Download - Blok 12.Psikosis Post Partum
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BLOK 12BLOK 12PSIKOSIS POST PSIKOSIS POST
PARTUMPARTUM
**
YASLINDA YAUNIN SYAFWANBAGIAN PSIKIATRI FKUA
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PSIKOSIS (PSYCHOSIS)PSIKOSIS (PSYCHOSIS) ADALAH : GANGGUAN DALAM MENILAI REALITA (REALITY TESTING -
- ABILITY = RTA )
* PERILAKU* FIKIRAN* PERASAAN
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Post Partum ? ? ? Post Partum ? ? ?
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PSIKOSIS POST PARTUM PSIKOSIS POST PARTUM Adl. Su. Episode Psikosis Akut / Ggn yg
cukup berat pd wanita yang terjadi setelah melahirkan
Insiden :1 – 2 per 1000 kelahiran ( 0,1 – 0,2 % )[ O’Hara & Swain 1996 ] Onset : minggu pertama . . . . . Fase nifas
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Faktor ResikoFaktor ResikoRiwayat Gangguan Bipolar( 26-35 % )
Riwayat Psikosis Post Partum & Ggn Bipolar sebelumnya ( 38 – 50 % )
Primipara
Keluarga dgn Riw. Psikosis Post Partum
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Etiologi :Etiologi : Penyebab pasti belum bisa ditentukan
F. Biologik yg mempengaruhi : estrogen, progesteron, cortisol , tryptophan, hm.thyroid, prolaktin, β-endorphin.
Estrogen……antidopaminergic (antipsikotik) Post Partum ……….kdr estrogen sirkulasi supersensitif “Dopamin Reseptor” predisposisi Psikosis
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Etiologi :Etiologi :
F. Psikologik mungkin juga mempengaruhi
Stressor Kurang Percaya Diri Ketidak-mampuan beradaptasi
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Gambaran KlinikGambaran Klinik
Disorientasi Kebingungan Delusi / WahamHalusinasiPerubahan suasana alam perasaan/ Emosi Labil ( Depresif. . .. . . . . Manik )
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PenatalaksanaanPenatalaksanaan
Karena Resiko u/ * menolak anaknya “ child abuse ”
Hospitalisasi * “ infanticide ” * “ suicide”
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Penatalaksaan Samb….Penatalaksaan Samb….
**Terapi Ssi Penyakit Organik
* Mood Stabililizer* Antipsikotik* Antidepresan* Benzodizepine* E C T ( Terapi Kejang listrik)
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Ggn Psikiatrik PostGgn Psikiatrik Post Partum Lainnya Partum Lainnya
“Post Partum Blues” ( Maternity Blues ) adl masa transisi ,dimulai 2- 4 hari ssdh melahirkan dan berlangsung tdk lebih dari 2 minggu.
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Faktor ResikoFaktor Resiko
Ada Riw. Depresi
Depresi selama kehamilan
Riw. “Premenstrual Dysphoric Disorder”
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““Post Partum Blues” Post Partum Blues” ( Maternity Blues )( Maternity Blues )
GK/ sering menangis, mood labil, mudah tersinggung dan ansietas insiden : 85 % . . . . ibu muda
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Depresif Post Partum :
. . . Merupakan lanjutan onset dari “post partum blues” dimulai 2 – 4 mgg post partum insiden : 12 – 13 %
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Depresif Post Partum
GK/ Mood Depresif,
rasa bersalah/berdosa,
takut akan masa depan anaknya
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