Syllabus - Early Detection on Children's Mental Disorder Elective Module

7/29/2019 Syllabus - Early Detection on Children's Mental Disorder Elective Module

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Children's mental health problems is a problem that needs to be a concern at this timebecause of changes in various aspects of life, such as advances in information technology andglobalization so that the flow of information flows rapidly without a filter. In addition, thepresence of various crises in Indonesia increased cases of domestic violence accompanied byincrease in violent behavior towards children. School as a place of education for children, so faronly focused in improving the child's academic skills, while life skills has not yet be focused

enough, thus making a child's social skills not developed to the optimum. All this certainly madean impact in the occurrence of psychiatric disorders in children in Indonesia.

Data of the National Mental Health Policy from 2001 to 2005 showed that the ratio ofmental/emotional health disorders in the group of children aged 4-15 years is 104/1000 children.In a study of the prevalence of emotional and behavioral problems in children of primary schoolage in Central Jakarta in 2003 using Child Behavior Checklist instrument (Rahadian and Wiguna,2003), 27% of children had emotional and behavioral problems. Prevalence in boys was morethan girls (30.5% vs. 22.6%). Problems of internalization (anxiety, depression, and self-isolation)were greater when compared with problems of externalization (30% vs. 10.2%). Ang andWiguna (2007) studied the prevalence of mental disorders in children in junior high school inCentral Jakarta by using MINI for Kids instrument and found a prevalence of 26.5%. Mentaldisorders are more common in female students compared to male students. The type of mentaldisorder most commonly found are mood disorders, anxiety disorders, impaired concentration

and attention/hyperactivity (GPPH), and behavioral disorders.In this elective module the mental disorders in children are focused on the 3 (three)

types of mental disorders most often encountered in the clinic, which are pervasivedevelopmental disorders, concentration problems and hyperactivity, and mental retardation.

Module objectivesThrough this module and other modules that the students underwent, it is hoped that the sevencompetencies to be achieved at the first degree, which was listed in CBC 2005 FMUI, related tothe neuropsychiatry field is owned by a doctor after undergoing their education. These sevencompetencies are:

1. Effective Communication2. Basic clinical skills3. Basic science to practice medicine4. Management of medical and health problems5. Information technology6. Self awareness and lifelong learning7. Ethics, morals, and professionalism in practice

Specific objectivesAfter completing this elective module, students should be able to:

1. Communicate effectively both verbally and nonverbally in a dignified manner in anattempt to manage the client and pediatric patients by integrating clinical and biomedicalreasoning that support the creation of good cooperation between doctor and patient,family, community, peers, and other professionals involved in the handling of mental

disorders in children.2. Conduct psychiatric interviews and complete physical examination with the correct

techniques and record a complete history of the disease.3. Explain all routine clinical procedures and analyze secondary data of patients with mental

disorders by integrating biomedical science and clinical science.4. Choose a variety of clinical, laboratory and other supporting procedures and interpret the

results.5. Determine diagnosis from secondary data and plan management and referral of children

with mental disorders, which include pharmacological and non-pharmacological


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management on individuals, families, and communities to implement evidence-basedmedicine approach.

6. Seek, collect, collate, and interpret information regarding the problem of mentaldisorders in children from various sources by utilizing information and communicationtechnology to assist the diagnosis, therapy, prevention and health promotion, as well asmonitoring the health status of patients.

7. Recognize ethical issues and dilemmas and medico-legal problems in clinical situationsassociated with mental disorders in children and know when and how to get expertassistance or other sources in resolving those ethical and medico-legal choices

8. Be sensitive to the patients values and integrate moral considerations and the clinicalknowledge/skills in resolving ethical issues related to mental disorders in children.

Related disciplines:Biochemistry, Physiology, Nutrition, Clinical Pathology, Pharmacology, Radiology, PediatricNeurology, Pediatric Psychiatry, and Medical Rehabilitation

Students CharacteristicsStudents who can attend the early detection of mental disorders in children elective module arestudents who have passed the first phase of medical education, so they have achieved a variety

of skills learned in accordance with the objectives of Phase I - General Education that weretrained in Basic Education for Higher Education Module (PDPT). These students have achievedthe basic skills and attitudes, namely lifelong learning skills, a variety of generic skills and acaring attitude towards the environment/society.

Learning ObjectivesTerminal Learning ObjectivesWhen encountered with pediatric patients with psychiatric disorders (pervasive developmentaldisorders, concentration problems and hyperactivity, and mental retardation), accompanied bysecondary data from the laboratory, radiology and epidemiology of the mental disorders,students undergoing elective module are capable of interpreting these data and applying them insolving problems in a standard problem solving steps including preventive measures and referral,with the use of appropriate medical and information technology, by always paying attention tothe concept and development of ethics.

Supporting learning objectivesAfter attending this module, second phase students are expected to achieve the followingcapabilities:

1. When given patient data that includes: The results of anamnesis (the patient's complaint, the patient's life history,

history of past illnesses, patients socio-cultural environment) The results of a complete general physical examination, neurologic, and

psychiatric Supporting tests (laboratory, radiology, etc.)

students are able to: Formulate the patients problem Describe the structure and physiology of the organs associated with the

pathophysiological, psychopathological, and pathogenesis of the problem Explain the scientific basis of the disorders Explain the basis of diagnosis and differential diagnosis Determine the laboratory/other investigations needed based on

pathophysiology, psychopathology, and pathogenesis of the problem andable to interpret the results of these data


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Plan the management of therapy (pharmacology and non-pharmacology) Explain the basic pharmacological and non-pharmacological treatment of

the problems Explain the prognosis, sequelae, the impact of management, the impact

of patients illness towards the family, as well as the financing systemand where to find referral services when needed.

2. When encountered with a child who has a certain mental disorders, students are able to: Conduct psychiatric interview to both the child and the parents in

accordance with the ethical-humanistic problem approach (in BCSmodule)

Perform a routine physical examination in a lege artis method inaccordance with the problem (in BCS module)

Perform neurologic and psychiatric examination to obtain a completeneurologic and mental status of the child

Determine the necessary supporting tests Interpret the results of the supporting tests and relate them with the

patient's clinical condition Perform multi-axial diagnosis for psychiatric diagnosis in children, as well

as the differential diagnosis Plan the management (pharmacology and non-pharmacology) Explain the prognosis, sequelae, the impact of management, the impact

of patients illness towards the family, as well as the financing systemand where to find referral services when needed.

SCOPE

Scope Topics SubtopicsThe concept of psychiatry andmental health in children andadolescents

The basic conceptin the field of childpsychiatry

Psychiatry andchild psychiatry'srole in medicine

The basic conceptof child mentalhealth

Biopsychosocial concept Eclectic holistic concept The role and authority of physicians

in child mental health services Child mental health in the

community Role of child mental health in the

functioning of community healthcenters and public hospitals

Common causes of mentaldisorders in children andadolescents

Psychobiologyaspect on mentaldisorders

Socioculturalaspects of mentaldisorders

Neurobiology and neurochemicalaspects

Sociocultural aspects Parents' parenting method The interaction between nurture and

nature

Psychiatric examination andclinical features in children

with:1. Mental retardation2. Pervasive developmental

disorders3. Concentration problems

and hyperactivity

Doctor-patientrelationship

Psychiatricinterview onchildren

Overview andclinical symptoms

The doctor patient relationship Active listening

Empathy Non-verbal communication Communication with the parents and

children with mental retardation,PDD, and GPPH

Open, control and close an interview Mental status examination in

children with (identification ofvarious types of specific


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psychopathology)1.Mental retardation2.Pervasive developmental

disorders3.Concentration problems and

hyperactivity

Description and clinical symptomsof:4.Pervasive developmental

disorders5.Concentration problems and

hyperactivity6.Mental retardation

Multi-axial evaluation (axis I to V)

Psychopharmacotherapy inthe field of child andadolescent psychiatry

Biological Therapy Pharmacodynamics of drugs oftenused in children with psychiatricdisorders

Pharmacokinetics of drugs oftenused in children with psychiatric

disorders Dosage, side effects and interactions

of drugs frequently used in the fieldof child and adolescent psychiatry

Psychosocial therapy in thefield of child and adolescentpsychiatry

Psychotherapy Mental

rehabilitation

Play therapy Cognitive-behavioral therapy Other various psychosocial

treatment approaches

REFERENCES

BIOCHEMISTRYCompulsory textbook:

1. Lodish H et al. Nerve cells. In: Molecular cell biology. 3rd ed. New York; Scientific American,WH Freeman: 1996. pp. 925-90.2. Karp G. Membrane potensials and nerve impulses. In: Cell and molecular biology. 2nd ed. NewYork; John Wiley: 1999. pp. 166-79.3. Mark DB et al. Neurotransmitter synthesis. In: Basic Medical Biochemistry. 1st ed. Baltimore;William Wilkins: 1966. pp. 659-65

CLINICAL PATHOLOGYCompulsory textbook:1.Kjeldsberg CR, Knight JA. CerebroSpinal fluid. In : Body fluids. 2nd ed. ASCP Press: 1986.pp.31-67.2. Strasinger SK. CerebroSpinal fluid. In : Urinalysis and body fluids. 3rded . Philadelphia ; FA

Davis:1994. pp.135-52.3. Gandasoebrata R. Penuntun laboratorium klinik. Jakarta; Dian Rakyat: 1989. pp. 158-70.


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PHARMACOLOGY1. Seksi III: Obat Susunan Saraf Pusat. In: Buku Ajar Farmakologi dan Terapi. edisi V Jakarta;Dept. Farmakologi dan Terapi FKUI: 2007. pp. 139 209.2. Potter WZ, Hollister LE. Antidepressant agents. In: Katzung BG ed. Basic & ClinicalPharmacology. 9th ed. Singapore; Mc.Graw Hill: pp. 482-95.3. Potter WZ, Hollister LE. Antipsychotic agents and Lithium. In: Katzung BG ed. Basic & Clinical

Pharmacology. 9th ed. Singapore; Mc.Graw Hill: pp. 463-81.4. Aminoff MJ. Pharmacologic management of Parkinsonisme and other movement disorder. In:Katzung BG (ed). Basic & Clinical Pharmacology. 10th ed. Singapore: McGraw Hill: pp. 442-56.

RADIOLOGY1. FKUI. Buku Radiologi. Jakarta; FKUI: ( buku hitam).2. David Sutton. Textbook of radiology and imaging. 7th ed. Churchill Livingstone: 2003.3. David Stark, William G Bradley. Magnetic Resonance Imaging. 3 ed. Mosby: 1999.

PSYCHIATRYCompulsory textbook: Micheal Rutter, Eric Taylor. Child and adolescent psychiatry. 4th edition. USA. Blackwell

Science Ltd. 2006. Kaplan HI, Sadock BJ. Synopsis of Psychiatry, Behavioral Sciences/Clinical Psychiatry. 10 th

edition. Philadelphia; Lippincott Williams & Wilkins: 2008 Patel V. Where There is No Psychiatrist-A Mental Health Care Manual. The Royal Colleage of

Psychiatrist: 2003. World Health Organization. Diagnostic and Management Guidelines for Mental Disorders in

Primary Health Care - ICD X. Hogrefe & Huber: 1996.Recommended textbook: Kaplan HI. Emergency of Psychiatry. Philadelphia; Lippincott Williams & Wilkins: 2003. Direktorat Kesehatan Jiwa, Depkes RI. PPDGJ III dan Suplemen PPDGJ III. Jakarta; Depkes

RI: 1995.

Metoda Pembelajaran1. Lectures (10 hours)

Aims to provide insight into the extensiveness and scope of the problems in thefield of child psychiatry, providing an understanding of the concepts, terms andmechanisms, especially the difficult ones and to generate interest andenthusiasm of students to want to delve deeper into, and conduct research inthe field of neuropsychiatry.

Code

a. The concept of general psychiatry and child mental health (1 hour) K-1

b. Common causes of mental disorders of children (1 hour) K-2

c. Psychiatric and clinical examination in children with mental retardation(2 hours)

K-3

d. Psychiatric and clinical examination in children with PDD (2 hours) K-4

e. Psychiatric and clinical examination in children with GPPH (2 hours) K-5

f. Psychopharmacology in the field of child and adolescent psychiatry (1hour)

K-6

g. Psychosocial therapy in the field of child and adolescent psychiatry (1hour)

2. Practicals @ 2 hours (6 hours) Code

1. Psychiatric examination in children2. Children with pervasive developmental disorders

P-1P-2

3. Clinical activities (48 hours) Code

1. Clinical activity in child and adolescent psychiatry clinic FMUI/RSCMa. Case presentation 1b. Case presentation 2

KK-1KK-1aKK-1b


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2. Clinical activity in pediatric growth and development clinic FMUI/RSCMa. Case presentation 1b. Case presentation 2

KK-2KK-2aKK-2b

4.

A

Problem based learning (36 hours)Problem based learning consists of group discussions, self-directed learning andplenary

Group discussion (GD) with 2 triggers @ 6 hours (12 hours)1. Trigger 12. Trigger 2

Facilitators

DK-1DK-2

B Self-directed learning (18 hours)

C Plenary and summary (of GD) @ 3 hours (6 hours) ModeratorResourcepersons

LEARNING RESOURCESSources of learning include:

Textbooks Hand-outs (resource persons) Practical Guidelines

Internet

INSTRUCTIONAL MEDIAInstructional media used:

LCD Computer, VCD Player White Board Flip Chart Demonstration video CD, lab materials CD, and other lab materials


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Matrix of Activities

Week I

Time Monday Tuesday Wednesday Thursday Friday

07.00-08.00

Introduction ofEarly Detection ofMental Disorders

in ChildrenElective Module

Psychiatric and

clinicalexamination inchildren withconcentrationproblems andhyperactivity

Group DiscussionTrigger 1


Plenary 1 +feedback08.00-09.00

General conceptof psychiatry andmental health in

children andadolescents

09.00-10.00

Common causesof mental

disorders inchildren

Practical 1 Practical 2 Clinical work 1

10.00-11.00 Psychiatric andclinical

examination inchildren with

mental retardation

Psychosocialtherapy in the

field of child andadolescentpsychiatry

11.00-12.00

Psycho-pharmacotherapyin the field of child

psychiatry

Clinical work 2 Clinical work 1 Clinical work 1

12.00-13.00

13.00-13.00Psychiatric and

clinicalexamination inchildren with

pervasivedevelopmental

disorders


Clinical work 2 Clinical work 1

Formativeevaluation 1

14.00-15.00Self-directed

learning

15.00-16.00 Self-directed learning

Week II


07.00-08.00 Group DiscussionTrigger 2



Plenary 2 +feedback

Self-directedlearning

08.00-09.00

Clinical work 109.00-10.00

Clinical work 2 Clinical work 1 Clinical work 210.00-11.00Clinical work 1

11.00-12.00

12.00-13.00

13.00-13.30

Clinical work 2Case

presentation 1 Clinical work 2 Clinical work 113.30-14.00Formative

Evaluation 2


learning15.00-15.30

Self-directed learning15.30-16.00


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Week III



learningSelf-directed

learningSelf-directed learning

Self-directedlearning Summative

Evaluation08.00-09.00

Clinical work 2 Clinical work 1 Clinical work 2 Clinical work 109.00-10.00

10.00-11.00

11.00-12.00

12.00-13.00

13.00-14.00Clinical work 2

Casepresentation 2

Clinical work 2 Clinical work 114.00-15.00

15.00-16.00 Self-directed learning

List of Teaching Staff

List of Resource PersonsNo Lecture Code Day Date Time Lecturer

1 The general concept ofpsychiatry and child and

adolescent mental health

K-1 Dr. Lukas Mangindaan, SpKJ

2 Common causes of mentaldisorders in children

K-2 Dr. Jan Prasetyo, SpKJ (K)

3 Psychiatric examinationand clinical features inchildren with mentalretardation

K-3 Dr. Noorhana SWR, SpKJ(K)

4 Psychiatric examinationand clinical features inchildren with PDD

K-4 Dr. Ika Widyawati, SpKJ (K)

5 Psychiatric examinationand clinical features inchildren with GPPH

K-5 Dr. Tjhin Wiguna, SpKJ (K)

6 Psychopharmacotherapyin the field of child andadolescent psychiatry

K-6 Dr. Irawati Masubrin, SpKJ(K)

7 Psychosocial therapy inthe field of child andadolescent psychiatry

K-7 Dr. Gitayanti H, SpKJ (K)

Location: Meeting room at the Department of PsychiatryFMUI/RSCM

Plenary Resource PersonsPlenary Topic Day Date Time Dept Moderator/Resource Persons

I Concentrationandhyperactivitydisorders +mentalretardation

Dr. Irawati M (moderator)Dr. Tjhin Wiguna (resourceperson)Dr. Ika Widyawati (resourceperson)

II Pervasivedevelopmentaldisorders

Dr. Tjhin Wiguna (moderator)Dr. Noorhana SWR (resourceperson)Dr. Gitayanti H (resource person)


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List of practical coordinator and tutorLab coordinator:

Practical Coordinator

P-1 Dr. Tjhin Wiguna

P-2 Dr. Ika Widyawati

Module Team

Advisor : Dr. Ika Widyawati, SpKJ (K)Chair : Dr. dr. Tjhin Wiguna, SpKJ (K)Vice chair : Dr. Gitayanti Hadisukanto, SpKJ(K)

Members :Dr.dr. Irawati Ismail M., SpKJ (K)Dr. Noorhana SWR, SpKJ (K)Dr. Lukas Mangindaan, SpKJ (K)

Secretariat (1 person) : Elin

FACILITIESLecture hall: Lecture hall at the Department of Psychiatry FMUI/RSCMChild and Adolescent Psychiatry Clinic FMUI/RSCMPediatric Growth and Development Clinic FMUI/RSCM

Evaluation1. Evaluation of Learning Outcomes (Individual)

Formative:During interactive lectures and practicals (formative quizzes, lab reports)

Summative:MCQ 1

MethodWeighting

(%)

Written test MCQ 1 30

Practical Exam 20

Observation/evaluation by the facilitator of group discussion 20

Students notebook 10

lab report/summative quiz 10

Documents

Syllabus - Early Detection on Children's Mental Disorder Elective Module