War Neurose

Dalam psikiatri militer dikenal istilah war neurose dan shell shock combat fatigue, yang menggambarkan gangguan kejiwaan para prajurit di medan pertempuran. Gejalanya sangat bervariasi sehingga sulit untuk dimasukkan ke dalam salah satu jenis gangguan psikiatri. Ada yang berpendapat gangguan ini dimasukkan ke dalam golongan transient situational disturbance.

Reggie’s Regression

Kasus Autis 4:

Reggie was 4 years old when he was evaluated by a child psychiatrist because of alarming changes in his behavior over the last 2 months. He is the first child born to professional parents. According to them, he was a normally sociable baby whose early development was entirely within normal limits—he was walking and saying single words by his first birthday and spoke in sentences before age 2. He was enrolled in nursery school at age 3 and was toilet trained at that time. The parents said they had videotapes showing that his development up to that point was entirely normal.

Rocking and Reading

Kasus Autis 3:

Twenty-two-year-old Betsy was referred for evaluation by the staff of her group home. She had been placed in the group home some 3 months previously, following court-ordered “deinstitutionalization” from a large residential facility for the retarded. The evaluation was requested because Betsy “didn’t fit in” with other patients and had developed some problem behaviors, particularly aggression directed toward herself and, less commonly, toward others. Unlike other patients in the group home, she tended to “stay to herself” and had essentially no peer relations, although she did respond positively to some staff members. Her self-abusive and aggressive behaviors usually were triggered by changes made in her routine.

Echo

Kasus Autis 2:

Richard, age 3 1/2, a firstborn child, was referred at the request of his parents because of his uneven development and abnormal behavior. Delivery had been difficult, and he had needed oxygen at birth. His physical appearance, motor development, and self-help skills were all age appropriate, but his parents had been uneasy about him from the first few months of life because of his lack of response to social contact and the usual baby games. Comparison with their second child, who, unlike Richard, enjoyed social communication from early infancy, confirmed their fears.

Kartografer

Kasus Autis 1:

A psychiatric evaluation is requested by the teachers of C.B., a 13-year-old boy. He is of average intelligence, according to the Wechsler Intelligence Scale for Children (WISC; 1974), with better verbal than performance skills. He does well on tasks requiring rote learning, but his teachers are deeply puzzled and concerned about his poor comprehension of abstract ideas and his social naiveté. They find him appealing, but sadly vulnerable to the hazards of everyday life.

Autistic Spectrum Disorder

Menurut DSM-IV autistic spectrum disorder (ASD) merupakan bagian dari pervasive developmental disorder. Pervasif artinya meresap atau yang mendasari sehingga mengakibatkan gangguan lain. Gangguan ini mempunyai 3 gejala utama, yaitu (1) hendaya di bidang sosialisasi, (2) hendaya di bidang komunikasi dan (3) terdapat perilaku repetitif dan stereotipik. Gejala-gejala tersebut harus sudah ada sejak sebelum usia 3 tahun, walaupun demikian diagnosis ditegakkan saat usia 3 tahun. Pada anak usia demikian gejala yang sudah muncul minimal 1 gejala gangguan berikut yaitu dalam hal (1) interaksi sosial, (2) komunikasi sosial atau bahasa, dan (3) permainan simbolik dan imajinatif. Syarat selanjutnya adalah gangguan tersebut bukanlah termasuk Rett’s Disorder dan Childhood Disintegrative Disorder.

Gangguan Tidur pada Penderita Depresi

Sebelum membahas gangguan tidur pada penderita depresi, ada baiknya diketahui terlebih dahulu pola tidur normal pada manusia dewasa. Gambar di atas memperlihatkan siklus tidur orang dewasa normal. Tidur manusia umumnya dibagi menjadi 2 macam yaitu tidur REM (rapid eye movement) dan tidur non-REM. Pembagian tersebut didasarkan atas pemeriksaan EEG (electro-encephalogram), EOG (electroocculogram) dan EMG (electromyogram).

Obesitas termasuk Gangguan Otak?

Seseorang dinyatakan menderita obesitas apabila mempunyai body mass index lebih dari 30. Problem obesitas ini meningkat secara tajam dalam waktu 30 tahun terakhir ini (rata-rata 50% perdekade). Obesitas meningkatkan risiko penyakit kardiovaskuler, diabetes, kanker dan penyakit lain dan mengakibatkan penurunan life expectancy 5 sampai 20 tahun.

Adakah Pemeriksaan Laboratorium Spesifik dalam Psikiatri?

Telah diterima secara luas oleh masyarakat bahwa gangguan psikiatri berkaitan dengan gangguan di otak. Namun demikian bidang ini sampai saat ini belum bisa mengidentifikasi petanda neurobiologi tunggal sebagai alat diagnostik gangguan psikiatri. Penggunaan tes laboratorium spesifik akan sangat membantu klinisi yang selama ini hanya mengandalkan adanya tanda dan gejala psikiatri sebagai dasar diagnosis. Dengan demikian dapatlah dikatakan bahwa gangguan psikiatri mempunyai basis neurobiologi.

Trauma dan Psikotik

Akhir-akhir ini etiologi gangguan psikotik merupakan isu yang sering dibicarakan di dunia psikiatri. Ada peneliti yang mempertajam fokus etiologi pada faktor genetika, faktor gangguan kepribadian yang mendasari, faktor psikososial dan ada juga yang menekankan pada aspek hubungan yang salah antara ibu dan anak. Suatu penelitian prospektif (Jansenn dkk) telah melaporkan bahwa anak yang mengalami penyiksaan (child abuse) di usia kurang dari 16 tahun akan mempunyai risiko mengalami simptom psikosis saat dewasanya. Peristiwa tersebut disebut sebagai traumatic experience yang seringkali dikaitkan dengan timbulnya gangguan psikotik.