Latar Belakang : Tujuan terapi skizofrenia saat ini adalah untuk mengembalikan fungsi pasien kepada fungsi sebelum menderita skizofrenia atau paling tidak mendekati fungsi sebelum menderita skizofrenia. Pengobatan skizofrenia dengan antipsikotika saat ini dianjurkan dengan pemberian tunggal, namun akhir-akhir ini terjadi peningkatan pemberian antipsikotika secara kombinasi baik di Indonesia maupun di dunia. Pemberian antipsikotika secara kombinasi diperkirakan pada akhirnya mempengaruhi performa fungsi pasien skizofrenia. Penilaian performa fungsi pasien dapat dilakukan melalui penilaian dengan Personal and Social Performance Scale (PSP). Tujuan : Menilai performa fungsi pasien skizofenia dengan terapi tunggal dan kombinasi antipsikotika, serta membandingkan performa fungsi di antara kedua kelompok tersebut. Metode: Dua ratus lima pasien dengan diagnosis skizofrenia berusia 18-59 tahun yang berobat jalan didampingi keluarga/care giver di Poliklinik Jiwa Dewasa RSCM pada Desember 2011 sampai Mei 2012, pria maupun wanita, tanpa membedakan jenis skizofrenianya, disertakan dalam penelitian dengan simple random sampling, dan dikelompokkan menjadi dua menurut jumlah antipsikotika yang diterima, tunggal dan kombinasi. Dilakukan pengumpulan data dan penilaian pasien menurut Personal and Social Performance Scale (PSP) yang sudah divalidasi kedalam bahasa Indonesia. Hipotesis penelitian adalah performa fungsi pasien skizofrenia yang mendapatkan terapi tunggal antipsikotika lebih baik dibandingkan yang mendapatkan terapi kombinasi antipsikotika. Dilakukan analisis non parametrik untuk membandingkan nilai PSP antara kedua kelompok tersebut, serta analisis multivariat untuk mengetahui faktor yang paling berperan terhadap performa fungsi pasien. Hasil : Hasil analisis non parametrik dengan uji Mann-Whitney memberikan hasil p<0.005, yang artinya performa fungsi pasien skizofrenia yang mendapatkan terapi tunggal lebih baik daripada yang mendapatkan terapi kombinasi. Hasil analisis multivariat menunjukkan faktor yang paling bermakna dalam memberikan performa fungsi yang baik adalah tingkat pendidikan pasien, apabila dibandingkan dengan faktor lainnya. Performa fungsi menjadi salah satu faktor dalam menentukan pemilihan antipsikotika. Dalam penelitian ini tidak dianalisis hubungan antara awitan, lama penyakit, jenis skizofrenia, frekuensi kekambuhan, serta faktor sosial ekonomi pasien terhadap baik atau buruknya performa fungsi. Kesimpulan : Performa fungsi pasien skizofrenia yang mendapatkan terapi tunggal antipsikotika lebih baik daripada yang mendapatkan terapi kombinasi antipsikotika.
Background : The goal of therapy for schizophrenia nowadays is to restore patient?s function to their premorbid level, or at least near that original capability. Single drug therapy, or monotherapy for schizophrenia is recommended, but there are evidences that the use of combination therapy with antipsychotic or polypharmacy is frequent, this is true in Indonesia and also in the rest of the world. The use of the combination therapy is believed to affect performance and function of the patients. Measurement of performance and function can be done with the Personal and Social Performance Scale (PSP),for the clinical assessment. Objectives : To assess the functioning performance in patients with schizophrenia who have been given monotherapy and poltpharmacy of antipsychotics, followed by a comparison analysis between both groups. Method: Two hundred and five patients who have been diagnosed withschizophrenia between the ages of 18-59 years and accompanied by a family member or their caregivers coming to the Poliklinik Jiwa Dewasa RSCM in December 2011 to April 2012, were assessed. Both male and female patients were studied and no differentiation of schizophrenia type was done in this study. Simple random sampling was used and they were then listed in two groups, one group receiving single drug and the other getting combination therapy. Data collection conducted by researcher and the assessment is according to the protocol of the Personal and Social Performance Scale (PSP), Indonesian validated translation. Research hypothesis is that the performance of the functions of patients with schizophrenia who received single therapy is better compared to those receiving combination antipsychotic therapy. Non-parametric analysis was performed to compare values between groups, as well as multivariate analysis to determine the factors that most contribute to the performance of the functions of the patient. Results : The result of non-parametric analysis with Mann-Whitney test is p <0.005, which means that the performance of the functions of patients with schizophrenia who received single therapy was better than the group who received combination therapy. The results of multivariate analysis showed that the most significant factor in delivering good performance is the educational level of the patients, when compared with other factors. Conclusions : Performance of the functions of patients with schizophrenia who received single therapy antipsychotics was found to be better than the group who were given combination antipsychotic therapy. |
