MANAGEMENT OF DEPRESSION IN CHILDREN WITH LUPUS ERYTHEMATOSUS SYSTEM

CASE REPORTMANAGEMENT OF DEPRESSION IN CHILDREN WITH LUPUS ERYTHEMATOSUS SYSTEMRisza Subiantoro*, Nining Febriyana**, Lestari Basoeki**, Endang Wasiki** *Participant in Specialist I Psychiatric / Psychiatric Education Program, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Hospital, Surabaya, Indonesia Bumi Panua Hospital, Pohuwato, Gorontalo, Indonesia** Psychiatrist (Consultant), Teaching Staff at Department / SMF Psychiatry, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Hospital, Surabaya, Indonesia ABSTRACT Depression is a comorbid in patients with Systemic Lupus Erythematus (SLE). Depression can affect up to 60% of adolescents who are comorbid. Depression in adolescents is likely many factors, etiology, psychological burden, chronic disease, effects of long term steroid treatment, social, cultural and genetic factors. Depression is frequently associated with poorer treatment outcomes and poor treatment and health care outcomes in individuals with SLE. In this case, we will discuss the available treatment options. Keyword: Child Depression, Erythematous Systemic Lupus, Management.

Family Role on Schizoaffective Type Patients Treatment

Schizoaffective disorder is a mental disorder accompanied by schizophrenic and affective symptoms that both stand out at one time. Affective symptoms that appear are manic, depressive or both. The prevalence of patients with schizoaffective disorder is about 0.3% of the general population. Women suffer more from schizoaffective disorder and usually suffer from depressive type schizoaffective disorder. The case that will be discussed here is a young adult woman who first suffered from a schizoaffective mixed type disorder. The difficulty faced in handling this case is to provide an understanding of the patient and family about schizoaffective disorders and how patients take medication regularly for a long time. Therefore, a biopsychosocial approach is considered the most suitable to overcome the difficulties in handling this case.

Association Between Residence And Disease Incidences In The Dr. Soetomo Hospital Psychiatric Clinic

Background; The increasing mental disorders prevalence adds countries’ burdens. One of the mental disorder’s risks is residence. There is no research about the relationship between residence and ten most psychiatric diseases in Surabaya. Objective; This research aims to study the relationship between residence and ten most diseases in Dr. Soetomo hospital psychiatric clinic. Methods; This research method using observational-analytic design with a cross-sectional approach in Dr. Soetomo hospital psychiatric clinic. Data were taken from medical records based on inclusion and exclusion criteria. The research used a chi-square test with 95%CI. Results: The dominant districts where research subjects lived were education-related psychiatric examinations in Semampir, paranoid schizophrenia in Sawahan, mental disorders due to brain damage in Sawahan, moderate depressive episodes in Gubeng, MMR in Kenjeran, activity and behavior disorders in Sawahan, hebefrenic schizophrenia in Tambaksari, family-related psychiatric examinations in Tambaksari, atypical autism in Sukomanunggal and Semampir, MADD in Tambaksari. Distribution of patients’ residence based on five regions of Surabaya was East Surabaya as the dominant residence of paranoid schizophrenia, moderate depressive episodes, hebefrenic schizophrenia, atypical autism, MADD; North Surabaya as the dominaNt residence of education-related psychiatric examinations, MMR; South Surabaya as the dominant residence of paranoid schizophrenia, mental disorders due to brain damage, activity and behavior disorders, family-related psychiatric examinations. Chi-square test showed a significant relationship between residence and ten most diseases. Conclusion; There is a significant (goodness of fit) relationship between residence and ten most diseases in Dr. Soetomo hospital psychiatric clinic. Keywords: Mental disorders, Residence, Surabaya City

Inflammation in Depression

Depression is a chronic condition that imposes a substantial burden of disability globally. Three principal neurotransmitters (norepinephrine (NE), dopamine (DA), and serotonin (5-HT)) implicated the pathophysiology and treatment of depression. Clinical studies have found a significant association between numerous pro-inflammatory cytokines with depressive symptoms, endocrine, and neurotransmitter systems. Here, we detail our current understanding about the role of inflammation in depression, the mechanisms that are involved, and show how it is possible to innovate and develop new therapeutics of depression in the field of neuroinflammation.

Literature Review: Immune System and Its Relation to Depression

It has been shown that the immune system and mental status are interrelated. Psychoneuroimmunology is a field that studies these two relationships, one of the most studied is the relationship between the immune system and depression. Psychological stress can substantially increase inflammatory activity and increase risk for various health problems. Socioal-environmental conditions trigger biological responses that may lead to an increase in the proinflammatory phenotype which is hypothesized to be a key phenomenon driving the pathophysiology and relapse of depression, as well as the overlap of depression with several somatic conditions such as rheumatoid arthritis, chronic pain, cardiovascular disease, and neurodegeneration. The immune system and depression have a bidirectional link that influences each other. Exposure to chronic stressful situations can cause a maladaptive response by the immune system, which will be involved in the pathophysiology of depression.

Application of Transference Focused Psychotherapy in Borderline Personality Disorders

Borderline Personality Disorder (BPD) is a condition that is currently commonly found in daily psychiatric practice, and causes serious psychiatric disorders because it has an impact on the emergence of various other comorbid psychiatric disorders. The management of BPD is a challenge, because it is quite difficult and complex. Psychotherapy is an effective first-line therapy for BPD. Transference Focused Psychotherapy (TFP) is psychodynamic based psychotherapy that is specifically designed for BPD and is considered effective based on the specific psychopathology of BPD, namely the lack of identity integration. TFP focuses on the relationship between patient and therapist in sessions which have the aim of facilitating better behavioral control and increasing reflection and influencing regulation so as to produce identity integration that leads to a more coherent identity, better regulatory abilities, less self-destructive behavior. forming a more balanced and constant relationship, and increasing overall functioning.Keywords : Borderline Personality Disorder, Psychodynamic Psychotherapy, Transference Focused Psychotherapy.

The Importance of Family Support in Successful Treatment Adherence of Schizophrenic Patient

Background: Schizophrenia is a treatable disease but requires patient’s high adherence to treatment. Family support of a schizophrenic patient plays an important role in encouraging the patient to continue his treatment. This report aims to enhance the importance of family support of schizophrenic patient in patient’s adherence to achieve a good mental health for all family member.Case: A hospitalized male paranoid schizophrenic patient who was admitted and observed in Dr. Soetomo General Hospital from September 15th-25th, 2020. Patient came to the hospital with chief complaint could not stop talking (rambling) since 1 day before admission. Patient could neither eat nor sleep for that day. Patient relapsed after stopping taking medication from the psychiatrist.Discussions: The patient in this case suffered a relapse of his paranoid schizophrenia because he stopped taking medication. Lack of support from family is the most important factor in a schizophrenia patient. Psychoeducation to patient’s family about schizophrenia and the importance of medication would be a great help for patient’s adherence to treatment.Conclusions: Schizophrenia needs a long-life treatment. High adherence to treatment could improve schizophrenia’s symptoms and prevent relapse. Family support is important to make sure the patient keeps taking his medicine regularly.

The Association between Acne Vulgaris and Stress among Adolescents in Kenjeran, Surabaya

Background: Acne vulgaris is the main skin disease problem for adolescents. The complication of acne in adolescents is scars left on the face, which affects stress levels. Stress has harmful potential when the conditions exceed the individual's ability to cope. Kenjeran area has a tropical climate and weather which are the factors that cause acne vulgaris. Objective: This research aims to study the association between acne vulgaris severity and stress among adolescents in Kenjeran, Surabaya Methods: This research used non-probability purposive sampling technique and observational analytic method with cross-sectional design. Assessment of the acne severity was carried out by dermatologist using Lehmann’s Grading System and stress levels were assessed using the Perceived Stress Scale questionnaire in 109 adolescent subjects. Results: The highest frequency is women aged 15 years. The dominance is in mild acne severity with moderate stress. It was found that adolescents with acne vulgaris are at risk of experiencing stress even though the analysis of the results using fisher-exact showed that there was no significant association between the acne severity and stress level in adolescents with acne vulgaris (p=0.113). Conclusion: The presence of acne vulgaris puts adolescents at risk of experiencing mild, moderate, or severe stress. It requires attention because can cause adverse effects that affect adolescents into adulthood life.

Psychoanalytic listening: Between unconscious and conscious

Psychoanalytic listening can be deployed for enhancing the quality of clinical psychiatric practice. As a clinical skill, it should be teachable throughout the years of psychiatric residency. Nevertheless, the teaching of such important faculty is difficult due to the scarcity of a systematic, relatively structured model that can be used as an underpinning of learning that capability. This article is aimed at fulfilling a part of that lack of teaching methodology. The model offered in this article describes psychoanalytic listening as a mental process initiated by the therapist, which then goes through the patient too, which involves a continuing oscillation of unconscious apprehension and conscious comprehension. This rhythmic proceeding of affectively experiencing and rationally considering will expectedly bring about a mutual understanding between patient and therapist which then facilitates further clinical enterprises.

Community Based Pasung Release on Schizophrenia

Schizophrenia is a severe mental disorder, persistent, chronic, easy to relapse. Schizophrenics at risk of becoming victims of pasung. Confinement is any form of limitation of movement of people with mental illness by families and/or communities. The government has launched the program to end pasung, but the incidence of pasung in the community is still quite high. Liberation of community-based pasung includes prevention of pasung, handling of pasung and rehabilitation of post-pasung. The method of community-based pasung release at the rehabilitation stage that is widely used is Assertive Community Treatment (ACT) and has been proven to reduce recurrence and hospitalization rates in schizophrenics so as to reduce the incidence of pasung and prevent re-pasung.