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7/26/2019 Referat Neni

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BAGIAN PSIKIATRI

FAKULTAS KEDOKTERAN REFERAT

UNIVERSITAS MUSLIM INDONESIA 15 JUNI 2016

GANGGUAN CAMPURAN ANXIETAS DAN DEPRESI (F41.2)

Disusun ol! "

MASNAENI A#ALIA$ % 110 212 01&0

Dosn P'(i'(in)"

*+, $AM F, SUSANTO- M,Ks- S.,KJ

Di(///n D/l/' R/n)/ Tu)/s K./ni+//n KliniB/)i/n Psii/+i F/ul/s K*o+/n

Uni3+si/s Musli' In*onsi/

M//ss/+

2016


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KATA PENGANTAR

Ass/l/'u/l/iu' /+/!'/ull/!i /(/+//u!,

Pu4i suu+ .nulis ./n4//n !/*i+/ All/! S#T,- /+n/ i/ '/si!

*i(+i li'./!/n +/!'/ */n !i*//! s!in))/ (is/ 'nls/i/n ++/ ini, D/n

/ lu./ s!/l// */n /sli' +u4u ./*/ N/(i Mu!/''/* SA#,- su+i /ul/*/n

u'/ *i slu+u! *uni/,

S// in)in 'n/'./i/n +/s/ +i'/ /si! ./*/ .i!/7.i!/ /n)

+li(/ s8/+/ l/n)sun) '/u.un i*/ l/n)sun) ./*/ .'(u//n ++/ ini, T/n./

(/nu/n */+i s'u/n/- s// i*/ //n */./ 'nls/i/n ++/ ini,

S// .un ''o!on '// /n) s(s/+7(s/+n/ //s s'u/ s/l/!/n */n

u+/n)/n /n) /*/ ./*/ ++/ ini, S// 'n/*/+i (/!/ l/.o+/n ini '/si!

4/u! */+i s'.u+n//n, Ol! /+n/ iu- s/+/n */n +ii /n) ''(/n)un /.

s// n/ni/n unu 'n)/!/sil/n ++/ /n) l(i! (/i, $/+/./n s//- s'o)/

++/ ini */./ (+)un/%(+'/n// (/)i (/n/ o+/n)

D'ii/n /n) in)in s// s/'./i/n,

#/ss/l/'u/l/iu' /+/!'/ull/!i /(/+//u,

M//ss/+- 15 Juni 2016

M/sn/ni A/li/!

2


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DAFTAR ISI

SAMPUL,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

1

KATA PENGANTAR,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

2

DAFTAR ISI,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

&

LEMBAR PENGESA$AN,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

9

BAB I " PENDA$ULUAN,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

5

BAB II " TINJAUAN PUSTAKA,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

:

2,1, Dinisi

:

2,2, E.i*'iolo)i

:

2,&, Eiolo)i

;

2,9, M/nis/si Klinis

11

2,5, Di/)nosis

1&

3


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2,6, Di/)nosis B/n*in)

15

2,:, P+4/l/n/n G/n))u/n */n P+o)nosis

15

2,


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LEMBAR PENGESAHAN

=/n) (+/n*/7/n)/n *i (//! ini 'n///n (/!/"

N/'/ " M/sn/ni A/li/!

S/'(u " 110 2012 01&0

Ju*ul L/.o+/n " G/n))u/n >/'.u+/n An?i/s */n D.+si @F91,2

Insiusi " F/ul/s K*o+/n Uni3+si/s Musli' In*onsi/

Tl/! 'nls/i/n u)/s R+/ */l/' +/n)/ K./ni+//n Klini ./*/

B/)i/n Psii/+i F/ul/s K*o+/n Uni3+si/s Musli' In*onsi/,

M//ss/+- 15 Juni 2016,

P'(i'(in)-

*+, $/' F, Sus/no- M,Ks- S.,KJ

5


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BAB I

PENDAHULUAN

Si/. '/nusi/ ''.un/i +/s/ 8'/s- +/s/ 8'/s ini +4/*i ./*/ s//

/*/n/ 4/*i/n //u .+isi/ +nu- '/u.un */l/' 'n)!/*/.i su/u !/l,

S(/)/i 8ono!- o+/n) '+/s/ 8'/s i/ /'.il *i !/*/./n (/n/ o+/n) //u

'+/s/ 8'/s i/ s(lu' u4i/n (+l/n)sun), K8'/s/n /n) *i'ilii

sso+/n) /n) s.+i *i //s /*/l/! no+'/l- */n (/!/n 8'/s/n ini .+lu

*i'ilii '/nusi/, A/n /.i 8'/s/n (+u(/! 'n4/*i /(no+'/l i/

8'/s/n /n) /*/ *i */l/' *i+i in*i3i*u 'n4/*i (+l(i!/n //u 'l(i!i */+i

/./si/s u'u'n/,

In*i3i*u /n) 'n)/l/'i )/n))u/n s.+i ini (is/ *i///n 'n)/l/'i

/n?i *iso+*+ @)/n))u/n 8'/s/n /iu /u/n /n) (+l(i!/n */n

si/n/ i*/ +/sion/l, Sso+/n) *i///n 'n*+i/ )/n))u/n 8'/s/n

/./(il/ 8'/s/n ini 'n))/n))u /i3i/s */l/' !i*u./n */+i *i+i in*i3i*u

+s(u- s/l/! s/un/ /ni )/n))u/n un)si sosi/l, Mis/ln/ 8'/s/n /n)

(+l(i!/n ini 'n)!/'(/ *i+i sso+/n) unu 'n4/lin !u(un)/n /+/(

/n/+in*i3i*u //u lo'.on/,

Si/. '/nusi/ 4u)/ '+/s/ s*i! (il/ /*/ 4/*i/n /n) 'n*i!/n-

*/n (i/s/n/ .+/s//n +s(u +//si *n)/n sn*i+in/, $/l *'ii/n /*/l/!

/4/+, L/in !/ln/ *n)/n )/n))u/n *.+si- '+u.//n )/n))u/n /n)

'n/n)u lu!/n (/*/ni/!- .+/s//n */n .ii+/n, Bil/ i*/ *io(/i- *.+si

*/./ 'n/. (+(ul/n7(ul/n //u (/!/n 'n/!un, D.+si */./ ''.+(+/

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//u 'nin)//n +isio .n/i isi */n 'nin)//n +isio (unu! *i+i,

D.+si (is/ (+*i+i sn*i+i '/u.un (+s/'//n *n)/n .n/i o+)/ni, D.+si

//n suli *i *i/)nosis 4i/ *.+si *i'u/n (+s/'//n *n)/n .n/i l/in,

N/'un +*/./ l/in/n /n) *is(u G/n))u/n >/'.u+/n An?i/s */n

D.+si- ./*/ ./sin ini +*/./ )4/l/7)4/l/ /n?i/s '/u.un *.+si- n/'un

'/sin)7'/sin) i*/ 'nun4u/n +/n)/i/n )4/l/ /n) 8uu. (+/ unu

'n)//n *i/)nosis +sn*i+i,

7


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BAB II

TINJAUAN PUSTAKA

2.1 DEFINISI

An?i/s */l/' (/!/s/ In*o J+'/n /*/l/! C/n)! /n) */l/' (/!/s/

l/in (+!u(un)/n *n)/n // C/n)usus- /n)o- /n)o+- /n?ius- /n?i/s- /n)in/,

Ks'u/n/ 'n)/n*un) /+i Cs'.i //u Cons+isi, P/*/ /!un 1/'.u+/n An?i/s */n D.+si //u *is(u 4u)/ Mi?*

An?i D.+ssion Diso+*+ @MADD *i)/'(/+/n s(/)/i )4/l/7)4/l/

/n?i/s '/u.un *.+si- *i'/n/ '/sin)7'/sin) i*/ 'nun4u/n +/n)/i/n

)4/l/ /n) 8uu. (+/ unu 'n)//n *i/)nosis +sn*i+i, Unu /n?i/s-

((+/./ )4/l/ oono'i !/+us *i'u/n /l/u.un i*/ +us7'n+us-

*is/'.in) +/s/ 8'/s //u !//i+/n (+l(i!/n,

K8'/s/n /*/l/! /*//n in*i3i*u //u lo'.o 'n)/l/'i .+/s//n

)lis/! @.nil/i/n //u o.ini */n /i3i/s sis' s/+/ /uono' */l/' (+s.ons

+!/*/. /n8/'/n /n) i*/ 4l/s- nons.sii, K8'/s/n '+u.//n unsu+

8


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4i//n /n) 'n))/'(/+/n .+/s//n- /*//n 'osion/l /n) *i'ilii

sso+/n) ./*/ s// 'n)!/*/.i n///n //u 4/*i/n */l/' !i*u.n/,

G/n))u/n *.+si '+u.//n su/u '/s/ +)/n))un/ un)si '/nusi/

/n) (+/i/n *n)/n /l/' .+/s//n /n) s*i! *n)/n )4/l/ .n+/ +'/su

.+u(/!/n .ol/ i*u+- n/su '//n- .sio'oo+- onsn+/si- /n!*oni/-

ll/!/n- +/s/ .uus /s/- / (+*// */n )/)/s/n (unu! *i+i,2

2.2 EPIDEMIOLOGI

K(+/*//n )/n))u/n *.+si (+/ */n )/n))u/n ./ni s8/+/

(+s/'//n l/i' *i'u/n, Du/ .+i)/ ./sin *n)/n )4/l/ *.+si ''ilii

)4/l/ /n?i/s /n) 'non4ol- */n *u/ .+i)/n/ */./ ''nu!i +i+i/

*i/)nosi )/n)u/n ./ni, Pnlii l/! 'l/.o+/n (/!/ 20 s/'./i ;0 .+sn

./sin *n)/n )/n)))u/n ./ni ''ilii .iso* )/n))u/n *.+si (+/, D//

ini 'n)s/n/n (/!/ (+/*//n )4/l/ *.+si */n /n?i/s s8/+/

(+s/'//n- i*/ /*/ *i /n/+/n/ /n) ''nu!i +i+i/ *i/)nosi )/n))u/n

*.+si //u /n?i/s l/in */./ l/i' *i'u/n, Msi.un *'ii/n- s4u'l/!

linisi */n .nlii ''.+i+//n (/!/ .+/3lnsi )/n))u/n ini ./*/ .o.ul/si

u'u' /*/l/! 10 .+sn */n *i lini .l//n/n .+i'+ s/'./i +in))i 50

.+sn- /l/u.un .+i+//n ons+3/i 'n)s/n/n .+/3lnsi si/+ 1 .+sn

./*/ .o.ul/si u'u',

9


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2.3 ETIOLOGI

E'./ )/+is (ui .nin) 'n)s/n/n (/!/ )4/l/ /n?i/s */n )4/l/

*.+si +/i s8/+/ /us/l ./*/ s4u'l/! ./sin /n) 'n)/l/'i )4/l/ ini,

P+/'/- s4u'l/! .nlii 'l/.o+/n 'u/n nu+on*o+in /n) s+u./ ./*/

)/n))u/n *.+si */n /n?i/s- +u/'/ )/n))u/n ./ni- +'/su

'nu'.uln/ +s.ons o+isol +!/*/. !o+'on /*noo+ */n o+o.i-

'nu'.uln/ +s.on !o+'on .+u'(u!/n +!/*/. loni*in @>//.+s- */n

+s.on TS$ @!+oi* si'ul/in) !o+'on s+/ .+ol/in /n) u'.ul +!/*/.

TR$ @!+o+o.in7+l/sin) !o+'on,

K*u/- s4u'l/! .nlii 'l/.o+/n *// /n) 'nun4u/n (/!/

!i.+/ii/s sis' no+/*+n+)i s(/)/i .n(/( +l3/n ./*/ s4u'l/!

./sin *n)/n )/n))u/n *.+si */n )/n))u/n /n?i/s, S8/+/ +in8i- su*i ini

l/! 'n'u/n /*/n/ onsn+/si '/(oli no+.n+in &7'!o?797

!*+o?.!nl)l8ol @M$PG /n) 'nin)/ *i*/l/' u+in- .l/s'/- //u 8/i+/n

s+(+os.in/l @L>S ./*/ ./sin *n)/n s+/n)/n ./ni, S.+i ./*/ )/n))u/n

/n?i/s */n )/n))u/n *.+si l/in- s+oonin */n /s/' H7/'ino(ui+/ @GABA

4u)/ 'un)in +li(/ s(/)/i .n(/( *i */l/' )/n))u/n 8/'.u+/n *.+si

/n?i/s,

Ki)/- (/n/ su*i 'n'u/n (/!/ o(/ s+oon+)i- s.+i

luo?in @P+o/8 */n 8lo'i.+/'in @An/+/nil- (+)un/ */l/' +/.i )/n))u/n

*.+si */n /n?i/s,

10


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K'./- s4u'l/! su*i lu/+)/ 'l/.o+/n *// /n)

'nun4u/n(/!/ )4/l/ /n?i/s */n *.+si (+!u(un)/n ./*/ s8/+/ )ni

s*iin/ ./*/ ((+/./ lu/+)/,

No+.in.!+in ''ilii onsn+/si in))i *i */l/' lo8us 8+ulus s+/

*/l/' onsn+/si sun*+ */l/' !i..o8/'.us- /')*/l/- */n o+? 8+(+/l,

Sl/in iu *i'u/n 4u)/ */l/' onsn+/si in))i *i s/+/ si'./is,

No+.in.!+in *i.in*/!/n */+i 8l/! sn/.i8 */n '(/li .ni'./n/n

'l/lui .+oss reuptake /i, Fun)si U/'/ /*/l/! 'n)/u+ un)si si/)//n-

.us/ .+!/i/n */n o+in/si 'n)/u+ i)!7li)!*/n .+oss .'(l/4/+/n */n

''o+, S*/n)/n l/in/n S+oonin @5$T (+i'.li/si +!/*/. ((+/./

4nis )/n))u/n 4i/ /n) 'n8/u. /n?i/s- *.+si- .siosis- 'i)+n- )/n))u/n

un)si ssu/l- i*u+- o)nii- */n )/n))u/n '//n, B/n/ in*//n ./*/

)/n))u/n 4i/ *n)/n 4/l/n ''.n)/+u!i sis' s+oonin +s(u, Fun)si

U/'/ */+i S+oonin @5$T /*/l/! */l/' .n)/u+/n i*u+- .+s.si n+i-

'n)/u+ s/us 'oo* */n '.+/u+ u(u! s+/ (+.+/n */l/' .+il/u /))+si

//u '/+/! */n li(i*o,

11


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GABA '+u.//n nu+o+/ns'i+ /n) '')/n) .+/n/n .nin)

*/l/' )4/l/7)4/l/ ./*/ )/n))u/n 4i/, $/'.i+ i/.7i/. /+/ o/ (+isi nu+on7

nu+on GABA, B/n/ pathway*i o/ 'n))un//n GABA */n '+u.//n

nu+o+/ns'i+ u/'/ unu sl Pu+in4, GABA *i.in*/!/n */+i sin/.s

'l/lui //(olis' ol! GABA +/ns/'in/s, Fun)si u/'/ /*/l/! 'nu+un/n

/+ous/l */n 'n)u+/n)i /)+si- 8'/s/n */n /i */l/' un)si si/si,

2.4 MANIFESTASI KLINIS

G/'(/+/n linis (+3/+i/si- *i/)nosis G/n))u/n An?i/s Mnlu+u!

*i)//n /./(il/ *i4u'./i )4/l/7)4/l/ /n/+/ l/in lu!/n 8'/s- !//i+-

/s7/s- +/)u unu (+in*/- .+/s//n /u /n) (+l(i!/n- )lis/! ./*/ !/l7

!/l /n) s.l */n i*/ u/'/ /n) '/n/ .+/s//n +s(u ''.n)/+u!i

slu+u! /s. !i*u./nn/- s!in))/ .+i'(/n)/n //l s!/- .+/s//n */n

.+il/u +.n)/+u!, Sl/in iu s.sii unu G/n))u/n An?i/s Mnlu+u!

/*/l/! 8'/s/n/ +4/*i +onis s8/+/ +us7'n+us 'n8/u. siu/si !i*u.

@8'/s //n +4/*i 8l///n- suli/n in/nsi/l- 8'/s //n +4/*in/

(/!//- 8'/s !il/n)/n on+ol- 8'/s //n'n*/.//n s+/n)/n 4/nun),

S+in) .n*+i/ i*/ s/(/+- 'u*/! '/+/!- suli i*u+, &-:-


13/24

6, J/nun) (+*(/+7*(/+

:, Tl/./ /n)/n (/s/!%*in)in


14/24

Konsn+/si */n .+!/i/n (+u+/n)

$/+)/ *i+i */n .+8///n *i+i (+u+/n)

G/)/s/n n/n) +/s/ (+s/l/! */n i*/ (+)un/

P/n*/n)/n '/s/ *./n /n) su+/' */n .si'isis

G/)/s/n //u .+(u//n ''(/!///n *i+i //u (unu! *i+i

Ti*u+ +)/n))u

N/su '//n (+u+/n),

G4/l/7)4/l/ *i//s *i/l/'i ol! ./sin !/'.i+ si/. !/+i */n *i nil/i

(+*/s/+/n un)/./n .+i(/*i //u !/sil .n)/'//n o+/n) l/in 'is/ln/ lu/+)/

./sin,&-9-5

2.5 DIAGNOSIS

K+i+i/ DSM7IV7TR 'n)!/+us/n /*/n/ )4/l/ su(sin*+o' /n?i/s

*/n *.+si s+/ /*/n/ ((+/./ )4/l/ so'/i- s.+i +'o+- ./l.i/si- 'ulu

+in)- */n +/s/ .+u /n) (+)4ol/, S4u'l/! su*i .n*/!ulu/n 'nun4u/n

(/!/ snsii3i/s *o+ u'u' unu sin*+o' )/n))u/n 8/'.u+/n /n?i/s

*.+si '/si! +n*/! /l/u.un u+/n)n/ .n)n/l/n ini */./ 'n8+'in/n

u+/n)n/ l/(l *i/)nosi /n) ssu/i (/)i ./sin,

14


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Kr!"r# DSM$I%$TR G#&''#& C#*r#& A&+"!#, D"*r",-

Moo* *iso+i /n) (+ul/n) //u 'n/. */n (+/!/n s*iin/ 1 (ul/n

Moo* *iso+i *is+/i './ @//u l(i! )4/l/ (+iu sl/'/ s*iin/ 1 (ul/n"

1, Ksuli/n (+onsn+/si //u .ii+/n oson)

2, G/n))u/n i*u+ @suli unu 4/u! +i*u+ //u /. i*u+ //u )lis/!' i*u+ i*/

.u/s

&, Ll/! //u n+)i +n*/!

9, I+i/(ili/s

5, K!//i+

6, Mu*/! n/n)is

:, $i.+3i)il/n8


16/24

P"/#& #'&/,!0 "&r! PPDGJ$III

1, T+*/./ )4/l/7)4/l/ /n?i/s '/u.un *.+si- *i'/n/ '/sin)7'/sin) i*/

'nun4u/n +/n)/i/n )4/l/ /n) 8uu. (+/ unu 'n)//n *i/)nosis

+sn*i+i, Unu /n?i/s- ((+/./ )4/l/ oono'i !/+us *i'u/n

/l/u.un i*/ +us7'n+us- *is/'.in) +/s/ 8'/s //u !//i+/n

(+l(i!/n,

2, Bil/ *i'u/n /n?i/s (+/ *is+/i *.+si /n) l(i! +in)/n- !/+us

*i.+i'(/n)/n /)o+i )/n))u/n /n?i/s l/inn/ //u )/n))u/n /n?i/s

o(i,

&, Bil/ *i'u/n sin*+o' *.+si */n /n?i/s /n) 8uu. (+/ unu

'n)//n '/sin)7'/sin) *i/)nosis- '// *u/ *i/)nosis +s(u

*i'u//n- */n *i/)nosis )/n))u/n 8/'.u+/n i*/ */./ *i)un//n, Ji/

/+n/ ssu/u !/l !/n/ */./ *i'u//n s/u *i/)nosis '// )/n))u/n

*.+si !/+us *iu/'//n,

9, Bil/ )4/l/7)4/l/ +s(u (+/i/n +/ *n)/n s+s !i*u./n /n) 4l/s-

'// !/+us *i)un//n /)o+i F9&,2 )/n))u/n .nsu/i/n,

2. DIAGNOSIS BANDING

Di/)nosis (/n*in) 'n8/u. )/n))u/n /n?i/s */n *.+si l/inn/ s+/

)/n))u/n .+i(/*i/n, Di /n/+/ )/n))u/n /n?i/s- )/n))u/n /n?i/s

'nlu+u! '+u.//n )/n))u/n /n) l(i! (s/+ 'un)in/nn/ unu

(+u'./n) in*i! *n)/n )/n))u/n 8/'.u+/n /n?i/s7*.+si, Di/n/+/

)/n))u/n 'oo*- )/n))u/n *si'i- */n )/n))u/n *.+si +in)/n /*/l/!

)/n))u/n /n) l(i! (s/+ 'un)in/nn/ unu (+u'./n) in*i! *n)/n

)/n))u/n 8/'.u+/n /n?i/s7*.+si, Di/n/+/ )/n)))u/n .+i(/*i/n-

16


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)/n))u/n .+i(/*i/n 'n)in*/+- *.n*n- */n o(ssi o'.ulsi */./

''lii )4/l/ /n) 'i+i. *n)/n )4/l/ )/n))u/n 8/'.u+/n /n?i/s7*.+si,

Di/)nosis )/n))u/n so'/oo+' 4u)/ !/+us *i.+i'(/n)/n,

2. PEJALANAN GANGGUAN DAN PROGNOSIS

B+*/s/+/n *// linis s/'./i s// ini- ./sin /'./ s/'/ (s/+

'un)in/nn/ unu ''ilii )4/l/ /n?i/s /n) 'non4ol- )4/l/ *.+si

/n) 'non4ol- //u 8/'.u+/n *u/ )4/l/ *n)/n (s/+ /n) s/'/ s// /i/n,

Sl/'/ .+4/l/n/n .n/i- *o'in/si )4/l/ /n?i/s */n *.+si */./

(+)/ni/n, P+o)nosis n/ i*/ *i/!ui,

2. PENATALAKSANAAN

K/+n/ su*i /n) ''(/n*in)/n 'o*/li/s +/.i )/n))u/n 8/'.u+/n

/n?i/s7*.+si i*/ +s*i/- linis 'un)in l(i! 8n*+un) ''(+i/n

+/.i (+*/s/+/n )4/l/ /n) 'un8ul- ./+/!/nn/- */n in)/ .n)/l/'/n

linis +s(u *n)/n (+(/)/i 'o*/li/s +/.i, F/+'/o/.i unu )/n))u/n

8/'.u+/n /n?i/s7*.+si */./ 'n8/u. o(/ /ni/n?i/s- o(/ /ni*.+si-

//u *u/n/, An?i/s *i/+i/n s(/)/i /*//n *i'/n/ sso+/n) 'n)/l/'i

+s/!/n, O(/ /ni7An?i/s ''.un/i ((+/./ sinoni' /n/+/ l/in

.siol.i- +/nsuili+ 'ino+- /nsiolii- /ni/n?i *+u)s */n /nsiolii/,

D/l/' ''(i8/+//n o(/ /ni7An?i/s /n) ./lin) s+in) *i*n)/+ /*/l/!

*i/./' //u lo+*i/.osi*,

17


18/24

Pn))olon)/n o(/ /ni7/n?i/s +*i+i */+i Bno*i/.in */n Non7

Bno*i/.in, Bno*i/.in 8ono!n/ Di/./'- Klo+*i/.osoi*-

Lo+/./'- >lo(//'- B+o'/./'- O?/olo'- Klo+/./- Al.+/ol/'-

P+/./', S*/n)/n )olon)/n Non7Bno*i/.in- 8ono!n/" Sul.i+i*-

Bus.i+on- $*+o?in,

$i.os/ /n) *i)un//n s// ini 'n///n (/!/ sin*+o' An?i/s

*is(/(/n !i.+/i3i/s */+i ss' li'(i8 SSP /n) +*i+i */+i *o./'in+)i8-

non/*+n+)i8- s+onn+)i8 /n) *in*/li/n ol! GABA+)i8 /n)

'+u.//n su/u in!i(io+ nu+o+/ns'i+, O(/ /ni7An?i/s (no*i/.in

/n) (+/si *n)/n +s.o+n/ /n) //n 'n)7+ino+8 @'n)u//n

+4/ */+i the inhibitory action of GABA neuron- s!in))/ !i.+/i3i/s

+s(u '+*/, A*/.un on+/in*i/si .'(+i/n /ni7An?i/s ini /iu ./sin

*n)/n !i.+snsii +!/*/. (no*i/.in- )l/uo'/- 'i/sni/ )+/3is-

insuisinsi ./+u +oni- .n/i )in4/l */n .n/i !/i +oni,

P/*/ ./sin usi/ l/n4u */n /n/ */./ +4/*i +/si /n) (+l//n/n

@paradoxal reaction (+u./ )lis/!/n- i+i/(ili/s- *isin!i(isi- s./si/s oo

'nin)/ */n )/n))u/n i*u+, K+)/nun)/n +l/i s+in) +4/*i ./*/ in*i3i*u

*n)/n +i// .'inu' /lo!ol- .n/l/)un//n o(/ //u unstable

personalities, Unu 'n)u+/n)i +sio +)/nun)/n o(/- '/si'u' l/'/

.'(+i/n & (ul/n */l/' +n/n) *osis +/.ui, Ponsi 'ni'(ul/n

+)/nun)/n l(i! +n*/! */+i n/+oi/, Ponsi +)/nun)/n o(/

*is(/(/n ol! o(/ /n) '/si! sl/! *osis ++/!i+ (+l/n)sun) s/n)/

sin)/,

18


19/24

Pn)!ni/n o(/ s8/+/ 'n*/*/- //n 'ni'(ul/n )4/l/ .uus o(/-

./sin 'n4/*i i+i/(l- (in)un)- )lis/!- inso'ni/- +'o+- ./l.i/si- +in)/

*in)in- on3ulsi,

Unu s/'.in) /ni7An?i/s */./ (+u./ s*/si @+/s/

'n)/nu- /s./*//n (+u+/n)- in+4/ .sio'oo+ 'nu+un- '/'.u/n

o)nii 'l'/!- +l/s/si oo @+/s/ l'/s- 8./ ll/! */n l/in7l/in,

Ani*.+ss/n //u Ani*.+si /*/l/! o(/ unu 'n)//si //u

'n8)/! *.+si 'n/l, D.+si *i*inisi/n s(/)/i )/n))u/n 'n/l *n)/n

.nu+un/n 'oo*%/- !il/n)/n 'in/ //u .+/s//n sn/n)- /*/n/ .+/s//n

(+s/l/! //u +n*/! *i+i- )/n))u/n i*u+ //u .nu+un/n sl+/ '//n- suli

onsn+/si //u l'/!/n isi @#$O-2006, Sinoni' /ni *.+s/n /*/l/!

!i'ol.i/%!'ol.i8s- .sii n+)i+ //u /ni *.+ss/n, U'u'n/ /n)

*i)un//n s/+/n) /*/l/! */l/' )olon)/n +isili @'is/ln/ i'i.+/'in-

/'i+i.ilin- *o!i.in */n lo.+/'in,

Pn))olon)/n o(/ /ni *.+s/n +*i+i */+i )olon)/n T+isili%T+i88li8

Ani*.+ss/n @T>A- T+/sili- Ai.i/l- Mono/'in Osi*/s In!i(io+

R3+si(l @MAOI7R%RIMA- */n Sl8i3 S+oonin Ru./ In!i(io+ @SSRI,

Golon)/n T+isili 8ono!n/ A'i+i.ilin- I'i.+/'in- >lo'i.+/'in- Ti/n.in-

O.i.+/'ol, Golon)/n T+/sili 8ono!n/ Mi/ns+in- M/.+oilin- A'o?/.in,

Ani *.+s/n /i.i/l 8ono!n/ T+/o*on- Ti/n.in- Mi+//.in, Golon)/n

MAOI7R /iu Mo8lo('i*, S*/n)/n )olon)/n SSRI 8ono!n/ Sn+/lin-

Flu3o?/'in- Fluo?in- P/+o?in- */n >i/lo.+/',

19


20/24

B+*/s/+/n !i.osis- sin*+o'/ *.+si *is(/(/n ol! *isinsi

+l/i3 s/l/! s/u //u ((+/./ /'in+)i nu+o+/ns'i+ @no+/*+n/lin-

s+oonin- *o./'in ./*/ sin/.s nu+on *i SSP @!ususn/ ./*/ sis' li'(i8,

S(/)i/n (s/+ /ni *.+s/n *i.+8// (+4/ *n)/n ''.+l/'(/

.'(u/n)/n */n +7u./ su/u /7/ i'i/ *i */l/' o/ @nu+o+/ns'i+,

T+isili @T>A ''(lo/* reuptake */+i no+/*+n/lin */n s+oonin /n)

'nu4u nu+on .+sin/.s, SSRI !/n/ ''(lo/* reuptake */+i s+oonin,

MAOI7R 'n)!/'(/ .+us//n s+oonin ./*/ sin/.s, Mi/ns+in */n 'i+//.in

@T+/sili /i.i/l ''(lo/* +s.o+ /l/72 .+sin/.s, Si/. '/nis'

+4/ */+i /ni*.+s/n 'li(//n 'o*ul/si .+ //u .os sin/.s //u *is(u

+s.on l+oisiolo)is,

In*i/si /ni *.+s/n *iu4u/n ./*/ .n*+i/ *.+si */n /*/n)

(+)un/ 4u)/ ./*/ .n*+i/ /nsi/s o(i/- o(ssi7o'.ulsi- */n 'n8)/!

/'(u!/n *.+si, S*/n)/n on+/in*i/si */./ (+u./ .n/i 4/nun)

o+on+- )l/u8o'/- +nsi u+in- !i.+nsi .+os/- )/n))u/n un)si !/i- //u

.il.si, $/l ini *i*/s/+/n ./*/ ((+/./ s/'.in) /n) (i/s/ 'un8ul ./*/

.'(+i/n /ni *.+s/n- *i /n/+/n/ s/'.in) +isli */n MAOI (+u./

/niolin+)i @'ulu +in)- +nsi u+in- .n)li!//n /(u+- onsi./si-

sinus /i/+*i */n /ni/*+n+)i @.+u(/!/n EKG- !i.onsi, E s/'.in)

SSRI */./ (+u./ n/us/ '/u.un s/i ./l/,

Ji/ .'(+i/n l/! 'n8/./i *osis osi i'(ul atropine toxic

syndrome *n)/n )4/l/ si/si SSP- !i.+.i+si/- !i.+nsi- on3ulsi- *li+iu'-

8onusion */n*iso+in/si, Tin*//n /n) */./ *il/u/n unu 'n)//sin/

20


21/24

/iu G/s+i8 l/3/)- Di/./' 10 ') IM unu 'n)//si on3ulsi- Posi)'in

0-571 ') IM unu 'n)//si /niolin+)i @*/./ *iul/n)i si/. &0790

'ni !in))/ )4/l/ '+*/- s+/ Monio+in) EKG unu 'n*si l/in/n

4/nun),

Di/n/+/ o(/ /n?iolii- s4u'l/! *// 'nun4u/n (/!/ .n))un//n

+i/olo(no*i/.in- s.+i /l.+/ol/' @/n/? */./ *iin*i/si/n /+n/

i3i/sn/ */l/' 'n)o(/i *.+si /n) *is+/i /n?i/s, O(/ /n)

''.n)/+u!i +s.o+ 57$T- s.+i (usi.+on 4u)/ */./ *iin*i/si/n, Di /n/+/

/ni *.+s/n- 'si.un o+i no+/*+n+)i 'n)!u(un)/n )/n))u/n /n?i/s

*n)/n )/n))u/n *.+si- /ni *.+si s+oon+)i //u */+i )olon)/n SSRI

/n) ''.un/i s/'.in) 'ini'/l @8ono!n/ luo?in */./ 'n4/*i

o(/ /n) ./lin) i */l/' 'n)o(/i )/n))u/n 8/'.u+/n /n?i/s7*.+si,

T//l/s/n/ non7/+'/olo)is s/n)/ .nin) ./*/ ./sin *n)/n

G/n))u/n >//'.u+/n An?i/s */n D.+si- (+u./ Psio+/.i Su.o+i */n

Sosio+/.i (+o+in/si7ili/n, Psio+/.i */./ *il/u/n *n)/n

.sio*in/'i/- .sio/n/lis/ s+/ /n) .o.ul+ s// ini /iu >o)nii3

B!/3io+/l T!+/. /n) /'./n/ ''ilii '/n4u+/n 4/n)/ ./n4/n) */n

4/n)/ .n*, Pn*//n o)nii s8/+/ l/n)sun) 'n4//( *iso+si o)nii

./sin /n) *i!i.osis/n- */n .n*//n .+il/u 'n4//( lu!/n so'/i

s8/+/ l/n)sun), Tni u/'/ /n) *i)un//n */l/' .n*//n o)nii */n

.+il/u /*/l/! l(i! i *i(/n*in)/n ni +s(u 4i/ *i)un//n sn*i+i7

sn*i+i,

21


22/24

T/.i su.o+i 'n//+/n n+/'/n */n n/'/n/n (/)i ./sin-

/l/u.un '/n// 4/n)/ ./n4/n)n/ /*/l/! '+/)u/n, Psio+/.i (+o+in/si7

ili/n ''us//n unu 'n)un)/./n onli (//! s/*/+ */n 'n)n/li

u//n )o, S(/)i/n (s/+ ./sin 'n)/l/'i n*u+/n 8'/s/n /n)

4l/s 4i/ *i(+i/n s'.//n unu ''(i8/+//n suli/nn/ *n)/n *o+

/n) .+i!/in */n si'./i, Ji/ linisi 'n'u/n siu/si s+n/l /n)

'n(/(/n 8'/s/n- linisi 'un)in '/'.u sn*i+i/n //u *n)/n

(/nu/n ./sin //u lu/+)/n/ unu 'n)u(/! lin)un)/n */n *n)/n

*'ii/n 'nu+un/n /n/n /n) .nu! )/n)/n, Pnu+un/n )4/l/

s+in)/li ''un)in/n/n ./sin unu (+un)si s8/+/ i */l/'

.+4//n */n !u(un)/nn/ s!/+i7!/+i- /)n ''(+i/n sn/n)/n */n

.'u/s/n (/+u /n) *n)/n sn*i+in/ (+si/ +/.i,

Psio/n/lis/ '+u.//n /li+/n .siolo)i /n) ./lin) *in/l */n ''ilii

(/n/ .n)/+u! */l/' *uni/ .siolo)i */n *i (i*/n) l/inn/, $i.osis .oo

.sio/n/lis/ 'n///n (/!/ in)/! l/u '/nusi/ s(/)i/n (s/+ *inu/n

ol! 'oi7'oi i*/ s/*/+- s!in))/ Si)'un* F+u**i4ului s(/)/i (/./

.n4l/4/! */n .'(u/ ./ i*/s/*/+/n, P/*/ */* //l /(/* 20-

.sio/n/lis/ s'/in .o.ul+ */n ulis/n7ulis/n F+u* s'/in (+.n)/+u!,

P/n*/n)/n .sio/n/lii /*/l/! (/!/ */l/' /sus +nu 8'/s/n /*/l/!

su/u sin/l */+i /8/u/n (//! s/*/+ /n) ''+lu/n .'+is//n,

K8'/s/n */./ no+'/l- /*/.i- '/l/*/.i- +l/lu u/- //u +l/lu +in)/n-

+)/nun) ./*/ /*//n, K8'/s/n /'./ */l/' (+(/)/i siu/si sl/'/

22
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23/24

.+4/l/n/n silus !i*u. sso+/n) ./*/ (/n/ /sus- .n)u+/n)/n )4/l/ (u/n

'+u.//n u4u/n in*//n /n) ./lin) ./,

B/)i ./sin /n) s8/+/ .siolo)is (+'/su* */n +'oi3/si unu

'n)+i su'(+ 8'/s/nn/- .sio+/.i 'un)in '+u.//n .n)o(//n

+.ili!, T/.i .sio*in/'i/ (+4/ *n)/n /n))/./n (/!/ 8'/s/n

'un)in 'nin)/ ./*/ .n)o(//n /n) i, Tu4u/n .n*//n *in/'i/

/*/l/! unu 'nin)//n ol+/nsi 8'/s/n ./sin @*i*inisi/n s(/)/i

'/'.u/n unu 'n)/l/'i 8'/s/n /n./ !/+s 'l/'.i/s/nn/-

(u/nn/ unu 'n)!il/n)/n 8'/s/n,

23


24/24

DAFTAR PUSTAKA

K/.l/n- $,- S/*o8- Bn4/'in, 1;;:, Gangguan Kecemasan */l/' Sinopsis

Psikiatri: Ilmu Pengetahuan Perilaku Psikiatri Klinis disi ke!" #ilid $%

J//+/" Bin/ Ru./ As/+/, $/l, 266726:

To'(- D, A, 2000,Buku Saku Psikiatri disi &% J//+/ " EG>, $/l, ;67110

M/sli'- Rus*i, 2001, 'iagnosis Gangguan #iwa( )u*ukan )ingkas PP'G#!III%

J//+/" B/)i/n Il'u K*o+/n Ji/ F/ul/s K*o+/n Uni/

A'/4//, $/l, :27:5

M/sli'- Rus*i, 200:,Penggunaan Klinis +bat Psikotropik% J//+/" B/)i/n Il'u

K*o+/n Ji/ F/ul/s K*o+/n Uni/ A'/4//, $/l, 12

>n+ En- MD- >' O/- MD- As B/8/nli- MD- B*i/ Guln- MD- >'

Ko./+/n- MD- S/n*+/ S+'in U)+/s- MD- =il*i+/ >- MD,Anxiety and

'epressi,e 'isorders in Patients Presenting with -hest Pain to the

mergency 'epartment: A -omparison Between -ardiac and .on!-ardiac

+rigin% , M*s8/. R+n8 2011 u.*/* 2;%0&%2011 8i* on Jun

201& A3/il/(l +o'" !."%%'*i8in,'*s8/.,8o',
http://emedicine.medscape.com/http://emedicine.medscape.com/

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