Journal of Psychiatry Psychology and Behavioral Research

PREVALENCE OF METABOLIC SYNDROME AMONG PATIENTS WITH SCHIZOPHRENIA FROM LONG CARE UNIT IN FORENSIC PSYCHIATRY PROGRAM: AN OBSERVATIONAL STUDY

Sun, 31 Mar 2024 00:00:00 +0000

Introduction – Metabolic syndrome is a leading health concern among schizophrenia patients treated with antipsychotics. The morbidity and mortality rates of these patients can increase when they already have cardiovascular disease and other risk factors. This study aimed to examine the prevalence of metabolic syndrome and its relationship to various clinical parameters such as blood pressure, fasting blood glucose, triglycerides, high-density lipoprotein, and waist circumference.

Methods – This disease-oriented observational study was carried out in the forensic psychiatric rehabilitation ward at the Erada & Mental Health Complex - Taif, Saudi Arabia. Patients admitted to the inpatient ward between 2018 and 2023 participated in the study (N = 71). The relationship between metabolic syndrome and psychotropic medications was also examined. Schizophrenia was defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) criteria. Metabolic syndrome was assessed based on the international criteria National Cholesterol Education Program’s Adult Treatment Panel III report (ATPIII) criteria and AHA/NHLB.

Results – In this study, 71 volunteer schizophrenic patients were included, and an observational study over five years was conducted. We found the total number of metabolic syndrome patients was 40 (56.34%) compared with 31 (43.66%) patients without metabolic syndrome. The majority of metabolic syndrome patients (57.50%) were aged 41 to 50. The highest number of patients suffering from metabolic syndrome are those taking atypical antipsychotic medications. Among antipsychotic medications, aripiprazole was found the maximum number of 10 (25%) followed by olanzapine 7 (17.5%). Maximum number of metabolic syndrome parameters increased fasting blood sugar 26 (65%) followed by increased body mass index 21 (52.5%).

Discuss – This research can contribute to the study of the prevalence of metabolic syndrome among patients with schizophrenia. In the present study, the prevalence of metabolic syndrome was 56.34 percent in schizophrenia. There are several metabolic side effects associated with second-generation antipsychotics and if these aren't treated properly, they can lead to serious health complications, such as diabetes, dyslipidemia, and fatal heart disease.

Conclusion - In our study, metabolic syndrome was most prevalent among patients between 41 - 50 years of age. Therefore, clinicians are encouraged to screen and monitor metabolic syndrome and treat cardio-metabolic risk factors for optimum long-term management.

Keywords: schizophrenia, metabolic syndrome, antipsychotics.

LATE ONSET PSYCHOSIS – A CASE REPORT

Sun, 31 Mar 2024 00:00:00 +0000

Introduction – Late-onset psychosis is a disorder that is well-known but poorly understood, and it has emerged as an increasingly significant issue in geriatric patients. There is no clear information about whether this psychosis occurs for the first time at this age. Despite being underdiagnosed, this late-onset psychosis responds well to treatment. A bizarre, persecutory delusion is a hallmark symptom of late-onset schizophrenia.

Methods – Presented the case of a 67-year-old woman who visited the Emergency Psychiatry Department complaining of persecutory thoughts, auditory hallucinations, and mild cognitive impairment.

Results – This case report explores the diagnostic process and treatment options for very late-onset schizophrenia-like psychosis, including non-pharmacological and pharmacological approaches.

Discuss – Psychotic symptoms can be caused by a variety of general medical conditions in elderly patients. It is necessary to rule out delirium, dementia, substance-related disorders, delusional disorder, and dissociative disorder before diagnosing Late-onset psychosis. A late-onset psychosis is not only challenging to diagnose but also to treat. Non-pharmacological treatments are the first option in managing late-life psychosis. It includes psycho-education for patients and their families, as well as cognitive behavior therapy (CBT). It is important to monitor for adverse reactions while administering medication, and the lowest dosage should be used to achieve short-term efficacy. In addition to antipsychotic medication, anticholinesterase inhibitors may also be effective in treating these patients.

Conclusion: A careful observation and approach are required to make an etiological diagnosis of late-onset psychosis since there are no pathognomonic signs or symptoms. To achieve the best results, their efficacy and side effects should be monitored with regularity.

Keywords: late-onset psychosis, dementia, schizophrenia.

EMOTION RELEASING PROCESS AS A NEW APPROACH TO EASE UNCOMFORTABLE EMOTION: A CASE SERIES

Jiemi Ardian — Sun, 31 Mar 2024 00:00:00 +0000

Introduction – This paper explores the potential of the Emotion Releasing Process (ERP) as a therapeutic approach for individuals suffering from anxiety and depression, often stemming from traumatic memories. This case series aims to describe two cases using ERP as a therapeutic approach for individuals dealing with anxiety and depression.

Methods – The study investigates the effectiveness of ERP through case series analyses of two individuals experiencing significant emotional distress.

Results – Both cases demonstrated substantial reductions in anxiety and depression symptoms (56.25% and 93.75% decrease in HSCL scores) following a single ERP session. The paper highlights the unique strengths of ERP compared to traditional methods like CBT and psychodynamics, emphasizing its focus on directly addressing emotional sensations in the body rather than cognitive restructuring or storytelling.

Discuss – Traumatic memories are different from ordinary memories in several ways. The emotional impact of traumatic memories can be significant. In addition to the emotional impact of traumatic memories, they can also have physical effects on the body.

Conclusion - This approach, bypassing the need for detailed memory recall, holds promise for individuals struggling to verbalize or confront traumatic experiences. Further research is encouraged to explore the broader applications of ERP across various diagnoses and specific trauma types such as PTSD or complex trauma.

Keywords: ERP, emotion, trauma, psychotherapy

EXPLORING THE EFFICACY OF ART-RELATED ACTIVITIES PARTICULARLY PAINTING AS ADJUVANT THERAPY IN SCHIZOPHRENIA: AN EVIDENCE-BASED CASE REPORT

Theresia Rini Krisniati — Sun, 31 Mar 2024 00:00:00 +0000

Introduction – Schizophrenia is a condition that affects approximately one in 300 individuals across the globe, leading to the experience of both positive and negative symptoms. While antipsychotic medication remains the primary treatment, some patients still contend with residual symptoms and relapses. Art-related activities, particularly painting, are frequently used as potential adjuvant therapies for individuals with schizophrenia. Therefore, this study aimed to critically assess the efficacy of art-related activities, specifically painting, as supplementary therapy.

Methods – A comprehensive literature search was conducted on PubMed, Google Scholar, and ScienceDirect, guided by clinical questions and strict inclusion or exclusion criteria. The selected articles were critically evaluated to determine their validity, significance, and applicability.

Results – The literature search identified 3 randomized controlled trials (RCTs) and 1 case series, each with varying validity and analysis outcomes. Among the RCTs, 2 reported a positive effect of art therapy on the negative symptoms of schizophrenia, while the remaining 1 found no significant impact on patients. In a case series study, a substantial difference was observed in the symptoms of schizophrenia patients who engaged in art activities.

Discuss – The 3 RCTs were done with the involvement of a licensed art therapist. The practical application of the RCT study results was still limited by the case examined since there are no art therapists in the case observed. However, in this case, the patient was observed to be more calm, cooperative and increase in ADL score after the art-related activity done in a rehabilitation program.

Conclusion: There is potential for art-related activities as adjuvant therapy for individuals with schizophrenia, but it still lacks sufficient and consistent evidence.

Keywords:art, painting, therapy, schizophrenia, art-related activity.

MICRO-RNA AS DIAGNOSTIC MODALITY OF MAJOR DEPRESSIVE DISORDER

Estyka Ratu — Sun, 31 Mar 2024 00:00:00 +0000

Introduction – Major Depressive Disorder (MDD) is a chronic mental health disorder, with suicidal ideation, but until now an exact diagnostic approach has not been found. For the limitations of the current diagnosis, such as subjective reports of patients or their families with mental status examinations, there is still a lack of objective diagnostic results. In this case, it is still a challenge for researchers. Neutropic factors, hypothalamic-pituitary-adrenal hormones (HPA), indicators of inflammation, and metabolic factors, were found to be novel biomarkers for MDD. However, these biomarkers show limited sensitivity and specificity. The most recent diagnostic development effort is the use of microRNA as a diagnostic modality approach for MDD.

Methods – This study uses a qualitative method by collecting valid journals with certain inclusion and exclusion criteria. The keywords used were MDD, microRNA, and Diagnostic. There are journals used as the source of this literature review which come from valid scientific sources such as NCBI, ScienceDirect, and PubMed which were published in the last 10 years.

Results – The results of the miRNA-124-3p expression test showed a significant difference between the healthy control group and the MDD patient group. The specificity and sensitivity of miRNA-221-3p, miRNA-451a, miRNA-34a-5p, and let-7d-3p showed high accuracy in the diagnosis of MDD.

Discuss – The unknown etiology of MDD makes some patients have no results or significant progress of their depression in clinical settings which is contributed by gene regulatory pathway that shows high significance associated with neural function brain in depressive disorders such as apoptotic pathway, P13K-Akt signaling, axon guidance, neurotrophin signaling pathway, mTOR signaling pathway.

Conclusion- The diagnostic effectiveness of miRNA in major depressive disorder can be significantly enhanced by using miRNA expression coding and has been proven by various tests. Therefore, this research is expected to be an innovation in diagnosing MDD for further research.

Keywords: MDD, depression, microRNA, diagnostic

THE IMPACT OF SMARTPHONE USAGE ON PRESCHOOL AND SCHOOL-AGE CHILDREN INTELLIGENCE

Titania Novira Utami — Sun, 31 Mar 2024 00:00:00 +0000

Introduction – The internet is very important and useful for a variety of purposes, such as rapid sharing of information, entertainment, convenient electronic commerce, emotional support, and contact with other cultures, in the end, the internet is what we need, and so we use smartphones. A smartphone combines a mobile phone and the services of the internet. Smartphones offer many useful services that relieve our daily lives. Smartphones are not only used by young adult people, but also commonly used by children, both those are preschool and school-age children. Children spend a lot of time using smartphones instead of playing with their friends in real life. Some of them are even addicted to using smartphones all the time. Smartphone usage in children has both negative and positive impacts. The objective of this paper is to better understand the impact of smartphone usage on preschool and school-age children's intelligence.

Methods – This paper takes a review method by 11 articles related to the main objective.

Results – A resume by 11 articles reveals that damage to brain tissue and bone marrow of children’s heads absorbs almost ten times more than adults. Beyond their negative impact, still, positive impact refers to learning through interesting media so that it is easier for children to understand things they want to know.

Discuss – Excessive smartphone usage by preschool children will cause various developmental problems and will cause a decrease in cognitive abilities. Excessive smartphone usage by school-age children makes children not interested in learning anymore and harms children’s achievement levels. The positive impacts are smartphone has so many educational media and applications and children can look for unlimited information easier.

Conclusion – Although smartphone usage is known to have so many impacts on children’s cognitive development and children’s development in general, there is no evidence that smartphone usage has an effect on children’s intelligence which can be measured through IQ, so further research is needed.

Keywords: smartphone usage, preschool, school.

DIFFERENCES BETWEEN GRANDIOSE AND VULNERABLE NARCISSISM: SELF-ESTEEM, EMOTION DYSREGULATION, AND INTERPERSONAL RELATIONSHIP

Audri Shabrina Fadhila — Sun, 31 Mar 2024 00:00:00 +0000

Introduction – Narcissism is most often associated with someone arrogant, domineering, and conceited which is captured in the term grandiose narcissism. However, it is agreed that there are two different dimensions of narcissism which are grandiose narcissism and vulnerable narcissism. Manifestations of the two dimensions are differently affecting one’s self-esteem and interpersonal relationships.

Methods – The researcher used several journals and literature discussing grandiose and vulnerable narcissism including assessment, self-esteem, emotion dysregulation, difficulties in interpersonal relationships, and parenting about grandiose and vulnerable narcissism.

Results – Narcissism is an effort to protect one’s self-concept which is characterized by an intense need for validation and admiration that pushes them to seek self-enhancements. There are two types of narcissism which are grandiose and vulnerable narcissism. Vulnerable narcissism is associated with lower self-esteem than grandiose narcissism and in turn, has a more positive association with difficulties in regulating negative emotions than grandiose narcissism.

Discuss – The assessment of grandiose narcissism is less of a challenge because of the overt presentation of grandiosity. On the other hand, the assessment of vulnerable narcissism is tricky. The entitlement is usually hidden in these individuals with the overt presentation being fearful, cautious, and easily threatened.

Conclusion – Vulnerable narcissists tend to develop social avoidance to cope with their vulnerabilities in a relationship, while grandiose narcissist tends to say positive things about themselves.

Keywords: grandiose, narcissism, self-esteem, emotion dysregulation, interpersonal relationship.

THE ROLE of GENERAL PRACTITIONER in PSYCHOTHERAPY of PATIENT BINGE EATING DISORDER

Ria Fajrin — Sun, 31 Mar 2024 00:00:00 +0000

Introduction – Binge Eating Disorder (BED) is a condition in which an individual has repeated episodes of binge eating or episode purging type (inducing vomiting by himself or by using laxatives, diuretics, or enemas). It has happened during at last 3 months. The prevalence of binge eating disorder peaks in female adolescents aged 19-22 years and male adolescents aged 24 years. Treatment that can be given for BED includes psychotherapy, pharmacotherapy, and weight loss therapy. Psychotherapy is the first-line treatment for BED. Types of psychotherapy used in BED are Cognitive behavior therapy (CBT), Interpersonal psychotherapy (IPT), and Dialectical behavior therapy (DBT).

Methods – The searching method in this article is based on several journals and textbook reviews including diagnosis of BED, and psychotherapy of BED such as Cognitive Behavior Therapy (CBT), Dialectical Behavior Therapy (DBT), and Interpersonal Psychotherapy (IPT).

Results – A binge eating disorder (BED) is someone who experiences uncontrollable binge eating, and these episodes can be repeated. after that, someone is trying to get his food out or purging (inducing vomiting by himself or by using laxatives, diuretics, or enemas). This is happened during the last 3 months. Psychotherapy is a formal process that involves the interaction between 2 or more people. Several professionals in mental health use psychotherapy. Types of psychotherapy used in BED are CBT, IPT, and DBT.

Discuss – The role of GP in CBT is to help patients change their patterns of thinking and what they do. CBT also helps patients develop their skills to identify, and deal with problematic thoughts, and beliefs The role of a GP in IPT is to help people manage negative feelings so they don't vent those feelings by binge eating. IPT enhances the development of healthy interpersonal skills by replacing maladaptive behavior by promoting a positive self-image. DBT is a complete therapy. it consists of many different components, which include behavior therapy such as exposure therapy, skill in taking an action (contingency), stimulus control skills, problem-solving, cognitive restructuring, and other interventions.

Conclusion – The three psychotherapies are interrelated with each other, with the combination of the three therapies on BED the results will be better.

Keywords: BED, CBT IPT, DBT, general practitioner.

INTERNET-BASED COGNITIVE BEHAVIORAL THERAPY FOR SOMATIC SYMPTOM DISORDER

Nyoman Triska Ariyanti — Sun, 31 Mar 2024 00:00:00 +0000

Introduction – Somatic symptom disorder (SSD), before known as somatoform disorder (SD), is characterized by a preoccupation that is nondelusional and general with fears of having, or the idea that the body has a serious disease based on his or her misinterpretation of bodily symptoms in six or more months. In SSD management there is a multifaceted approach that is tailored to each patient. Psychological interventions specifically cognitive behavioral therapy reported can improve the symptoms and reduce the healthcare cost significantly. Internet-delivered cognitive behavior therapy (ICBT) has an accepted evidence base for a range of psychiatric problems, especially for SSD treatment also has been suggested as one possible approach that could adapted to this situation.

Methods – In this article, researchers used the review method by collecting several kinds of literature from 2011-2021 that discuss somatic symptom disorder, cognitive behavioral therapy, and internet-based cognitive behavioral therapy for somatic symptom disorder.

Results – A referral system for patients with SSD to a mental health expert is needed if they do not find any progress when handled by the physician in primary care. Proven therapies for SSD such as CBT and mindfulness-based therapy. ICBT was approved and increased usage within the pandemic of COVID-19 and brought some highly standardized courses consistent across patients.

Discuss – The effectiveness of ICBT has been evaluated in the management of generalized anxiety disorder (GAD), depression, panic disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), adjustment disorder, chronic pain, bipolar disorder, and phobias. CBT in multicenter randomized controlled trials reported effectiveness in the treatment of SSD and medically unexplained symptoms, “Health anxious” patients get over two years of sustained symptomatic benefit, without any different impact on total costs, and also decreased the physical symptoms, disability, and psychological distress.

Conclusion – Internet-based Cognitive Behavioral Therapy (ICBT) can be highly effective in the treatment of somatic symptom disorder (SSD). ICBT can provided in therapist-guided, unguided, or as a bibliotherapy. This tool is already recommended as a treatment of choice during the pandemic. Although wider RCT on the use of ICBT in clinical practice, particularly in SSD therapy, with a variety of demographic characteristics to provide additional evidence of the effectiveness of this technique, as well as increased awareness among clinicians and the general public.

Keywords: SSD, somatic, CBT.

PSYCHOSTIMULANT USE AMONG COLLEGE STUDENTS

Batrisyia Rosieta Widanty — Sun, 31 Mar 2024 00:00:00 +0000

Introduction – Undergraduate students are transitioning to a learning curriculum, it's not unexpected that many of them are stressed out by academic and non-academic pressures. Many college students use psychostimulants, which are supplied legally or illegally, to cope with their pressures. College student consume coffee, which is known to contain caffeine, to remain awake for a longer period, improve their physical energy, and stay focused on their work. Furthermore, for academic purposes, students use psychostimulants. Although the number of college students who use psychostimulants without a prescription is modest, It's a form of drug addiction with potentially fatal effects.

Methods – The author uses journals with a range of 2011-2021 to discuss the use of psychostimulants in college students.

Results – Many college students consume caffeine, but studies show that they also use amphetamine non-medical prescription stimulants such as Adderall and methylphenidate, which are sold under the brand names Ritalin and Adderall.

Discuss – Students commonly take non-medical prescription stimulants for a variety of reasons, including improving focus, being more productive with academic activities, working more efficiently, and reducing distractions. Sleep deprivation, sadness, abnormal movements, hallucinations, tachycardia, and loss of appetite are all common adverse effects of psychostimulants.

Conclusion – Undergraduate students abuse psychostimulants because they can minimize their stresses and thus perform better in class. The usage of psychostimulants rises as the exam time approaches. Caffeine, a legal psychostimulant, has been found to improve alertness and concentration, allowing it to preserve cognitive performance that has deteriorated due to a lack of sleep.

Keywords: psychostimulant, college student, caffeine.