Slide Lapsus gangguan afektif bipolar

8/8/2019 Slide Lapsus gangguan afektif bipolar

1/20

LAPORAN KASUS PSIKOTIKGANGGUAN AFEKTIF BIPOLAR

EPISODE KINI MANIK DENGANGEJALA PSIKOTIK(F31.2)

1

Amrul Mushlihin (1102090113)

Pembimbing,

dr. Anisa

Supervisor,dr. Andi Suheyra Syaui, M.es, Sp.!"


2/20

IDENTITAS PASIEN

2

#ama $ #y. A#%

&mur $ 21 'ahun

Agama $ slam

Saus Pera*inan $ meniah

Pendidian $ 'ama SMAPeer+aan $ bu umah 'angga

Alama $ -ingungan %osso ab. -u*u

iirim oleh $ Ayah Pasien


3/20

RESUME

• Keluhan Utama : Menga!"

• Pe#e$!an !!# 21 %a&!n 'a*a 'engan "e+!&anenga!" ,ang %e#-a' e"%a# 1 ngg! ee+! 'a*a

"e RS /a&'n S!'#0&!0'0. Paen ean%ng a#anga#ang 'e"%a#n,a e+e$a# 0#ang0#ang %e#!%aaa,a&n,a. Paen enga!" +a "engnann,a %'a" '%!#!%Paen -!ga enga%anga%a a,a&n,a g0#++a 'an $e!n!&!n,a. Ge+a& !+% %'!# e+a+! 0n'a#an'# 'a+a

#!a& 'an e+a+! ngn "e+!a# #!a&. Paen %'a" $e#na&e#&en% a#a e&a#an. Paen -!ga '$e#&a%"an e#nge#'an'an en0# e#$a"aan ,ang en0+0" 'enganan"an". Paen -!ga enga%a"an 'a$a% eaa$"#an 0#ang 'an enga"! 'a$a% en-a' $"0+0g.

0/0/13


4/20

+an-!%an

• I! $aen enngga+ 4 %a&!n ,ang +a+! "a#ena a"% -an%!ng 'an &$e#%en.

• a,a& $aen en"a& +ag 3 %a&!n ,ang +a+!. Paen%'a" e%!-! 'an %'a" !"a a,a&n,a en"a& +ag.Paen enga%a"an a,a&n,a enga-a e!n!&!n,a "a#ena ngn en"a& +ag e-a" aa% %!$aen !+a eng!#!ng '# ' "aa# e#ngenang -a#ang a"an 'an %'a" a! e#a"%5%a.Na!n e%e+a& %! $aen !+a e#a"%5%a "ea+.

• "!#ang +e& 2 %a&!n ,ang +a+! e%e+a& $aen

'%ngga+"an 0+e& !an,a. Paen e#aa a"% &a%'an e#ng ea" !an,a %!. Se-a" aa% %!+a&$aen !+a e#'an'an en0# ea"a $a"aan,ang en0+0" 'an an"an" e#ng "e+!a##!a& 'an an,a" a#a.

0/0/1


5/20

+an-!%an

• Paen e$a% e"e#-a ' 6,$e#a#%' Pa+0$0 2 ngg! ,ang +a+!.See+! a"% $aen a'a+a& ana",ang $en'a %e#%!%!$ -a#ange#ga!+ 'an 0$an %e#&a'a$ 0#ang%!an,a.

0/0/1 % epresi


6/20

Hendaya/disfungsi :

•6en'a,a 0a+ a'a

•6en'a,a $e"e#-aan a'a

•6en'a,a *a"%! enggang a'a

Fakto stesso !sikososial

•D%ngga+"an 0+e& !an,a

•6!!ngan 'engan a,a& 'an ! %#n,a"!#ang a"

0/0/1 % epresi /


7/20

"i#ayat $angguanSe%elumnya

• "i#ayat Penyakit Dahulu

#*a,a% $en,a"% 5" ee+!n,a e$e#% n7e"%#a!a "a$% 'an "e-ang %'a" a'a.

• "i#ayat Penggunaan &at Psikoaktif

Paen %'a" e#0"0" %'a" $e#na& eng0n!a+"0&0+ 'an 0a%0a% %e#+a#ang.

"i#ayat $angguan Psikiati Se%elumnya

See+!n,a !'a& $e#na& enga+a gangg!an,ang aa. T'a" e#0a% 'an ea" en'#.

0/0/1 4


8/20

"i#ayat Kehidu!anPi%adi

• R*a,a% P#ena%a+ 'an Pe#na%a+Paen +a&# n0#a+ !"!$ !+an 'an $e#a+nan 'an%!0+e& 'an. Paen e#!$a"an ana" ,ang'ngn"an. R*a,a% "e&a+an $a'a ! %'a"'"e%a&!.

• R*a,a% Maa Kana" A*a+ ( e-a" +a&# &ngga !a 13

%a&!n)Pe#%!!&an 'an $e#"eangan n0#a+ e!a 'enganana" e!an,a.

• R*a,a% Maa Kana" Pe#%enga&an ( !a 811 %a&!n)Pe#%!!&an 'an $e#"eangan n0#a+ e!a 'enganana" e!an,a. P#e%a $aen ' e"0+a& e'ang

e'ang. Paen %aa% Se"0+a& Daa#.• R*a,a% Maa Kana" A"&# 'an Rea-a ( !a 1219

%a&!n)Pe#%!!&an 'an $e#"eangan n0#a+ e!a 'enganana" e!an,a. Paen e+an-!%"an $en''"an&ngga SMA

0/0/1 5


9/20

+an-!%an•

R*a,a% Maa De*aa:• R*a,a% Pen''"an

Lan-!% 6ngga SMA• R*a,a% Pe"e#-aan Paen e"e#-a eaga ! #!a& %angga 'an e$a%

e"e#-a ' 6,$e#a#% 2 ngg! ,ang +a+!• R*a,a% Pe#n"a&an

Paen !'a& en"a& 'an e+" 2 0#ang ana"• R*a,a% Ke&'!$an e#agaa

Paen ee+!" agaa I+a 'an %e#a!" 0#ang ,ang#a-n e#a'a&

• R*a,a% M+%e#Paen %'a" $e#na& eng"!% "ega%an +%e#

• R*a,a% Pe+angga#an 6!"!Se+aa n $aen %'a" $e#na& %e#+a% 'engan aa+a&&!"!

0/0/1 9


10/20

• "i#ayat Kehidu!an KeluagaPaen e#!$a"an ana" "e'!a 'a# 8 e#a!'a#a( (;) ; ). T'a" a'a #*a,a% "e+!a#ga ,angen'e#%a $en,a"% ,ang aa.

• Situasi SekaangPaen %ngga+ 'engan a,a& 'an ! %#n,a e#%a2 0#ang ana"n,a (%'a" %ngga+ 'engan!an,a). 6!!ngan 'engan "e'!a 0#ang%!a "!#ang a".

• Pese!si Pasien Tentang Dii danKehidu!annyaPaen e#aa '#n,a %'a" a"% e&ngga %'a"ngn en! 0a%. (T+"an 'e#a-a% 1)

0/0/1 10


11/20

(E"'AKNA

• A++0anane : – Paen enga!" ,ang %e#-a' 1 ngg! ee+!

'a*a "e RS /S. – e#ng enga%a a,a&n,a g0#++a 'an $e!n!&

!n,a – ge+a& ,ang 'a+a e"%a# 1 ngg! ,ang +a+! – $aen !+% %'!# e+a+! 0n'a#an'# %e#%a*a

en'# a#a en'# %'a" e#&en% a#a. – Paen -!ga e#ng e#'an'an en0# e#$a"aan

en0+0" 'engan an"an". – Paen -!ga enga%a"an 'a$a% eaa $"#an

0#ang +an 'an enga"! 'a$a% en-a' $"0+0g. – Tga %a&!n ,ang +a+! $aen e#ng eng!#!ng '#

' "aa# e#ng enang -a#ang e#a"%5%a!a& %'!# 'an -a#ang a"an. Na!n ee#a$a!+an "e!'an $aen !+a ea".

0/0/1 11


12/20

+an-!%an

• D!a %a&!n ,ang +a+! (aa% '%ngga+!an,a) en-a' +e& an,a"a#a aa a#a en'# e#ng

"e+!a# #!a& 'engan e#'an'an ,angen0# $a"aan ,ang en0+0"'engan an"an". Paen e$a%

ea" e+aa "!#ang +e& 1 %a&!n.Paen e$a% e"e#-a ' &,$ea#% 'Pa+0$0 e+aa "!#ang +e& 2 ngg!

0/0/1 12


13/20

• Da# $ee#"aan %a%! en%a+ $ena$+an%a$a" $e#e$!an e#"ee-a 0#a" e#a&#! e+ana -ean #! ea"a an"an"

e#'an'an en0# $e#a*a"an aga" ge!"$e#a*a%an '# !"!$ 'an *a-a& e!a !!#.Kea'a#an e#!a& $e#+a"! 'an a"%5%a$"00%0# ge+a& 'an &$e#a"%7. Men-a*a$e#%an,aan 'engan +ane# $0n%an n%0naaga" %ngg 'an "ean ean-#. S"a$%e#&a'a$ $ee#"a "00$e#a%7.

• M00' ge#a a7e" &$e#%a e$a% %'a"'a$a% '#aa#aa"an "ee#aan %'a" e#a.Penge%a&!an e!a %a#a7 $en''"an 'a,a

"0en%#a !'a& e#a+&. T'a" a'a gangg!an0#en%a *a"%! %e$a% 'an 0#ang. Inga%an -ang"a $an-ang $en'e" ege#a a". P"#ana%#a" %e#gangg!. Kea$!an en0+0ng '#en'# !"!$.

0/0/1 13


14/20

• T'a" ''a$a%"an gangg!an $e#e$ a#!$"# ea#a $#0'!"%5%a !"!$ fight oideas a'a "0n%!n%a "a'ang #e+e


15/20

E)A*UASI 'U*TIAKSIA*AKSIS I•Be#'aa#"an a++0anane a!%0nane 'an $ee#"aan %a%! en%a+''a$a%"an ge-a+a "+n ,ang e#a"na e#!$a $0+a $e#+a"! e#ng

enga!" e#a#a en'# ge+a& e#ng $e#g$e#g. Kea'aan nen!+"an $en'e#%aan (distress) "e+!a#ga $aen e#%a %e#'a$a% &en'a,a(dissability) $a'a 7!ng $"00a+ $e"e#-aan 'an $engg!naan *a"%!enggang e&nga 'a$a% '$!+"an a&*a $aen en'e#%a $angguan

+i#a,•Pa'a $ee#"aan %a%! en%a+ '%e!"an &en'a,a e#a% 'a+a en+a#ea+%a e#!$a *a&a "eea#an 'an *a&a !#ga e&ngga ''agn0$angguan -i#a Psikotik,•Pa'a $ee#"aan %a%! n%e#n! 'an ne!#0+0g %'a" '%e!"an a'an,a"e+anan e#a#% e&ngga "e!ng"nan a'an,a $angguan mental oganik'a$a% 'ng"#"an.•Da# a++0anane a!%0anane 'an $ee#"aan %a%! en%a+''a$a%"an a7e" ,ang &$e#%a 00' ge#a fight o ideas a'a$"00%0# &$e#a"%7 e&ngga een!& "#%e#a ana. Te#-a' $e#0'e #e'a# 7ae ana '!+! "e 7ae ana e"a#ang 'ana $aen -!ga $e#na&

enga+a &a+ ,ang aa ee+!n,a 'an $e#na& enga+a $en,e!&an.•Paen -!ga 'e#%a *a&a "eea#an ,a%! enga%a"an a$! eaa$"#an 0#ang +an enga"! 'a$a% en-a' $"0+0g. /a&a !#ga ,a%!en!#ga a,a&n,a enga-a e!n!& !n,a. Se&ngga e#'aa#"anPe'0an Pengg0+0ngan Dagn0 Gangg!an -*a (PPDGJ) III 'agn0'a#a&"an $a'a $angguan Afektif (i!ola. E!isode kini 'anik dengan$e+ala Psikotik F01,23.

0/0/1 1


16/20

AKSIS II•Paen a'a+a& ana" ,ang $en'a%e#%!%!$ -a#ang e#ga!+ 'an 0$an "e$a'a

0#ang %!an,a. Se&ngga %'a" 'a$a%'a!""an 'a+a # "e$#a'an %e#%en%!.

AKSIS III• T'a" a'a 'agn0.

AKSIS I)•D%ngga+"an 0+e& !an,a.•6!!ngan 'engan a,a& 'an ! %# "!#anga".

AKSIS )•G+0a+ Aeen% F!n%0nng (GAF) Sa+e=> 81 ge-a+a e#a% 'a+%a e#a%.

0/0/1 1/


17/20

Dagn0 een%a#a

• Gangg!an a7e"%7 $0+a# e$0'e "nan" 'engan ge-a+a $"0%"

0/0/1 14


18/20

Renana %e#a$

Psikofamakologi

•R$e#'0n 2g 3 ? 1

•Na%#! '


19/20

P"4$N4SIS• Dubia

Fakto !endukung :• Ge-a+a "+n a'a+a& e#!$a ge-a+a $0%7 :

berupa waham 'an a7e" &$e#%a.• S%#e0# $"00a+ -e+a• Ke+!a#ga en'!"!ng "ee!&an $aen• T'a" %e#'a$a% #*a,a% ,ang aa 'a+a

"e+!a#ga.

Fakto !engham%at :• T'a" '"e%a&! "e$a%!&an 'a+a en!

0a% "a#ena $aen en'# ,ang ngneng!#! $eng0a%ann,a.

0/0/1 19


20/20

Teima Kasih

0/0/1 20

Documents

Slide Lapsus gangguan afektif bipolar