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Anita E. Affect : external expression of mood. Mood disorders : a group of clinical conditions characterized by a loss of that sense of control and a subjective experience of great distress. Mixed : Pr Age The onset of bipolar I disorder 5 tahun mean Depresi : onset 20 50 tahun Mean 40 tahun.
Usia an meningkat krn pengaruh zat. Socioeconomic and Cultural Factors socioeconomic status : Depression, no correlation. Rural areas. Bipoar, upper class. Bipolar I disorder is more education : Bip, under college grad. Vice versa. Neurobiology 1. Neuroanatomi dan neurofisiologi Otak abnormal hyperintensities in subcortical regions Ventricular enlargement, cortical atrophy, and sulcal widening.
Silvano Arieti depressed people lived their lives for someone else rather than for themselves. He referred to the person for whom depressed patients live as the dominant other, which may be a principle, an ideal, or an institution, as well as an individual.
Depression sets in when patients realize that the person or ideal for which they have been living is never going to respond in a manner that will meet their expectations. Edith Jacobson depression is the state of powerless, helpless child victimized by a tormenting parent. Melanie Klein : expression of aggression toward loved ones.
Edward Bibring : discrepancy between extraordinarily high ideals and the inability to meet those goals. Heinz Kohuts : the developing self has specific needs that must be met by parents to give the child a positive sense of self-esteem and self-cohesion. When others do not meet these needs, there is a massive loss of self-esteem that presents as depression.
John Bowlby believed that damaged early attachments and traumatic separation in childhood predispose to depression. Adult losses are said to revive the traumatic childhood loss and so precipitate adult depressive episodes.
Psychodynamics : Mania defense against underlying depression. Abraham : inability to tolerate a developmental tragedy, such as the loss of a parent. The manic state may also result from a tyrannical superego, which produces intolerable self-criticism that is then replaced by euphoric self-satisfaction. Bertram Lewin : manic patient's ego as overwhelmed by pleasurable impulses, such as sex, or by feared impulses, such as aggression.
Klein : defensive reaction to depression, using manic defenses such as omnipotence, in which the person develops delusions of grandeur. F 30 Episode Manik. Kini hipomania. Kini campuran. Major Depressive Episode Depressed mood most of the day, nearly every day. Manic Episode. Gangguan bipolar gangguan tipe I bipolar tipe- terdapat riwayat dari episode II. Waham dan Halusinasi ; waham rasa bersalah, waham somatik dan nihilistik.
Ciri khas pada usia tertentu Depresi akan memberikan gambaran berbeda pada usia tertentu a. Pubertas : keluhan somatik, agitasi, halusinasi, gelisah, fobia b. Remaja : penyalahgunaan obat, antisosial, kegelisahan, bolos sekolah, ingkar janji, sensitif pada penolakan, higiene yang buruk c. Perilaku yang tidak tertahan dan tak menentu - Pengeluaran yang berlebihan atau berjudi - Perjalanan impulsif. Berlebihan dalam aktivitas dan tanggungjawab. Toleransi frustasi yang rendah d.
Tanda-tanda vegetatif. Patients with rapid cycling bipolar I disorder are likely to be female and to have had depressive and hypomanic episodes. No data indicate that rapid cycling has a familial pattern of inheritance and, thus, an external factor such as stress or drug treatment may be involved in the pathogenesis of rapid cycling. There are associated feelings of inadequacy, guilt, irritability, and anger; withdrawal from society; loss of interest; and inactivity and lack of productivity.
The term dysthymia, which means humored, was introduced in Before that time, most patients now classified as having dysthymic disorder were classified as having depressive neurosis also called neurotic depression. Cyclothymic disorder is symptomatically a mild form of bipolar II disorder, characterized by episodes of hypomania and minor depression.
The disorder is differentiated from bipolar II disorder, which is characterized by the presence of major not minor depressive and hypomanic episodes. Gangguan mood lainnya Tidak memenuhi kriteria distimia, gangguan penyesuaian dengan mood depresi atau campuran. Atau termasuk Anksietas ytt. Include : Premenstrual dysphoric disorder: in most menstrual cycles during the past year, symptoms e.
These symptoms must be severe enough to markedly interfere with work, school, or usual activities and be entirely absent for at least 1 week postmenses. Minor depressive disorder: episodes of at least 2 weeks of depressive symptoms but with fewer than the five items required for major depressive disorder. Recurrent brief depressive disorder: depressive episodes lasting from 2 days up to 2 weeks, occurring at least once a month for 12 months not associated with the menstrual cycle.
Postpsychotic depressive disorder of schizophrenia: a major depressive episode that occurs during the residual phase of schizophrenia. A major depressive episode superimposed on delusional disorder, psychotic disorder not otherwise specified, or the active phase of schizophrenia.
Situations in which the clinician has concluded that a depressive disorder is present but is unable to determine whether it is primary, due to a general medical condition, or substance induced. Mood disorder resulting from general medical condition secondary to medical illness e. Substance-induced mood disorder caused by drugs or toxin 3. Schizophrenia 4. Grief 5. Personality disorders 6. Adjustment disorder with depressed mood maladaptive response Primary sleep disorders 8. I dapat sembuh sempurna.
Angka ini berkurang pada perawatan berulang. Yang tidak sembuh tetap menderita distimia. Psikofarmaka profilaksis dan episode depresi memperbaiki prognosis. Makin sering kambuh, masa interepisode makin pendek, keparahan sakin meningkat. Prognosis bipolar poorer prognosis than mdd. Poor prognostic factor : a premorbid poor occupational status, alcohol dependence, psychotic features, depressive features, interepisode depressive features, and male gender.
Good prognostid factor : Short duration of manic episodes, advanced age of onset, few suicidal thoughts, and few coexisting psychiatric or medical problems predict a better outcome. Patients may have from 2 manic episodes mean 9. One third of all patients with bipolar I disorder have chronic symptoms and evidence of significant social decline. Prognostic Indicators : Mild episodes, the absence of psychotic symptoms, a short hospital stay.
Psychosocial indicators, a history of solid friendships during adolescence, stable family functioning, and generally sound social functioning for the 5 years preceding the illness. Men poorer than women.
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Anita E. Affect : external expression of mood. Mood disorders : a group of clinical conditions characterized by a loss of that sense of control and a subjective experience of great distress. Mixed : Pr Age The onset of bipolar I disorder 5 tahun mean