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Abstrak :
[ABSTRAK
Gangguan depresi mayor merupakan suatu gangguan kejiwaan ditandai dengan kemurungan, ketiadaan gairah hidup, perasaan tidak berguna dan putus asa dan mengalami minimal empat dari gejala berikut yaitu perubahan berat badan dan nafsu makan, perubahan tidur dan aktivitas, tidak ada energi, rasa bersalah, masalah dalam berfikir dan membuat keputusan, berfikir berulang tentang kematian dan bunuh diri tampa riwayat episode manik, campuran atau hipomanik, sekurang-kurangnya telah dirasakan selama 2 minggu. Survei kesehatan mental dunia pada 17 negara menemukan sekitar 1 dari 20 orang dilaporkan menderita episode depresi setiap tahunnya, paling sering terjadi adalah gangguan depresi mayor. Pengobatan dengan farmakoterapi golongan antidepresan hanya menunjukkan efektifitas 60-70% disertai efek samping yang serius sehingga berbagai modalitas terapi dikembangkan, salah satunya akupunktur. Penelitian ini bertujuan untuk mengetahui efektivitas terapi kombinasi akupunktur dengan antidepresan dibandingkan kombinasi akupunktur sham dengan antidepresan terhadap perubahan skor Hamilton Rating Scale for Depression (HAM-D 17) pada penderita gangguan depresi mayor. Uji klinis acak tersamar tunggal dilakukan pada 48 pasien gangguan depresi mayor dialokasikan ke dalam kelompok kombinasi akupunktur dengan antidepresan dan kelompok kombinasi akupunktur sham dengan antidepresan. Penilaian kemajuan terapi digunakan skor HAM-D 17. Hasil penelitian menunjukkan rerata skor HAM-D 17 pada kelompok kasus sebelum terapi 22,2±3,38 dan setelah terapi ke-12 turun menjadi 7,3±2,64. Sedangkan pada kelompok kontrol rerata skor HAM-D 17 sebelum terapi 21,4±3,10 dan setelah terapi ke-12 turun menjadi 9,3±3,33. Terdapat perbedaan bermakna antara selisih rerata penurunan skor HAM-D 17 sebelum dan setelah 12 kali terapi pada kelompok kasus 14,9±2,45 dibandingan dengan kelompok kontrol 12,2±4,30 (p<0,005). Terapi kombinasi akupunktur dengan antidepresan lebih efektif mengurangi gejala gangguan depresi mayor dibandingkan kombinasi akupunktur sham dengan antidepresan.

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ABSTRACT
Major depressive disorder is a psychiatric disorder that is characterized at least four of the following symptoms, loss of weight and appetite, sleep disturbance and loss of interest of activity, low energy level, guilt, difficulty concentrating and making decisions, recurrent death or suicide, without a history of manic episodes, mixed or hypomanic. These sings and symptoms have been felt at least for 2 weeks. The mental health survey conducted in 17 countries found that about 1 in 20 people are reported to suffer from a depressive episode each year and most are major depressive disorder. The effectiveness of antidepressant medication only 60-70% with serious side effects, so that various therapeutic modalities developed, one of which is acupuncture. This study aims to determine the effectiveness of combination therapy of acupuncture with antidepressants compared to combination of sham acupuncture with antidepressants in patients with major depressive disorder and the outcome was the score Hamilton Rating Scale for Depression (HAM-D 17). Single-blind randomized clinical trial conducted in 48 patients with major depressive disorder and the patients were allocated into two groups, intervention (acupuncture with antidepressants) and control (sham acupuncture with antidepressant). The mean of HAM-D 17 score in the intervention group before treatment was 22,2±3,38 and after treatment was 7,3±2,64. The mean of HAM-D 17 score in control group before treatment was 21,4±3,10 and after treatment was 9,3±3,33. There was significant differences between intervention and control group before and after 12 times of therapy in the mean decrease of score on HAM-D 1714.9±2.45 to12.2±4.30 (p<0.005). A combination of acupuncture therapy with antidepressants is more effective in reducing the symptoms of major depressive disorder compared to sham acupuncture combination with antidepressants, Major depressive disorder is a psychiatric disorder that is characterized at least four of the following symptoms, loss of weight and appetite, sleep disturbance and loss of interest of activity, low energy level, guilt, difficulty concentrating and making decisions, recurrent death or suicide, without a history of manic episodes, mixed or hypomanic. These sings and symptoms have been felt at least for 2 weeks. The mental health survey conducted in 17 countries found that about 1 in 20 people are reported to suffer from a depressive episode each year and most are major depressive disorder. The effectiveness of antidepressant medication only 60-70% with serious side effects, so that various therapeutic modalities developed, one of which is acupuncture. This study aims to determine the effectiveness of combination therapy of acupuncture with antidepressants compared to combination of sham acupuncture with antidepressants in patients with major depressive disorder and the outcome was the score Hamilton Rating Scale for Depression (HAM-D 17). Single-blind randomized clinical trial conducted in 48 patients with major depressive disorder and the patients were allocated into two groups, intervention (acupuncture with antidepressants) and control (sham acupuncture with antidepressant). The mean of HAM-D 17 score in the intervention group before treatment was 22,2±3,38 and after treatment was 7,3±2,64. The mean of HAM-D 17 score in control group before treatment was 21,4±3,10 and after treatment was 9,3±3,33. There was significant differences between intervention and control group before and after 12 times of therapy in the mean decrease of score on HAM-D 1714.9±2.45 to12.2±4.30 (p<0.005). A combination of acupuncture therapy with antidepressants is more effective in reducing the symptoms of major depressive disorder compared to sham acupuncture combination with antidepressants]

Abstrak :
ABSTRAK Depresi merupakan suatu gangguan kejiwaan pada alam perasaan, yang ditandai dengan kesedihan, hilangnya minat atau kebahagiaan, perasaan bersalah, gangguan tidur dan nafsu makan, perasaan lelah dan konsentrasi yang kurang baik. Tiga terapi utama untuk depresi yaitu psikoterapi, farmakoterapi dan electroconvulsive therapy (ECT). Selective Serotonin Re-uptake Inhibitor (SSRI) merupakan terapi antidepresan yang paling sering dipakai. Efektifitas farmakologis antidepresan hanya mencapai 60%-70%. Sebagian pasien depresi tidak merespons penuh, mengalami relaps, atau menderita efek samping yang tidak diharapkan sehingga memerlukan pengembangan terapi pilihan lain, seperti laserpunktur. Penelitian ini bertujuan untuk mengetahui efektivitas terapi kombinasi laserpunktur dengan antidepresan dan psikoterapi dibandingkan dengan terapi kombinasi laserpunktur sham dengan antidepresan dan psikoterapi terhadap perubahan skor Hamilton Rating Scale for Depression 17 (HAM-D 17) dan kadar serotonin penderita depresi. Uji klinis acak tersamar tunggal pada 33 penderita depresi dialokasikan kedalam kelompok perlakuan dan kontrol. Terdapat penurunan skor HAM-D 17 yang bermakna (p<0.001) setelah 8 kali terapi laserpunktur dan peningkatan kadar serotonin yang bermakna (p=0,004) setelah terapi. Penelitian ini menunjukkan terapi kombinasi laserpunktur dengan antidepresan dan psikoterapi efektif mengurangi gejala depresi dan meningkatkan kadar serotonin lebik baik dibandingkan terapi kombinasi laserpunktur sham dengan antidepresan dan psikoterapi saja.

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ABSTRACT Depression is a psychiatric disorder in mood, which is characterized by sadness, loss of interest or happiness, feeling guilty or worthless, sleep or appetite disorders, feeling tired and lack of concentration. There are three main treatment for depression are psychotherapy, pharmacotherapy and electroconvulsive therapy (ECT). The effectiveness of pharmacological antidepressant only reach 60% to 70%. The majority of depressed patients do not respond fully, relapse, or suffer side effects are not expected to require the development of therapies other options, one of which laserpuncture. This study aims to determine the effectiveness of combination therapy with antidepressants and psychotherapy laserpuncture compared with sham laserpuncture combination therapy with antidepressants and psychotherapy to change in Hamilton Rating Scale for Depression 17 (HAM-D 17) and the serotonin levels of people with depression. Single-blind randomized clinical trial was conducted on 33 patients with depression were allocated into intervention and control groups. The results showed there is a decrease in HAM-D 17 were significantly (p <0.001). There is a significant increase serotonin levels (p = 0.004). Conclusion of the study is laserpuncture combination therapy with antidepressants and psychotherapy are effective in reducing symptoms of depression and elevating cortisol level compared to sham laserpuncture combination therapy with antidepressants and psychotherapy.