PSYCHIATRYPSYCHIATRY

By : dr.Nyoman Ratep, Sp.KJ(K) By : dr.Nyoman Ratep, Sp.KJ(K) Psychiatry Departement Faculty of Medicine of Psychiatry Departement Faculty of Medicine of Udayana University / General Public Hospital Udayana University / General Public Hospital Sanglah DenpasarSanglah Denpasar

PSYCHIATRYPSYCHIATRY

One of subdivisions of medical science One of subdivisions of medical science which learn everything that related to which learn everything that related to

psychological disturbance. In the case of psychological disturbance. In the case of introduction, treatment, rehabilitation and introduction, treatment, rehabilitation and

prevention as well as building and prevention as well as building and increasing psychological healthincreasing psychological health

HISTORYHISTORY

Ancient times had known and cured Ancient times had known and cured psychic disturbance (skull punched)psychic disturbance (skull punched)

Psychic disturbance caused by evil spirit Psychic disturbance caused by evil spirit which go into human body, does not which go into human body, does not handled by doctorhandled by doctor

Handling patient by being hurtHandling patient by being hurt 1818th th Century,in France,care for Century,in France,care for

psychological disturbance more humanlypsychological disturbance more humanly

HISTORYHISTORY

At the end of 19At the end of 19th th Century,investigating Century,investigating the causes of psychiatric disturbancethe causes of psychiatric disturbance

Martin Charcot; about histeria is cured in Martin Charcot; about histeria is cured in hypnotherapyhypnotherapy

Emil Kraepelin (1855-1926) as the father Emil Kraepelin (1855-1926) as the father of psychiatric writing a bookof psychiatric writing a book

Kretschmer and Sheldon,the body shape Kretschmer and Sheldon,the body shape connected with diseaseconnected with disease

MODERN PSYCHIATRYMODERN PSYCHIATRY

Pioneer: Sigmun FreudPioneer: Sigmun Freud

Carl Gustav JungCarl Gustav Jung

Alfred AdlerAlfred Adler

Eugen BleulerEugen Bleuler

Psychotropic medicine begun in 1950Psychotropic medicine begun in 1950

HISTORY in INDONESIAHISTORY in INDONESIA

Since the old days had already known there Since the old days had already known there was psychological disturbance (Srikandi edan, was psychological disturbance (Srikandi edan, Gatot Kaca gandrung)Gatot Kaca gandrung)

Sufferer was placed in stocks-lock legs Sufferer was placed in stocks-lock legs between two pieces of wood (just snappy one)between two pieces of wood (just snappy one)

Sufferer becomes vagrant, on the contrary Sufferer becomes vagrant, on the contrary called “ORANG SAKTI”called “ORANG SAKTI”

The Dutch Colonial Period, before there was The Dutch Colonial Period, before there was insane asylum, were housed in a Military insane asylum, were housed in a Military HospitalHospital

Japan colonial period a great number of Japan colonial period a great number of asylums were broken, undevelopedasylums were broken, undeveloped

Freedom periodFreedom period

1947; The departement of psychiatric pro- blem 1947; The departement of psychiatric pro- blem because physical revolution undevelopedbecause physical revolution undeveloped

1950; refreshment1950; refreshment

1958; psychiatric problem1958; psychiatric problem

1959; psychiatric section1959; psychiatric section

1966; directorate psychiatric health1966; directorate psychiatric health

1862; Population cencus of psychological 1862; Population cencus of psychological disturbance,600 people in Java & disturbance,600 people in Java & Madura, and 200 in other regionsMadura, and 200 in other regions

RSJ Bogor : July 1RSJ Bogor : July 1stst , 1882 , 1882 RSJ Lawang : June 23RSJ Lawang : June 23rdrd , 1902 , 1902 RSJ Magelang : 1923RSJ Magelang : 1923 RSJ Sabang : 1927RSJ Sabang : 1927RSJ was built away from city/public, RSJ was built away from city/public,

isolated and strict guardedisolated and strict guarded

Terbaring di lantai kakus

Dirantai dan tak berbusana

Tergolek telanjang di dekat hewan

Remaja ikut terkurung

Udara dipenuhi dengan lalat dan bau tak sedap

Terlalu lemah untuk bangkit dan makan

Fasilitas untuk 200 orang ditempati oleh 305 orang

Bebaskan kami!

Rumah pasungan

Penderita (perempuan) dalam pasungan

Tidak diberi busana untuk sekadar berpakaian layak

Penderita hidup dalam peti dari kayu

Psychiatry DepartementPsychiatry Departement Prof.Dr.dr.Luh Ketut Suryani, Sp.KJ(K)Prof.Dr.dr.Luh Ketut Suryani, Sp.KJ(K) Dr. Nyoman Hanati, Sp.KJ(K)Dr. Nyoman Hanati, Sp.KJ(K) Dr. Nyoman Ratep, Sp.KJ(K)Dr. Nyoman Ratep, Sp.KJ(K) Dr. Wayan Westa, Sp.KJ(K)Dr. Wayan Westa, Sp.KJ(K) Dr. IGA Endah Arjana, Sp.KJ(K)Dr. IGA Endah Arjana, Sp.KJ(K) Dr. Lely Setiawati, Sp.KJ(K)Dr. Lely Setiawati, Sp.KJ(K) Dr. AA Sri Wahyuni, Sp.KJDr. AA Sri Wahyuni, Sp.KJ Dr. Cok Bagus Jaya Lesmana, Sp.KJDr. Cok Bagus Jaya Lesmana, Sp.KJ Dr. IA Kusuma Wardani, SPKJDr. IA Kusuma Wardani, SPKJ Dr. IGA Indah Adani, SpKJDr. IGA Indah Adani, SpKJ

THE LAWTHE LAW

No.9/1960; the law of the main healthNo.9/1960; the law of the main health No.3/1966; the law of psychic healthNo.3/1966; the law of psychic health A condition that enable physic, intellectual A condition that enable physic, intellectual

and emotional from someone and the and emotional from someone and the development run in harmony with development run in harmony with someone else conditionsomeone else condition

Estimated 2-3% the population of the RI Estimated 2-3% the population of the RI suffering seriously psychic disturbancesuffering seriously psychic disturbance

(120.000 – 130.000 people)(120.000 – 130.000 people)

THE CAUSE OF PSYCHIC THE CAUSE OF PSYCHIC DISTURBANCEDISTURBANCE

1.1. GENETIC FACTORGENETIC FACTOR

2.2. CONSTITUTION FACTORCONSTITUTION FACTOR

3.3. DEVELOPMENT FACTORDEVELOPMENT FACTOR

4.4. PSYCHOSOCIAL FACTORPSYCHOSOCIAL FACTOR

PERSONALITYPERSONALITY

Definition; a unique characteristic of someone to Definition; a unique characteristic of someone to react against stresser (either come from the react against stresser (either come from the inner of him surroundings) to reach balancinginner of him surroundings) to reach balancing

Mature; able to work, have friends, take Mature; able to work, have friends, take anvantage of spare time being happy, general anvantage of spare time being happy, general viewview

Personality is formed by phases of child Personality is formed by phases of child development. When having passed through development. When having passed through satisfactorily become maturesatisfactorily become mature

STRESSSTRESS

Definition; a condition that need a new Definition; a condition that need a new adaptation. Stressor is its kindadaptation. Stressor is its kind

Stress always happens (24 hours), and Stress always happens (24 hours), and good for living (eustres). Distress;the good for living (eustres). Distress;the stresser over durabilitystresser over durability

Stress creates worry (normal when Stress creates worry (normal when reaching progress, patologis becomes reaching progress, patologis becomes lengthy sick) Worry indication: physic faal lengthy sick) Worry indication: physic faal increases and psychologicalincreases and psychological

PSYCHOTIC NON-PSYCHOTIC

FEELING SICK NO FEELING SICK

SEEK TREATMENT NO YES

SOCIAL FUNCTION AFFECTED GOOD/MINIMMAL

THOUGHT PROCESS AFFECTED REALISTIC

PSYCHIATRY PSYCHOLOGY

MENTAL NORMAL + PATHOLOGIC

NORMAL

THERAPY BIOPSIKOSOCIAL PSYCHOSOCIAL

CONNECTION with other CONNECTION with other SCIENCE BRANCESSCIENCE BRANCES

PsychologyPsychology SosiologySosiology AntropologyAntropology GeneticGenetic NeuroanatomyNeuroanatomy NeurochemistryNeurochemistry PsychofarmakologyPsychofarmakology

SUBSPECIALIZATIONSUBSPECIALIZATION

Child PsychiatryChild Psychiatry PsychoterapyPsychoterapy PsychiatrysocialPsychiatrysocial PsychofarmakologyPsychofarmakology PsychogeriatryPsychogeriatry PsychiatryforensicPsychiatryforensic

Immature Immature

Stressor Big/Heavy

Non-psychosis Psychosis

Schizophrenia

Acute PsychosisHealthy

Personality Disorder

mature mature

PERSONALITY PERSONALITY

Small/Light Small/Light

MULTIAXIAL EVALUATIONMULTIAXIAL EVALUATION

I.I. CLINICAL DIAGNOSTICCLINICAL DIAGNOSTIC

II.II. PERSONALITY & PERSONALITY DISORDERS OR PERSONALITY & PERSONALITY DISORDERS OR MENTAL RETARDATIONMENTAL RETARDATION

III.III. MEDICAL PROBLEMMEDICAL PROBLEM

IV.IV. PSYCHOSOCIAL STRESSPSYCHOSOCIAL STRESS

V.V. GAF Scale (GLOBAL ASSESSMENT OF GAF Scale (GLOBAL ASSESSMENT OF FUNCTIONING)FUNCTIONING)

CONCLUSIONCONCLUSION

Psychiatric is a part of general medical, Psychiatric is a part of general medical, can be handled and curedcan be handled and cured

Handling from PUSKESMAS/RSU/RSJ Handling from PUSKESMAS/RSU/RSJ and involve community/familyand involve community/family

There is still negative stigma, considered There is still negative stigma, considered mysterious,possessed by bad mysterious,possessed by bad evil,handled by driving awayevil,handled by driving away

Psychiatry is at the same level with other Psychiatry is at the same level with other sciencessciences