Is Democracy Therapeutic? A Deweyan Reading of the Institutions of Antipsychiatry

This article presents a Deweyan reading of the processes of critique, experimentation, and reform that took hold of a minority of psychiatric institutions in Western Europe during the nineteen-sixties and seventies, under the influence of the so-called Italian and British antipsychiatry movements. Framed within a specific understanding of the sixties, the article examines these complex theoretical and institutional operations against the background of John Dewey’s idea of democracy, which it interprets, above all else, as the constant provision of material, intellectual, and human resources for the people to directly transform their environment and themselves in increasingly complex and creative ways. After acknowledging the historical and conceptual discontinuities that exist between these two autonomous bodies of knowledge, the first section presents a summary of Dewey’s philosophy. Next the article sheds light on Basaglia’s and Laing’s antipsychiatric projects by interpreting them as a sustained effort to distinguish between schizophrenia as a first and a second disease, an epistemological search in the midst of which each of them ended up creating new institutions that necessarily embarked their inmates on a radical process of Deweyan growth. The key role of the sixties counterculture is emphasized at this point, and examples from Gorizia’s and Trieste’s asylums, as well as British community households, are read in terms of Basaglia’s and Laing’s negative and affirmative dialectics, respectively. Finally, in the last two sections, the article argues that antipsychiatry’s analysis of psychotic behavior significantly enlarges Dewey’s understanding of the circuit of growth and experience, and that Dewey’s ideas of growth and experience provided, in turn, a missing criterion for defining mental health and deriving coherent therapeutic and institutional concretions.

COVID-19 related lockdown: a trigger from the pre-melancholic phase to catatonia and depression, a case report of a 59 year-old man

Background The pre-melancholic model described by Tellenbach may provide a common model for understanding the psychological implications of the lockdown. In this case report, we describe a rare catatonic status as a psychological implication linked to the COVID-19 pandemic, a really unique global situation. Case presentation B is a 59 year-old man with mute psychiatric anamnesis whose mother suffered from a major depressive disorder. As the lockdown began, he started to develop concerns about his family’s economic condition. According to his wife, he could see no end to the epidemic and no future at all. Moving from this, he started to show a severe and rapidly progressive depression and to develop mood congruent delusions. In addition, he had increasing anhedonia, apathy, starvation and insomnia. This turned in the end into a catatonic-like state, along with a deep desire to die. Admitted to the psychiatry ward in a state of mutism, he was discharged after 15 days with a diagnosis of “Major depressive disorder, single severe episode with no psychotic behavior”. He was treated with Sertraline, Olanzapine and Lorazepam. Conclusions Our aim is to draw attention to the effect of the lockdown upon a Tellenbach-like personality structure. Identifying this type of pre-morbid personality structure could help clinicians understand and treat some cases of patients with severe major depressive disorders elicited by the COVID-19 pandemic.

LAMANYA PERAWATAN PASIEN SKIZOFRENIA RAWAT JALAN DENGAN TINGKAT STRES KELUARGA

Schizophrenia is one form of chronic mental disorder, which causes serious persistent brain disease that results in psychotic behavior, concrete thinking, and difficulty in obtaining information. Prolonged treatment in schizophrenia patients will generally cause stress to families related to the high burden they bear.The purpose of this research is to know the relationship between the duration of treatment schizophrenia patients with the level of family stress.The design of this research is a descriptive correlation with the Cross-Sectional approach. The population of this study amounted to 181 people and samples of this study as many as 64 respondents.Sampling techniques with accidental sampling. The collection of data using questionnaires with test Chi-Square p = < 0.005. The results of this study showed that there is a connection between the duration of treatment schizophrenia patients with a level of family stress in the hospital psychiatric clinic Prof.Dr. Muhammad Ildrem Medan. From 64 respondents there were 43 respondents experiencing moderate stress (67.2%), 11 respondents experiencing severe stress (17.2%), and 10 respondents experiencing mild stress (15.6%).The results of this study indicate there is a significant relationship between the length of treatment with the level of family stress with P=0.035 or P=0.05.This research is expected that families are able to anticipate their stressements by giving support to schizophrenia patients. Abstrak Skizofrenia merupakan salah satu bentuk gangguan jiwa kronik, yang menyebabkan penyakit otak persisten serius yang mengakibatkan prilaku psikotik, pemikiran konkret, dan kesulitan dalam memperoleh informasi. Perawatan yang lama pada pasien skizofrenia umumnya akan menimbulkan stress kepada keluarga terkait tingginya beban yang mereka tanggung. Tujuan penelitian ini untuk mengetahui hubungan antara lamanya perawatan pasien skizofrenia rawat jalan dengan tingkat stress keluarga. Desain penelitian ini adalah deskriptif korelasi dengan pendekatan Cross-Sectional. Populasi penelitian ini berjumlah 181 orang dan sampel penelitian ini sebanyak 64 responden. Tehnik pengambilan sampel dengan accidental sampling. Pengumpulan data mengunakan kuesioner dengan menggunakan uji Chi-Square p= <0,05. Hasil penelitian ini menunjukan adanya hubungan antara lamanya perawatan pasien skizofrenia rawat jalan dengan tingkat stress keluarga di Poliklinik Rumah Sakit Jiwa Prof. Dr. M. Ildrem Medan. Dari 64 responden terdapat 43 responden mengalami stress sedang (67,2%), 11 responden mengalami stress berat (17,2%), dan 10 responden mengalami stress ringan (15,6%). Hasil penelitian ini menunjukan ada hubungan signifikan antara lamanya perawatan dengan tingkat stress keluarga dengan p=0,035 atau p=0,05. Penelitian ini diharapkan keluarga mampu mengantisipasi stresnya dengan memberi dukungan pada pasien skizofrenia.

Evaluation of seizure treatment in anti-LGI1, anti-NMDAR, and anti-GABABR encephalitis

ObjectiveThis nationwide cohort study evaluates seizure responses to immunotherapy and antiepileptic drugs (AEDs) in patients with anti-leucine-rich glioma-inactivated 1 (LGI1), anti-NMDA receptor (NMDAR), and anti-gamma-aminobutyric-acid B receptor (GABABR) encephalitis.MethodsAnti-LGI1, anti-NMDAR, and anti-GABABR encephalitis patients with new-onset seizures were included. Medical information about disease course, AEDs and immunotherapies used, effects, and side effects were collected. Outcome measures were (1) seizure freedom while using AEDs or immunotherapy, (2) days to seizure freedom from start of AEDs or immunotherapy, and (3) side effects.ResultsOf 153 patients with autoimmune encephalitis (AIE) (53 LGI1, 75 NMDAR, 25 GABABR), 72% (n = 110) had epileptic seizures, and 89% reached seizure freedom. At least 53% achieved seizure freedom shortly after immunotherapy, and 14% achieved seizure freedom while using only AEDs (p < 0.0001). This effect was similar in all types (p = 0.0001; p = 0.0005; p = 0.013, respectively). Median time to seizure freedom from AEDs start was 59 days (interquartile range [IQR] 27–160), and 28 days from start of immunotherapy (IQR 9–71, p < 0.0001). Side effects were psychotic behavior and suicidal thoughts by the use of levetiracetam, and rash by the use of carbamazepine. Carbamazepine was more effective than levetiracetam in reducing seizures in anti-LGI1 encephalitis (p = 0.031). Only 1 patient, of 86 surviving patients, developed epilepsy after resolved encephalitis.ConclusionEpilepsy after resolved encephalitis was rare in our cohort of patients with AIE treated with immunotherapy. In addition, seizure freedom is achieved faster and more frequently after immunotherapy. Therefore, AEDs should be considered as add-on treatment, and similar to treatment of other encephalitis symptoms, immunotherapy is crucial.

HUBUNGAN ANTARA PERAN KELUARGA DENGAN KEPATUHAN MINUM OBAT PASIEN SKIZOFRENIA

ABSTRAKSkizofrenia merupakan suatu penyakit otak persisten dan serius yang mengakibatkan perilaku psikotik, pemikiran konkret, dan kesulitan dalam memproses informasi,Prevalensi penderita skizofrenia di Indonesia adalah 0,3 - 1 % dan biasanya timbul pada usia 18 sampai 45 tahun. Peran keluarga (family role) yaitu menggambarkan seperangkat perilaku interpersonal, sifat,kegiatan yang berhubungan dengan individu dalam posisi dan situasi tertentu, Kepatuhan minum obat yaitu taat terhadap peraturan yang berlaku seperti minum obat sesuai dosis dan waktu yang diperintahkan. Peneltian ini bertujuan untuk mengetahui adakah hubungan antara peran keluarga dengan kepatuhan minum obat pasien skizofrenia di poliklinik jiwa RSAU dr. M. Salamun. Penelitian ini menggunakan metode deskriptif korelasi.Sampel dalam penelitian ini berjumlah 47keluarga pasien.Variabel independen yang di teliti yaitu peran keluarga dan variabel dependen yang diteliti yaitu kepatuhan minum obat. Hasil penelitian menunjukkan pasien yang mempunyai peran keluarga baik 18 responden (38,3%), peran keluarga cukup sebanyak 17 responden (36,2%), dan yang patuh minum obat sebanyak 36 responden (76,6%). Terdapat hubungan yang signifikan antara peran keluarga dengan kepatuhan minum obat pasien skizofrenia di poliklinik jiwa RSAU dr. M. Salamun p= 0,003. Saran untuk keluarga adalah lebih peduli terhadap kesehatan keluarganya baik kesehatan secara fisik maupun mental.Bagi pihak rumah sakit harus menampilkan lebih banyak lagi pomosi kesehatan baik dalam bentuk poster, baner dan lainnya. Kata kunci: Kepatuhan minum obat, peran keluarga THE RELATIONSHIP BETWEEN ROLE OF FAMILY AND THE OBEDIENCE OF PATIENTS WITH SCHIZOPHRENIA IN TAKING MEDICINE ABSTRACTSchizophrenia is a persistent and serious brain disease that causes psychotic behavior, concrete thought, difficulty in processing information, interpersonal relationship, and problem solving. The prevalence of people with schizophrenia in Indonesia is 0,3- 1 %, and it commonly emerges at the age of between 18 to 45 years old. The role of family describes a set of interpersonal behaviors, characters, and individuals’ activities related to certain position and situation. This study aims at finding out the relationship between role of family and the obedience of patients with schizophrenia in taking medicine in mental polyclinic of RSAU dr. M. Salamun. This study employed correlated descriptive method. Samples of this study are 47 families of patient. Independent variable studied is the role of family, and dependent variable is the obedience in taking medicine. The results of the study show that patients who have got good role of family are 18 respondents (38,3%), 17 respondents (36,2%) with adequate role of family, and patients who were obedient in taking medicine are 36 respondents (76,6%). There is a significant relationship between the role of family and the obedience of patients with schizophrenia in mental polyclinic of RSAU dr. M. Salamun by p= 0,003. It is suggested that the family should give more care to its members’ health condition, both physically and mentally. To the hospital, it is suggested that it should provide more health promotions in form of posters, banners, and other media. Keywords: Medication adherence, role of family

THE NEGATIVE EFFECTS OF JEALOUSY IN SHAKESPEARE’S THE WINTER’S TALE

This article reveals the negative effects of the protagonist's jealousy in one of Shakespeare's plays entitled "The Winter's Tale". The jealousy of the protagonist named Leontes is due to his nut misunderstanding towards his wife named Hermione, and his best friend named Polixenes. His misunderstanding bears his jealousy which drives him to be a temperamental man with uncontrollable emotion. His behavior directs to psychotic behavior, and it brings about his own deep regret in his life. He loses his wife, daughter, best friend and his henchman. Even he loses his son forever as his son passed away due to lack of getting care from his mother who is put into the jail by him. However, eventually he realizes his faults and regains his happiness. He reunites with his wife, daughter, best friend and his henchman.