Disorders In Indonesia Research Articles

Metaanalisis Efektivitas Acceptance and Commitment Therapy untuk Menangani Gangguan Kecemasan Umum

The prevalence of anxiety disorder in Indonesia increases significantly every year. It is worth special attention, especially in facing the uncertainty during pandemic. Acceptance and Commitment Therapy (ACT) is one of the third-wave cognitive behavior therapy (CBT), usually used for anxiety disorder treatment. In this research, I want to examine the effectiveness of Acceptance and Commitment Therapy (ACT) to decrease the level of Generalized Anxiety Disorder (GAD), taking General Anxiety Disorder-7 (GAD-7), Geriatic Anxiety Inventory (GAI), and Beck Anxiety Inventory (BAI), as the standard. It uses a meta-analysis techniques processed by statdirect trial version 2.0. It involves 17 experimental journals of ACT and GAD (n experiment group = 574; n control group = 513). The assessment of ACT and GAD bases itself on random effect size (I2 = 83.3%), without any publication bias (-3.88). The result shows that ACT is still effective to decrease the level of GAD (d= -.66; medium effect size). The result concludes that the ACT needs the assistance from other interventions. It also suggests research replication to multiply the references related to the effectiveness of ACT.

The challenges of metabolic disorders in Indonesia: focus on metabolic syndrome, prediabetes, and diabetes

[No abstract available]

IMPLEMENTATION OF MUROTTAL AL-FATIHAH AGAINST CLIENTS RISK OF VIOLENCE AT THE CLENDER HOSPITAL, EAST JAKARTA

Data from the World Health Organization (WHO) (2009) estimates that 450 million people worldwide experience mental disorders, about 10% of adults experience mental disorders and 25% of the population is estimated to experience mental disorders at a certain age during their life. This age usually occurs in young adults between the ages of 18-21 years. Other data from the National Institute of Mental Health shows that the rate of mental disorders reaches 13% of the disease as a whole and is expected to grow to 25% in 2030. The highest prevalence of mental disorders in Indonesia is in the province of the Special Capital Region (DKI) Jakarta (24, 3%), followed by Nagroe Aceh Darussalam (18.5%), West Sumatra (17.7%), NTB (10.9%), South Sumatra (9.2%), and Central Java (6.8%). while based on data Basic Health Research (2007). It shows that the national prevalence of mental disorders reaches 5.6% of the population, four to five people are suffering from mental illnesses. Based on these data, Indonesia's annual data that experience mental disorders is always increasing (MOH (2008). The increase in the proportion of mental disorders in the data obtained in Riskesdas 2018 is quite significant compared to Riskesdas in 2013, increasing from 1.7% to 7% of Indonesia's population (Riskesdas, 2018). In our country, there are approximately 2,400,000 children with mental disorders.

IMPLEMENTATION OF MUROTTAL AL-FATIHAH AGAINST CLIENTS RISK OF VIOLENCE AT THE CLENDER HOSPITAL, EAST JAKARTA

Data from the World Health Organization (WHO) (2009) estimates that 450 million people worldwide experience mental disorders, about 10% of adults experience mental disorders and 25% of the population is estimated to experience mental disorders at a certain age during their life. This age usually occurs in young adults between the ages of 18-21 years. Other data from the National Institute of Mental Health shows that the rate of mental disorders reaches 13% of the disease as a whole and is expected to grow to 25% in 2030. The highest prevalence of mental disorders in Indonesia is in the province of the Special Capital Region (DKI) Jakarta (24, 3%), followed by Nagroe Aceh Darussalam (18.5%), West Sumatra (17.7%), NTB (10.9%), South Sumatra (9.2%), and Central Java (6.8%). while based on data Basic Health Research (2007). It shows that the national prevalence of mental disorders reaches 5.6% of the population, four to five people are suffering from mental illnesses. Based on these data, Indonesia's annual data that experience mental disorders is always increasing (MOH (2008). The increase in the proportion of mental disorders in the data obtained in Riskesdas 2018 is quite significant compared to Riskesdas in 2013, increasing from 1.7% to 7% of Indonesia's population (Riskesdas, 2018). In our country, there are approximately 2,400,000 children with mental disorders.

The relationship between malnutrition and TH 2 immune markers: a study in school-aged children of different socio-economic backgrounds in Makassar, Indonesia.

ObjectiveThe burden of underweight remains a major problem in Indonesia, and at the same time, the prevalence of overweight is increasing. Malnutrition is a major determinant of health and has been linked to allergic disorders in children. We examined the relationship between malnutrition and TH2 immune markers in school‐aged children in Makassar, Indonesia.MethodsA cross‐sectional study was performed in five schools where socio‐demographic characteristics were recorded. Children’s standardised z‐scores of body mass index (z‐BMI) and age‐standardised z‐scores of height (z‐HA) were assessed using WHO child growth standards. Skin prick test (SPT) reactivity was determined to house dust mite allergens. Helminth infection status, (growth) hormones including insulin‐like growth factor (IGF‐1) and TH2 immune markers were measured.ResultsIn total, 954 children were included of whom 21.6% were underweight and 14.8% overweight. After controlling for confounders, overweight was positively associated with leptin (GMR 3.55, 95% CI: 2.99–4.23) and IGF‐1 (GMR 1.45, 95% CI: 1.15–1.82), whereas underweight was negatively associated (respectively GMR 0.57, 95% CI: 0.49–0.66 and GMR 0.78, 95% CI: 0.63–0.97). Underweight was associated with a lower eosinophil count (GMR 0.79, 95% CI: 0.64–0.97) but not with total IgE levels or SPT reactivity. Overweight was positively associated with SPT reactivity (adjusted OR 2.68, 95% CI: 1.50–4.78) but no relationship was found with the other TH2 immune markers.ConclusionMalnutrition is prominent in school‐aged children in Makassar, with overweight associated with increased SPT reactivity. Therefore, interventions should focus on undernutrition, but also on overweight to prevent the increase of allergic disorders in Indonesia.

Effectiveness of counselling to increase the family of soul patients about drug compliance

Background: According to WHO it is known that around 21 million people in the world are affected by schizophrenia and have psychiatric disorders. From the results of Riskesdas 2018 the prevalence of mental disorders in Indonesia is as much as 7%, and around 9.8% of the population experiences mental and emotional disorders. For the coverage of the treatment of people with mental disorders, data obtained by clients who went for treatment 48.9% for routine treatment and 51.1% for no routine treatment. The purpose of this research is to determine the effect of health promotion using counseling methods to increase the knowledge of mental patients' families about taking medication in the Adult Outpatient Polyclinic at the RSJ Prof. Hb Saanin Padang.Methods: This type of research is quasi-experimental (Quasi Experimental, Design uses One Group Pretest Postest design model. This research was conducted at RSB Haan Saanin Padang. The population in this study was the families of mental patients who visited the Polyclinic as many as 649 people with the number of respondents as many as 87 people, the sampling technique was by accidental sampling Statistical tests using the Non-Parametric Test (Wilcoxon Test).Results: Research results show that the mean range of Pre-Test knowledge is 8.48±1,982 and Postest knowledge is 17.13±1,641, with a p value p=0,000 (p≤0.05).Conclusions: Health promotion using counseling methods has a significant effect in increasing the family knowledge of mental patients about medication adherence.

Development an app for monitoring stress level and early detection of mental disorders in Indonesia

Abstract Background Stress may contribute to physical and mental health problems. The number of people with mental-emotional disorders has reached up to be 19 million people in Indonesia in 2018. Monitoring stress levels and early detection are important to prevent serious mental health problems. Therefore, we are developing De-stres©, a mobile app for monitoring the stress level and early detection of mental health disorders in Bahasa Indonesia. Methods De-stres© was developed for android OS and web-based app by using the web2py framework and PostgreSQL database. The app used the PSS-10 and Beck Depression-II questionnaires that were available in Bahasa Indonesia. It had six main functions: creating an account, approving the informed consent, filling the questionnaire, generating test results automatically, advice from psychologists based on the test result and saving test history. Results A month since its launch, the six functions test ran well on the Android OS and the website. A preliminary result showed that the app was downloaded more than 100 times from Google Playstore. Among the 420 data records, 71.6% (301) app users were students, with 60.7% (255) using the app to measure only stress level, 25.5% (107) resulting in severe stress and 4% (17) severe depression. Conclusions De-stres© is successfully developed and a promising instrument that can be implemented for Indonesia, by providing preliminary self-administered questionnaire. Key messages De-stres© is an app for monitoring stress levels and early detection of mental health problems and successfully developed with preliminary self-administered questionnaires in Bahasa Indonesia. De-stres© is a promising app that can be implemented for preventing serious mental health disorders in Indonesia.

Barriers to Treatment-Seeking Behavior Among Adolescents With Anxiety in Indonesia

This study aims to identify factors related to treatment-seeking behavior in people with anxiety disorders in Indonesia. The research was conducted in 3 (three) regions ie Bogor City, Jombang and Tojo Una-Una Regency. The study population was men and women aged 15 years and above. The total sample survey was 2,283 respondents. This research was a cross-sectional design with a quantitative approach. Selection of research location based on the village with a variety of mental disorder conditions. Bogor City in West Java Province was chosen to represent the urban areas of Java with a high prevalence of the mental disorder. Tojo Una-Una District in Central Sulawesi was selected to represent rural areas outside Java with a high prevalence of the mental-emotional disorder. Jombang District in East Java Province also elected to represent the area of low mental disorder with a well-known mental health program. Results show 16.6% of respondents are suffering from anxiety disorders, while others have only complained about 1 or more symptoms of anxiety. Of the total people with such anxious symptoms, only 46.2% of people are seeking treatment, while 36.3% with anxiety disorders doing the same. There is a relationship between age and sex with help-seeking behaviors (p = 0.00). Adolescents who suffer from anxiety at risk of no treatment 6.6 times (Adjusted OR=6.6; 95% CI= 3.4-23.9) compared to the elderly. Men with anxiety disorders are likely 1.97 times (Adjusted OR=0.5; 95% CI= 0.4-0.7) at no treatment than women. People who have an anxiety disorder at risk of 1.7 times (Adjusted OR=1.7; 95% CI= 1.1-2.4) for having no treatment than people with anxiety symptoms. It is essential to improve knowledge about anxiety and how important to find treatment through counseling and health education on mental health.

Validation of the Indonesian Version of Modified Checklist for Autism in Toddlers: a diagnostic study

Background Autism is a developmental disorder for which early detection in toddlers is recommended because of its increased prevalence. The Modified Checklist for Autism in Toddlers (M-CHAT) is an easy-to-interprete tool that can be filled out by parents. It has been translated into the Indonesian language but needs to be validated.
 Objective To evaluate the diagnostic validity of the Indonesian version of M-CHAT in detection of autism spectrum disorder in Indonesia.
 Methods A diagnostic study was conducted at Sanglah Hospital, Denpasar, Bali, from March 2011 to August 2013. Pediatric outpatients aged 18 to 48 months were included. The Indonesian version of the M-CHAT tool was filled by parents. Autism assessment was done according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV-TR). The assessment results were analyzed with the MedCalc program software, in several steps: (i) reliability of M-CHAT; (ii) description, distribution, and proportion to determine the characteristics of the subjects of research; and (iii) validity of M-CHAT compared to the gold standard DSM-IV-TR by a receiver operating characteristic curve and several area under the curve cut-off points, in order to assess the sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratio, accompanied by the 95% confidence interval of each value.
 Results The Indonesian version of M-CHAT in toddlers had 82.35% sensitivity and 89.68% specificity, using the cut-off point of more than 6 failed questions.
 Conclusion The Indonesian version M-CHAT translated by Soetjiningsih has optimal diagnostic validity for detection of autism in toddlers.

Validation of the Indonesian Version of Modified Checklist for Autism in Toddlers: a diagnostic study

Background Autism is a developmental disorder for which early detection in toddlers is recommended because of its increased prevalence. The Modified Checklist for Autism in Toddlers (M-CHAT) is an easy-to-interprete tool that can be filled out by parents. It has been translated into the Indonesian language but needs to be validated.
 Objective To evaluate the diagnostic validity of the Indonesian version of M-CHAT in detection of autism spectrum disorder in Indonesia.
 Methods A diagnostic study was conducted at Sanglah Hospital, Denpasar, Bali, from March 2011 to August 2013. Pediatric outpatients aged 18 to 48 months were included. The Indonesian version of the M-CHAT tool was filled by parents. Autism assessment was done according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV-TR). The assessment results were analyzed with the MedCalc program software, in several steps: (i) reliability of M-CHAT; (ii) description, distribution, and proportion to determine the characteristics of the subjects of research; and (iii) validity of M-CHAT compared to the gold standard DSM-IV-TR by a receiver operating characteristic curve and several area under the curve cut-off points, in order to assess the sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratio, accompanied by the 95% confidence interval of each value.
 Results The Indonesian version of M-CHAT in toddlers had 82.35% sensitivity and 89.68% specificity, using the cut-off point of more than 6 failed questions.
 Conclusion The Indonesian version M-CHAT translated by Soetjiningsih has optimal diagnostic validity for detection of autism in toddlers.

<p>Medication Profile and Treatment Cost Estimation Among Outpatients with Schizophrenia, Bipolar Disorder, Depression, and Anxiety Disorders in Indonesia</p>

PurposeThe present retrospective study aimed to determine the medication profile and estimate the treatment costs from medical records of new outpatients with schizophrenia, bipolar disorder, depression, and anxiety disorders from a healthcare perspective at a national referral hospital in Indonesia from 2016 to 2018.MethodsMedical records (including medical and administrative data) of 357 new outpatients with schizophrenia, bipolar disorder, depression, or anxiety disorders were collected from the hospital information system. The records of new outpatients with schizophrenia, bipolar disorder, depression, or anxiety disorders aged >18 years and had only received drugs for treatment were included. The medication profile was descriptively assessed, and estimated costs were calculated based on direct costs from a healthcare perspective.ResultsOverall, 173 medical records were further analyzed. The main drugs administered to the new outpatients were atypical and typical antipsychotics for schizophrenia, atypical antipsychotics and mood stabilizers for bipolar disorder, antidepressants and atypical antipsychotics for depression, and antidepressants and benzodiazepines for anxiety disorders. The average annual treatment costs per patient were IDR 3,307,931 (USD 236) for schizophrenia, IDR 17,978,865 (USD 1,284) for bipolar disorder, IDR 1,601,850 (USD 114) for depression, and IDR 1,190,563 (USD 85) for anxiety disorders.ConclusionThe most commonly prescribed drugs for schizophrenia were haloperidol and risperidone; for bipolar disorders, sodium divalproex and risperidone; for depression, fluoxetine and sertraline; and for anxiety disorders, sertraline and lorazepam. Considering the high prevalence and estimated treatment costs for mental disorders, special attention is required to prevent an increase in their prevalence in Indonesia.

An insight into Indonesian current thalassaemia care and challenges

Thalassaemia is one of the most prevalent inherited blood disorders in Indonesia, with highly diverse mutations ranging from mild to severe that can be found across the nation. Nevertheless, thalassaemia management in Indonesia is still limited to supportive treatment, such as blood transfusion, iron chelation, complications monitoring, psychosocial support and a comfortable transition from child to adult clinic. However, these managements are still suboptimal in most parts of the nation. Indonesia still has a long way from implementing the optimal curative treatment for thalassaemia. Iron chelators are sometimes not available, especially in rural areas. The cost for optimal dosages of iron chelation also cannot be fully covered by the current national health insurance scheme. However, it still benefits our patients, considering it is the only treatment to decrease iron deposition in organs. With that situation, our patients, both paediatric and adults, have normal cardiac haemosiderosis, moderate‐to‐severe hepatic haemosiderosis and normal to mild pancreatic haemosiderosis. Therefore, the number of deaths, especially those due to heart failure and infection, was significantly reduced. An improvement in thalassaemia supportive treatments is in line with the increase in patients’ life expectancy. Without curative treatment options, the lifelong cost for treatment will extremely burden the national health budget. To date, thalassaemia stands for the 5th most costly disease in Indonesia. Therefore, a screening programme must be realized soon; hence, the treatment cost can be allocated for initiating the transplant unit or improving other important areas.

Perinatal and Background Risk Factors for Children with Autism Spectrum Disorder in Indonesia

Background: Indonesia has experienced an increased number of children with autism spectrum disorder (ASD). One of the challenges that Indonesia currently faces is how to reduce the perinatal and risk factors related with the incidence of autism. This study aimed to identify the perinatal and risk factors contributing to ASD. Method: This research was a case control study involving 52 children with ASD in the case group and 201 normal children in the control group in Banyumas district, Province of Central Java, Indonesia. Data collection used independently completed questionnaires, concerning perinatal factors such as maternal age at birthing, gestational age, labor method, fetus presentation in labor, and history of complications during labor. Results: Stepwise logistic regression analysis indicated a higher risk of preterm gestational age among children in the ASD group with p=0.019 and OR:5.883. Abnormal delivery method such as caesarean delivery or vacuum extraction also had association with the ASD group (p=0.001; OR=0.303). Abnormal fetus presentation during labor increased the risk of ASD (p=0.004; OR:6.908). Mother with complication during labor such as difficult labor, preeclampsia, and fetal distress correlated with ASD (p=0,.021; OR:2.101). Multivariate analysis also showed complications during labor became a risk factor for ASD (OR: 2.142 (1.904-4.196). There was no correlation between maternal age below 20 years (p=0.332; OR=1.871) or 31-40 years (p=0.115; OR=2.868) with ASD. Conclusion: Labor method, fetus presentation, and complication during labor were significantly related with ASD.

THE UNDERGRADUATE MEDICAL STUDENTS’ PITFALLS IN EYE EXAMINATION STATION OF OBJECTIVE STRUCTURED CLINICAL EXAMINATION

Background: High prevalence of eye disorders in Indonesia requires medical doctors to be skillful and well trained in ophthalmologic examination. Undergraduate medical students usually start their clinical simulation practice and ophthalmology assessment in a safe learning environment. Skill laboratory as the learning facility should be evaluated and improved regularly. This study aimed to evaluate student’s pitfalls in the eyes OSCE station. Methods: Descriptive analytic study involving Objective Structured Clinical Examination (OSCE) eye examination station score from 1st - 4th year undergraduate medical students batch 2010 in Faculty of Medicine, Universitas Gadjah Mada, Indonesia (n=516). All checklists’ scores were analyzed based on particular sub-scales in every examination topic to explore the most pitfalls made by students in eye examination station during OSCE. Results: The order average value of each subscale in OSCE are: Doctor patient interaction (88.42), History taking skills (82.44), Professionalism (76.43), Physical Examination (74.62), Diagnosis (60.68), Management of Pharmacotherapy (54.70). The percentage of failed-students (scores <70) in 1st-4th year OSCE based on topics skills were Year 1: Visual field (5.08%), Visual acuity (14.21%), Anterior Segment (2.54%). 2nd year: IOP by palpation (24.38%), Visual acuity (9.38%), Anterior Segment (29.38%). Year 3: visual field (4.94%), IOP by palpation (2.47%), Visual acuity (12.35%), Anterior Segment (7.41%), Posterior Segment (22.22%). Year 4: Comprehensive eye exam (17.95%). Conclusions: Students mostly challenged in the skills of diagnosis establishment and pharmacological management. The highest number of failed students in each year OSCE vary from each year. 1st year failed most at visual acuity examination, 2nd year was anterior segment examination and 3rd year was posterior segment examination. Those three skills need to be enhanced systematically. Keywords: OSCE, pitfall pattern, eye examination, undergraduate students, skill laboratory

The Analysis of Adult Autism Spectrum Disorders Screening Using Neural Network

One of the increasing developmental disorders in Indonesia is Autism Spectrum Disorder (ASD), developmental disorder characterized by difficulties to conduct verbal and non-verbal communication and social interaction. This disorder cannot be tolerated and requires early treatment to reduce its development. However, ASD treatments required ineffective treatment costs and waiting times diagnosis were lengthly. One effective alternative diagnosis isto use the screening technology to determine the early symptoms of ASD disorders. The rapid development of the number of ASD cases around the world required researchers to determine a dataset with behavioral properties to update the screening process. Thus, the purpose of this study is to predict the success of screening performed on adults with Autism Spectrum Disorder (ASD) using the researchers’ results dataset, so that the dataset could be used as a benchmark for the success of the ASD screening process. The method used is machine learning neural network method with 100 training cycle, learning rate 0,01 and momentum 0,9 resulted in a classification accuracy of 96.00%

HUBUNGAN FAKTOR KELUARGA DENGAN KEKAMBUHAN PADA KLIEN SKIZOFRENIA DI POLIKLINIK RUMAH SAKIT JIWA PROF. DR. HB. SA’ANIN PADANG

The national prevalence of severe mental disorders in Indonesia is 1.7 per mile and 70% of them are schizophrenia. The inability to control symptoms can cause recurrence in schizophrenic clients. The purpose of this study was to determine the relationship of family factors with the relapse of schizophrenic clients at Prof. Dr. HB. Sa’anin Padang. This type of research was descriptive correlative with a cross sectional approach with the number of respondents 173 people schizophrenia clients and families at Prof. RS Polyclinic. HB. Sa’anin Padang. The sampling technique is convinience sampling. The study was conducted from April to June 2016. Data collection was carried out using a questionnaire. The results showed that there was a significant relationship between family support and caregiver burden with relapse of schizophrenic clients (p <0,05). The results of this study are expected to be an input for nurses and related agencies to prevent the relapse of schizophrenia clients by providing an understanding of the importance of family support and forming a supportive group of schizophrenic client families.
 Keywords : Family, relapse, schizophrenia

Pemberdayaan Pasien Dengan Pendekatan Self Help Group Terhadap Perubahan Mekanisme Koping Pada Pasien Gangguan Jiwa Skizoprenia Di RSJD Dr Arif Z Surakarta

Background: Schizophrenia is one of the most common forms of mental disorders in Indonesia. Effective treatments for mental disorders are coming from themselves (WHO, 2018), for some mental disorders require empowerment, one of which is Self Help Group therapy. Self Help Group aims to develop empathy among fellow group members where fellow group members provide mutual support to form adaptive coping. This study aims to determine the effect of empowering patients with the Self Help Group approach to coping mechanisms in patients with schizophrenic mental disorders. Method: The research is quasi-experiment with a pre-post test design with a control group design. Data were taken before and after the administration of self-help intervention groups in schizophrenia in the intervention group. The number of samples is 66 clients divided by 2, namely 33 respondents for the intervention group and 33 respondents for the control group. This study measured coping mechanisms. The research instrument used a coping mechanism questionnaire. Data were analyzed using a dependent t-test, independent multiple linear regression t-test. Results: The study proved that there are significant differences in the coping mechanism before and after giving the Self Help Group (p-value, 0.000). Self Help Group if implemented by the patient has the opportunity to improve coping mechanisms by 20.1% and is expected to improve the coping mechanism by 4.909 points. Conclusion: The Self Help Group used for interventions is considered effective to increase coping skills.

Identification Validity Early Detection of Child Development Using Indonesian Mch Handbook

Children are inevitably essential parts of Indonesian population. Prevalence of children developmental disorders in Indonesia is still pretty high, ranging from 10–18%. In fact, approximately 70% of children with developmental delays are detected without screening. Surabaya is the city with the largest number of Early Childhood Education (PAUD) institutions in East Java, Indonesia. Ministry of Health publish the latest Maternal and Child Health (MCH) Handbook containing a child development checklist. Thus, the purpose of this study is to examine the validity of MCH Handbook as a measuring tool for early detection of child development with Indonesian Pre-Screening Developmental Questionnaire (KPSP) as a gold standard among Early Childhood Education students in Surabaya city. This research was a cross sectional study using diagnostic test design. The population of the study were the children aged 3–72 months in Surabaya city. The sample were selected using multistage cluster random sampling technique, totaling of 400 children. The data were analyzed using Mc. Nemar statistic tests and Kappa Agreement tests. The results showed that there is no difference in the value of development between MCH Handbook and KPSP (p = 1, 000). The MCH Handbook was valid with the sensitivity value of 84.5%; specificity value of 96.9% and has a consistency rate of 81.9%. Thus, we can conclude that MCH Handbook is said to be a valid early detection tool for children aged 3 months to 72 months with high agreement value and high sensitivity and specificity. It suggested to health workers to promote the importance of MCH Handbook utilization through social media and Primary Health Care.

Effects of Valproate and Fluoxetine Combination on YMRS and MADRS Sores in Continuation Phase Treatment of Bipolar Disorder

Valproate is the most common drug to use in bipolar disorder in Indonesia and the only mood stabilizer drug in national formulary. Combination of valproate and fluoxetine are the most used combination in bipolar disorder therapy in Bhayangkara Hospital, Kediri. However, this combination has been controversial because of its risk of triggering mania or hipomania episode in 12 months. The aim of this study was to analyze mood change symptoms with YMRS and MADRS scale after treatment of valproate and fluoxetine combination in continuation phase treatment of bipolar disorder. This cross-sectional, observational study was conducted in psyciatry clinic in Bhayangkara Hospital Kediri between August 2016-October 2016 on 15 patients in YMRS. MADRS questionnaire was filled by physician before treatment and after 8 weeks treatments. Within 8 weeks, mean YMRS score changed from 1.4 to 1.26 (p>0.05). Whereas, mean MADRS score changed from 31.8 to 10.93 (p<0.05) after 8 weeks. There was no significant different in YMRS score between pre- and post-treatment, but there was significant different in MADRS score after treatment.

HUBUNGAN MEKANISME KOPING DENGAN RESIKO TERJADINYA DEPRESI PADA KORBAN PASCA BENCANA KEBAKARAN TOKO DI PASAR ATAS KOTA BUKITTINGGI TAHUN 2018

From the Word Health Organization data (WHO, 2016) shows that the number of people with mental disorders in Indonesia at this time is reaching about 236 million people with the category of mild mental disorder 6% of the population and 0.17% suffer from severe mental disorders, 14.3% experiencing disruption of the stove. 60 million people are exposed to bipolar, and 47.5 million people are affected by dementia and the incidence of depression is quite high almost more than 350 million people of the world suffer from depression and is a disease with the 4th rank in the world.The purpose of this study is to know how the Relationship Mechanism Koping With Risk of Depression in the Post Disaster Fire Disaster in pasar atas kota Bukittinggi Year 2018. This research method using descriptive analytic method with cross sectional design approach, then data processed by using Chi Square test. The sample in this research is 123 respondents. Based on the result of the research, it was found that more than half (64) 52,0% of post-disaster victims of shop fire in the city of Bukittinggi using mammaptif coping mechanism, and from the research also got result that more than half of 87 (70,0%) people are at risk of depression.The result of statistic test is obtained p value of valeu = 0,004 and OR= 0,282 (p <α) that there is a Relationship Mechanism Koping With Risk of Depression in Post Disaster Fire Disaster in pasar atas kotaBukittinggi Year 2018. So in this study can be concluded that there is a relationship between coping mechanism with the risk of depression. From this research is suggested for further researcher to know about the factors related to coping mechanism with risk of depression with more population.