Gangguan Mood

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Fakultas Kedokteran
Universitas Methodist Indonesia
 • Gangguan
depresi mayor

• Distimia • Mania

• Gangguan
Mood
• siklotimia • Gangguan afektif
Bipolar

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 Gangguan Depresi Mayor
S : Sleep disturbance
I : Lack of Interest
• Tanda utama G : Guilt , worthlessness
– Mood yang depresi E : Decreased of Energy
C :Decreased of Concentration
– Anhedonia A : Appetite disorders
– Tidak bertenaga P:Psychomotor agitation/retardation
S : Suicidal ideation
• Pengingat :
Setidaknya dialami dalam 2 minggu terakhir

–SIGECAPS

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 Tanda dan Gejala

• gejala • Tanda
• Psikomotor terganggu • Merasa sedih , murung
• Afek terbatas • Menarik diri
• Mood depresi, • Tidak ada motivasi
anhedonia • Tanda vegetatif
• Pikiran bunuh diri • Perubahan nafsu
makan
• Kognitif terganggu
• Mudah lelah
• Tilikan dan daya
pertimbangan • Konstipasi
terganggu • Sakit kepala

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DSM-5

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 PREVALENSI

• Prevalensi 12 bulan 7%
• 3 kali lebih tinggi pada populasi berusia
18-29 tahun dibandingkan dengan
populasi yang berusia > 60 thn
• Pria : Wanita = 1 : 1,5 – 3

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 • Episode Manik dengan
Mood Iritabel atau
Episode Campuran

• Gangguan Mood
• Kedukaan karena Kondisi Medis
Umum

• Diagnosis
• Gangguan Penyesuaian Banding
• Gangguan Depresi
Dengan Mood yang
yang Diinduksi Zat
Depresi

• Gangguan
Pemusatan
• Gangguan Bipolar
Perhatian dan
Hiperaktivitas

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 Persistent Depressive Disorder
(Dysthymia)
• Sebelumnya dikenal dengan istilah
depressive neurosis.
• Lebih ringan dibandingkan dengan
gangguan depresi mayor.
• Lebih sering dan lebih bersifat kronis
pada wanita dibanding pria.
• Onsetnya bersifat insidensi

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• Terjadi lebih sering pada individu
dengan riwayat stres yang berkelamaan
atau kehilangan yang terjadi tiba-tiba,
sering bersamaan dengan gangguan
psikiatri lainnya
• onset antara umur 20- 35 tahun.
• Lebih sering pada keluarga tingkat
pertama pada pasien dengan gangguan
depresi mayor.

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DSM-5

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 Mania
• Tanda utama
• Mood yang elevated/ iritabel
D : Distractility
• Pengingat I : Indiscreation
G : Grandiosity
F : Flight of ideas
• DIGFAST A : Activity increased
S : Sleep deficits
T : Talkativeness

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 setidaknya 1 minggu

4 hari berturutan
• mani
• hipomania a

• Normal mood

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Signs and Symptoms

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DSM-5

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 Cyclothymic disorder
• Less severe disorder, with alternating periods of
hypomania and moderate depression.
• The condition is chronic and non psychotic.
• Symptoms must be present for at least 2 years.
• Equally common in men and women. Onset usually is
insidious and occurs in late adolescence or early adulthood.
• Substance abuse is common.

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• Major depressive disorder and bipolar
disorder are more common among first
degree relatives than among the general
population.
• Recurrent mood swings may lead to social
and professional difficulties.
• May respond to lithium.

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Pemeriksaan Penunjang

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 Course and Prognosis
• Fifteen percent of depressed patients
eventually commit suicide.
• An untreated,average depressed
episode lasts about 10 months.
• At least 75% of affected patients have a
second episode of depression, usually
within the first 6 months after the initial
episode.
• The average number of depressive
episodes in a lifetime is five.
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• The prognosis generally is good:
– 50% recover,
– 30% partially recover,
– 20% have a chronic course.
• About 20% to 30% of dysthymic
patients develop, in descending order
of frequency, major depressive disorder
(called double depression), bipolar II
disorder, or bipolar I disorder

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• A major mood disorder, usually bipolar
II disorder, develops in about 30% of
patients with cyclothymic disorder.
• Forty-five percent of manic episodes
recur.
• Untreated,manic episodes last 3 to 6
months, with a high rate of recurrence
(average of 10 recurrences).
• Some 80% to 90% of manic patients
eventually experience a full depressive
episode.
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• The long-term prognosis for mania is
fair:
– 15% recover,
– 50% to 60% partially recover (multiple
relapses with good interepisodic
functioning),
– one-third have some evidence of chronic
symptoms and social deterioration

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 Treatment
• Depressive disorders.
– Major depressive episodes are treatable in
70% to 80% of patients.
– The most effective approach is to integrate
pharmacotherapy with psychotherapeutic
interventions.

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N
A
T
• Terapi kognitif
• Non
A farmakotera
• Terapi perilaku
L pi • Psikoterapi
A berorientasi tilikan
K
S
A
N • SSRI
A • Farmakotera
pi • SNRI
A
• TCA
N
Bipolar Disorder
– Mood Stabilizer
• Lithium
• Lamotrigin
• Divalproat
• Carbamazepin
– Second Generation antipsychotics
• Olanzapine
• Quetiapine
• Aripiprazole
• Risperidone
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Terima kasih

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