar komorbid fisik di R.S. Dr. H. Marzoeki Mahdi Bogor. Terdapat hubungan bermakna antara umur dengan terjadinya komorbid fisik. Pemberian obat polifarmasi/monoterapi juga bermakna dalam terjadinya hipertensi. Diperlukan kewaspadaan psikiater dalam mengawasi terjadinya komorbid fisik pada gangguan bipolar di layanan psikiatri.

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ABSTRACT
Bipolar disorders are known to cause various clinical comorbidity that may affect work, family and interpersonal function. Two third of bipolar disorder have comorbidities that may worsen the outcome of bipolar itself and interfere with it's therapy. There has not been sufficient study about physical comorbidities in bipolar in Indonesia. As the oldest psychiatric hospital in Indonesia that treats physical and psychiatric inpatients, Dr. H. Marzoeki Mahdi hospital still lacks data concerning types and frequencies of physical comorbidities. Method: This research uses cross-sectional design from 100 people with bipolar disorder at Psychiatric Clinic and Psychiatric Ward at Dr. H. Marzoeki Mahdi Bogor Hospital. This research also uses the Structured Clinical Interview For the DSM-IV Axis I Disorders to ensure the bipolar diagnosis, and criteria diagnostic for ten physical comorbidities from each of their field. Result: There is a significant relationship in this research between age and physical comorbidities p=0.001 (p below 0,005). In the additional analysis, there are significant relationship in this research between polypharmacy / monotherapy and hypertension (p=0,0001). Migraine, hypertension, and dermatitis were the top three physical comorbidities in this research. Conclusion: Hypertension, migraine and dermatitis are the top three in our physical comorbidities in Dr. H. Marzoeki Mahdi hospital. Age has a significant relationship with physical comorbidities. Polipharmacy and monotherapy also has significances in hypertension. Therefore psychiatrist must be aware about the possibility of physical comorbidity in the psychiatric care, Bipolar disorders are known to cause various clinical comorbidity that may affect work, family and interpersonal function. Two third of bipolar disorder have comorbidities that may worsen the outcome of bipolar itself and interfere with it’s therapy. There has not been sufficient study about physical comorbidities in bipolar in Indonesia. As the oldest psychiatric hospital in Indonesia that treats physical and psychiatric inpatients, Dr. H. Marzoeki Mahdi hospital still lacks data concerning types and frequencies of physical comorbidities. Method: This research uses cross-sectional design from 100 people with bipolar disorder at Psychiatric Clinic and Psychiatric Ward at Dr. H. Marzoeki Mahdi Bogor Hospital. This research also uses the Structured Clinical Interview For the DSM-IV Axis I Disorders to ensure the bipolar diagnosis, and criteria diagnostic for ten physical comorbidities from each of their field. Result: There is a significant relationship in this research between age and physical comorbidities p=0.001 (p below 0,005). In the additional analysis, there are significant relationship in this research between polypharmacy / monotherapy and hypertension (p=0,0001). Migraine, hypertension, and dermatitis were the top three physical comorbidities in this research. Conclusion: Hypertension, migraine and dermatitis are the top three in our physical comorbidities in Dr. H. Marzoeki Mahdi hospital. Age has a significant relationship with physical comorbidities. Polipharmacy and monotherapy also has significances in hypertension. Therefore psychiatrist must be aware about the possibility of physical comorbidity in the psychiatric care]

Abstrak :
Pendahuluan: Penelitian Badan Narkotika Nasional pada tahun 2011 menunjukkan prevalensi orang dengan penyalahgunaan zat di Indonesia sebesar 2,2% atau sekitar 3,8 juta penduduk. Namun, data Deputi Bidang Rehabilitasi Badan Narkotika Nasional menunjukkan hanya 6.738 orang yang mendapatkan pelayanan terapi dan rehabilitasi. Salah satu prediktor penting untuk mengetahui sikap seseorang untuk memperolah layanan rehabilitasi adalah kesiapan serta motivasi. University of Rhode Island Change Assessment Scale (URICA) adalah salah satu instrumen yang digunakan untuk menilai kesiapan orang dengan penyalahgunaan zat serta motivasinya. Tujuan: Melakukan uji validitas dan reliabilitas alat ukur URICA untuk menilai kesiapan serta motivasi penyalahguna zat untuk menjalani rehabilitasi versi Bahasa Indonesia yang sahih dan andal. Metode: Penelitian ini merupakan penelitian deskriptif uji instrumen dengan disain potong lintang. Sampel diambil secara acak sederhana. Subjek pada penelitian ini adalah residen yang mengikuti terapi dan rehabilitasi di Unit Terapi dan Rehabilitasi Lido, Badan Narkotika Nasional dan orang dengan penyalahgunaan zat di Pusat Penjangkauan binaan Badan Narkotika Nasional. Hasil: Hasil penelitian menunjukkan validitas URICA sebesar 0.882 dengan Cronbach alpha sebesar 0.753-0.806 dan reliabilitas test-retest 0.935-1. Nilai di atas atau sama dengan angka tujuh sebagai kelompok yang memiliki motivasi tinggi dan di bawah angka tujuh sebagai kelompok yang memiliki motivasi rendah. Simpulan: Instrumen URICA versi Bahasa Indonesia yang diuji dalam penelitian ini sahih dan handal untuk menilai kesiapan dan motivasi orang dengan penyalahgunaan zat berpartisipasi dalam program terapi dan rehabilitasi. ...... Background: A research conducted by National Narcotics Board in 2011 indicated that the prevalence of substance abuse in Indonesia is approximately 2,2% or 3,8 million people. However, based on Rehabilitation Deputy of National Narcotics Board only 6.738 people have obtained treatment and rehabilitation services. One of the most important predictor to identify one’s attitude to attain rehabilitation services is the readiness and motivation of substance abusers. University of Rhode Island Change Assessment Scale (URICA) is one of the instruments utilize to identify readiness to change and motivation of substance abusers. Aim: To conduct validity and reliability test on University of Rhode Island Change Assessment Scale (URICA) in order to recognize the readiness to change and motivation of substance abusers undergoing rehabilitation in Bahasa Indonesia. Method: This study was a descriptive cross-sectional instrument study. The sampling design was simple random sampling. The subjects in this study were residents undergoing treatment and rehabilitation services at Lido Treatment and Rehabilitation Centre and Outreach Centre supervised by National Narcotics Board. Result: The validity score of URICA is 0.882 with Cronbach alpha of 0.753-0.806 and a reliability test-retest of 0.935-1. The cut-off score obtained indicated that scores above seven are highly motivated and those below seven are least motivated. Conclusion: The Bahasa Indonesia version of URICA test conducted in this study is valid and reliable to address readiness and motivation of substance abusers to participate in treatment and rehabilitation program.

Abstrak :
Latar Belakang: Prevalensi Diabetes Melitus (DM) tipe 2 cenderung meningkat di seluruh dunia dan keteraturan pengobatan masih menjadi masalah hingga saat ini. Penelitian terdahulu menemukan bahwa terdapat hubungan antara temperamen dengan kontrol glukosa namun belum banyak penelitian yang membahas hal ini. Penelitian ini bertujuan mengetahui hubungan antara temperamen dengan terkontrol atau tidak terkontrolnya DM tipe 2. Metode: Penelitian ini adalah penelitian analitik potong lintang. Pengambilan sampel dilakukan dengan consecutive sampling pada 110 penyandang DM tipe 2 di Poliklinik Metabolik Endokrin RSCM selama bulan Agustus-Desember 2015. Responden dikelompokkan menjadi penyandang DM terkontrol atau DM tidak terkontrol berdasarkan hasil laboratorium HbA1c terakhir. Responden mengisi kuesioner Modified-Temperament and Character Inventory versi bahasa Indonesia. Hasil: Hasil penelitian ini menunjukkan bahwa skor temperamen harm avoidance, novelty seeking, dan reward dependence tidak berhubungan bermakna dengan terkontrol atau tidak terkontrolnya DM tipe 2. Simpulan: Tidak ada hubungan bermakna antara temperamen dengan pengendalian kadar HbA1c pada penyandang DM tipe 2.

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Background: Prevalence on type 2 Diabetes Mellitus (DM) tend to increase across the world and regulating treatment still being one of the matters to be discussed until recently. Previous research had found that there are correlations between temperament with glucose control but with limited study on that area. This research aim to qualify the relationship between temperament to controllable or uncontrollable type 2 DM. Method: This research is a cross sectional sampling method. Sampling conducted with consecutive sampling on 110 respondents with type 2 DM in RSCM Metabolism Endocrine Polyclinic, sampling was done between August to December 2015. Respondents are grouped to two different groups which is controllable DM and uncontrollable DM based on last HbA1c laboratory results. Respondents were requested to fill up Modified-Temperament and Character Inventory questionnaire in Bahasa Indonesia. Results: Result on this research indicates that temperament score in harm avoidance, novelty seeking, and reward dependence are unrelated with whether Type 2 DM being controllable or uncontrollable. Conclusion: Absent of significant relation between temperament and HbA1c level control in type 2 DM patients.

Abstrak :
ABSTRAK
Latar Belakang : Penilaian kebutuhan orang dengan skizofrenia adalah tugas penting bagi semua pihak yang terkait sehingga dapat mengurangi hendaya dalam penurunan fungsi baik fisik, psikologis atau sosial.Tujuan: Mengetahui gambaran kebutuhan hidup orang dengan skizofrenia menurut dirinya dan caregiver. Metode:Masing-masing sembilan puluh orang dengan skizofrenia yang berobat jalan dan caregivernya di poliklinik psikiatri RSCM, dengan consecutive sampling, dengan menggunakan instrumen CANSAS, Clinical Global Impression-Severity (CGI-S) dan Global Assessment Fungtioning (GAF).Hasil :Dari 22 butir pertanyaan CANSAS rata-rata kebutuhan yang dilaporkanorang dengan skizofrenia adalah 9 kebutuhan, sedangkan caregivernya 12 kebutuhan.Reratadari Global Assessment Fungtioning (GAF) adalah 40-50, Clinical Global Impression-Severity (CGI-S) adalah2-3. Baik orang dengan skizofrenia maupun caregivernya menilai adanya masalah pada kebutuhan fisik yang lebih tinggi dibanding kebutuhan lainnya. Kesimpulan : Dalam menilai kebutuhan hidup orang dengan skizofrenia ternyata tidak hanya fokus pada kebutuhan pada gejala psikotiknya saja, tetapi kebutuhan fisik juga dinilai penting baik bagi orang dengan skizofrenianya maupun caregiver.

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ABSTRACT
Background: Assessment of the needs of people with schizophrenia is an important task for all stakeholders so that they can reduce the impairment in physical, psychological or social function.AimAssessing the the needs of people living with schizophrenia based on themselves and the caregivers, and to obtain the differences between those assessment.Method:Ninety people with schizophrenia and ninety of their caregivers in RSCM outpatient clinic, using consecutive sampling. Instruments used by researcherduring the interview for people with schizophrenia and their caregivers are CANSAS, Clinical Global Impression-Severity (CGI-S) and Global Assessment Fungtioning (GAF).Result: Using CANSAS instrument, the mean total of needs reportedfor people with schizophrenia and their caregivers reported 9 and 12, respectively. The mean of Global Assessment Functioning (GAF) was range of 40-50, and Clinical Global Impression-Severity (CGI-S) was 2-3. Both people with schizophrenia and their caregivers assessed the problem of need on physical health higher than other needs.Conclusion: Assessment of the needs of people with schizophrenia was not only focused on the needs of the psychotic symptoms, but also physical needs which were considered important both for people with schizophrenia and their caregivers.

Abstrak :
Gangguan jiwa sering tidak mendapat pengobatan yang seharusnya. Dokter pada pelayanan primer merupakan kontak awal bagi pasien gangguan jiwa. Pada saat ini belum ada instrumen untuk menilai pengetahuan, sikap dan perilaku dokter Puskesmas terhadap gangguan jiwa sehingga perlu dibuat suatu instrumen dan menilai validitas serta reliabilitasnya.Sembilan puluh tujuh dokter umum yang bertugas di Puskesmas di DKI Jakarta, disertakan dalam penelitian dengan purposive sampling. Kuesioner terdiri dari sepuluh pertanyaan tentang perilaku, sepuluh pertanyaan tentang sikap dan dua puluh pertanyaan tentang pengetahuan terhadap gangguan jiwa. Hasil penghitungan denganCrohnbach?s Alpha menunjukkan instrumen ini belum memiliki construct validitydan reliabilitasyang baik (< 0,7). Di samping itu, terdapat korelasi antarbutiryang kurangkuat pada beberapa pertanyaan. Reliabilitas konsistensi internal masih belum dapat menunjukkan hasil yang baik, beberapa pertanyaan dapat memperbaiki nilai Crohnbach?s Alpha if item deleted secara signifikan.Instrumen pengetahuan, sikap dan perilaku dokter Puskesmas terhadap gangguan jiwa ini masih belum terbukti validitas dan reliabilitasnya, masih butuh penelitian lebih lanjut untuk mengembangkan instrumen ini.

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Mental disorders are often go untreated. Primary care phyisician is the initial contact to people with mental disorders. Currently, there are no instruments which can evaluate knowledge, attitude and behavior of primary care physician towards mental disorders. It is important to make such an instrument and to test its validity and realibility.Ninety seven primary care physicians who work at the Puskesmas in DKI Jakarta were involved. Purposive sampling was used in this study. Questionnaire consist of ten questions about behavior, tenquestions about attitude, and twenty questions about knowledge toward mental disorders.The analysis using by Crohnbach Alpha?s showed that this instrumen haven?t met good construct validity and reliability (< 0,7). There are also weak inter-item correlation in some of the questions. Internal consistency reliability is still not able to show good result. Some questions may improve Crohnbach?s Alpha if some items are deleted, but still cannot reach the level of good.The instrument of knowledge, attitudes and behavior of primare care physicians toward mental disorders is still not valid and reliabel and still need further research to develop this instrument.