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Abstrak :
[ABSTRAK
Gangguan bipolar dikenal memiliki kaitan dengan berbagai komorbiditas klinis yang memengaruhi pekerjaan, kehidupan berkeluarga, dan fungsi interpersonal. Duapertiga pasien dengan gangguan bipolar memiliki komorbid yang akan memperburuk luaran gangguan bipolar dan dapat menganggu penatalaksanaan terhadap penyakitnya. Belum ada penelitian yang menggambarkan frekuensi komorbiditas fisik yang terjadi pada penderita bipolar di Indonesia. Rumah Sakit Dr. H. Marzoeki Mahdi sebagai rumah sakit jiwa tertua di Indonesia juga belum memiliki data mengenai jenis dan frekuensi komorbid fisik, mengingat bahwa rumah sakit ini juga menangani rawat inap umum di samping rawat inap psikiatri Metode: Penelitian menggunakan rancangan potong lintang pada 100 orang dengan Gangguan Bipolar di Poliklinik Jiwa Dewasa dan Bangsal Psikiatri R.S. Dr. H. Marzoeki Mahdi Bogor. Penelitian ini menggunakan instrument Structured Clinical Interview For the DSM-IV Axis I Disorders untuk menentukan Gangguan Bipolar, dan kriteria diagnostik sepuluh komorbid fisik yang mengacu pada kriteria diagnostik masing-masing komorbid fisik. Hasil: Pada penelitian ini didapatkan adanya hubungan bermakna antara umur dengan terjadinya komorbid fisik yaitu p= 0.001(p di bawah 0.005). Pada analisis tambahan didapatkan adanya hubungan bermakna antara pemberian obat polifarmasi/monoterapi dengan terjadinya komobid fisik terbanyak yakni hipertensi (nilai p= 0,0001). Pada sepuluh komorbid fisik yang dinilai, migrain, hipertensi dan dermatitis merupakan yang paling banyak. Simpulan Hipertensi, migrain dan dermatitis merupakan tiga besar komorbid fisik di R.S. Dr. H. Marzoeki Mahdi Bogor. Terdapat hubungan bermakna antara umur dengan terjadinya komorbid fisik. Pemberian obat polifarmasi/monoterapi juga bermakna dalam terjadinya hipertensi. Diperlukan kewaspadaan psikiater dalam mengawasi terjadinya komorbid fisik pada gangguan bipolar di layanan psikiatri.

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ABSTRACT
Bipolar disorders are known to cause various clinical comorbidity that may affect work, family and interpersonal function. Two third of bipolar disorder have comorbidities that may worsen the outcome of bipolar itself and interfere with it's therapy. There has not been sufficient study about physical comorbidities in bipolar in Indonesia. As the oldest psychiatric hospital in Indonesia that treats physical and psychiatric inpatients, Dr. H. Marzoeki Mahdi hospital still lacks data concerning types and frequencies of physical comorbidities. Method: This research uses cross-sectional design from 100 people with bipolar disorder at Psychiatric Clinic and Psychiatric Ward at Dr. H. Marzoeki Mahdi Bogor Hospital. This research also uses the Structured Clinical Interview For the DSM-IV Axis I Disorders to ensure the bipolar diagnosis, and criteria diagnostic for ten physical comorbidities from each of their field. Result: There is a significant relationship in this research between age and physical comorbidities p=0.001 (p below 0,005). In the additional analysis, there are significant relationship in this research between polypharmacy / monotherapy and hypertension (p=0,0001). Migraine, hypertension, and dermatitis were the top three physical comorbidities in this research. Conclusion: Hypertension, migraine and dermatitis are the top three in our physical comorbidities in Dr. H. Marzoeki Mahdi hospital. Age has a significant relationship with physical comorbidities. Polipharmacy and monotherapy also has significances in hypertension. Therefore psychiatrist must be aware about the possibility of physical comorbidity in the psychiatric care, Bipolar disorders are known to cause various clinical comorbidity that may affect work, family and interpersonal function. Two third of bipolar disorder have comorbidities that may worsen the outcome of bipolar itself and interfere with it’s therapy. There has not been sufficient study about physical comorbidities in bipolar in Indonesia. As the oldest psychiatric hospital in Indonesia that treats physical and psychiatric inpatients, Dr. H. Marzoeki Mahdi hospital still lacks data concerning types and frequencies of physical comorbidities. Method: This research uses cross-sectional design from 100 people with bipolar disorder at Psychiatric Clinic and Psychiatric Ward at Dr. H. Marzoeki Mahdi Bogor Hospital. This research also uses the Structured Clinical Interview For the DSM-IV Axis I Disorders to ensure the bipolar diagnosis, and criteria diagnostic for ten physical comorbidities from each of their field. Result: There is a significant relationship in this research between age and physical comorbidities p=0.001 (p below 0,005). In the additional analysis, there are significant relationship in this research between polypharmacy / monotherapy and hypertension (p=0,0001). Migraine, hypertension, and dermatitis were the top three physical comorbidities in this research. Conclusion: Hypertension, migraine and dermatitis are the top three in our physical comorbidities in Dr. H. Marzoeki Mahdi hospital. Age has a significant relationship with physical comorbidities. Polipharmacy and monotherapy also has significances in hypertension. Therefore psychiatrist must be aware about the possibility of physical comorbidity in the psychiatric care]

Abstrak :
[Pendahuluan Penegakkan diagnosis gangguan bipolar sering mengalami kesulitan kerena adanya komorbiditas yang mengakibatkan gejala pada gangguan bipolar tidak menonjol. Tumpang tindih gejala pada gangguan bipolar dengan gangguan jiwa lainnya menyebabkan terjadinya ketidaktepatan diagnosis sehingga orang dengan gangguan bipolar didiagnosis sebagai gangguan jiwa lainnya pada pemeriksaan awal. Data dari National Depressive and Manic Depressive Association (NDMDA) menunjukan 60% gangguan bipolar didiagnosis depresi, 26% anxietas, 18% skizofrenia, 17% gangguan kepribadian borderline atau antisosial, 14% penyalahgunaan alkohol dan 11% skizoafektif. Sekitar 69%-73% pasien dengan gangguan bipolar mengalami ketidaktepatan diagnosis pada saat pemeriksaan awal. Peneliti ingin mengetahui besaran komorbiditas pada penderita gangguan bipolar dan hubungannya dengan ketidaktepatan diagnosis pada gangguan bipolar. Metode Studi ini merupakan penelitian deskriptif analitik dengan rancangan potong lintang. Responden adalah pasien dewasa di RSUPN dr Cipto Mangunkusumo Jakarta dan RS dr. Marzoeki Mahdi Bogor pada bulan Desember 2014 hingga didapatkan jumlah sampel, yaitu 80 responden. Pasien yang berobat dan terlihat adanya gejala mood dilakukan pemeriksaan dari rekam medis dan pemeriksaan dengan instrumen SCID I. Hasil Didapatkan 80 responden dengan gangguan bipolar, pada studi rekam medis diketahui ada 11 responden (13.8%) yang didiagnosis bukan sebagai gangguan bipolar setelah rutin mendapatkan perawatan medis. Diketahui juga ada 62.5% dari seluruh responden yang memiliki komorbid. Berdasarkan analisis menggunakan SPSS versi 20 didapatkan hasil adanya hubungan yang bermakna antara komorbid dengan terjadinya ketidaktepatan diagnosis gangguan bipolar dengan nilai p 0.046. Simpulan Pada penelitian ini instrumen SCID I digunakan sebagai standar baku emas untuk menegakkan diagnosis gangguan bipolar dan mengetahui adanya komorbid. Berdasarkan hasil penelitian ini didapatkan 13.8% responden yang didiagnosis bukan sebagai gangguan bipolar walaupun telah rutin mendapatkan perawatan medis. Terdapat hubungan antara kejadian komorbid dengan ketidaktepatan diagnosis gangguan bipolar., Background Diagnosing Bipolar Disorder often times has become difficult due to comorbidities causing indistinct features emerging from the disorder. Overlapping of bipolar disorder with other psychiatric disorders leads to inaccuracy since the beginning of diagnosis. Thus people with bipolar disorder has been diagnosed with other disorders previously.Data fromNational Depressive and Manic Depressive Association (NDMDA) shows 60% of bipolar disorder being diagnosed with depression, 26% with anxiety, 18% with skizofrenia 17% with borderline or antisocial personality disorder, 14% with alcohol abuse and 11%with schizoaffective. Approximately 69%-73% patients with bipolar disorder experienced inaccuracy of diagnosis in the beginning.The author would like to find comorbidities of people with bipolar disorder and its relationship with misdiagnosis of bipolar diagnosis. Method This is an analytic descriptive study with cross sectional in design. Respondents are adults patients at National Referal Hospital of dr Cipto Mangunkusumo in Jakarta and dr. Marzoeki Mahdi Hospital in Bogor on Desember 2014, and a total of 80 samples were acquired. Patients on medication and observed to be with mood symptoms were performed evaluation from medical record and SCID 1 instrument. Result From medical record evaluation, 11 (13.8%) out 80 respondents with bipolar disorder were found to be diagnosed with other than bipolar disorder after routine medical treatment. This study found 62.5% from all respondents to have comorbidities. Analysis using SPSS version 20 revealed significant relationship between comorbidities with misdiagnosis of bipolar disorder (p 0.046). Conclusion This study used SCID I instrument as gold standard in diagnosing bipolar disorder and to find comorbidities. 13.8% respondents were found to be diagnosed with other than bipolar disorder even after routine medical treatment. There is a relationship between comorbidity with misdiagnosis of bipolar disorder.]

Abstrak :
ABSTRAK Latar Belakang: Gangguan Bipolar (GB) merupakan gangguan jiwa yang ditandai dengan satu atau beberapa episode mood yang muncul bergantian secara dramatis. Presentasi klinis yang beragam, seringkali membuat GB salah didiagnosis di awal, terutama untuk GB-II yang datang dengan keluhan depresi berat, karena episode hipomania yang tidak terdeteksi. Oleh karena itu diperlukan suatu instrumen yang dapat mendeteksi hipomania sebagai penanda penting adanya bipolaritas pada pasien dengan gangguan mood. Metode: Penelitian ini adalah uji validitas dan reliabilitas instrumen Hypomania Checklist-33 dengan desain potong lintang. Pengambilan sampel dilakukan dengan teknikconsecutive sampling pada 111 penyandang gangguan mood dengan diagnosis Gangguan Bipolar I, Gangguan Bipolar II, dan Gangguan Depresi Berat di Poli Rawat Jalan Psikiatri RSCM dan di Komunitas Bipolar Care Indonesia dari bulan April hingga November 2015. Hasil: Hasil penelitian menunjukkan bahwa instrumen Hypomania Checklist-33 versi Bahasa Indonesia, terbukti sahih dan handal untuk menilai episode hipomania yang sering tidak terdiagnosis dalam praktik klinis. Simpulan: Instrumen Hypomania Checklist-33 versi Bahasa Indonesia dapat digunakan sebagai alat skrining rutin untuk mendeteksi bipolaritas pada pasien gangguan mood.

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ABSTRACT Background: Bipolar disorder is characterized by one or more of mood episode that change dramatically. The wide variation of clinical presentation of bipolar disorder often make this disorder wrongly diagnosed initially, especially for Bipolar Disorder Type II, who came with depression, because of the underdetection of hypomania episode. Therefore, there is an increasingly need for an instrument to help detecting hypomania episode as an important sign of bipolarity in patient with mood disorders. Method: This study is a validity and reability testing of Hypomania Checklist-33 applying cross sectional study design. The samples were recruited using consecutive sampling technique towards 111 respondents with mood disorders, including Bipolar Disorder Type I, Bipolar Disorder Type II, and Major Depressive Disorder, in RSCM Psychiatry Outpatient Unit and Bipolar Care Indonesia Community from April to November 2015. Results: The result of this study, shows that the Hypomania Checklist-33 Indonesian Version is valid and reliable to assess the episode of hypomania which often underdiagnosed in clinical setting. Conclusion: Hypomania Checklist-33 Indonesian version can be use as a routine screening tool in detecting bipolarity among patients with mood disorders.