RESUME SCHIZOPHRENIA AND DEPRESSION

Arranged in order to complete the assignment of Mental Health of Nursing course II

Lecturer Ns. Keksi Girindra Swasti, M.Kep., Sp.Kep.J

By:
Fuzna Dahlia Mudzakiroh I1J020010
International Class (C)/Semester V/Batch 2020

DEPARTMENT OF NURSING
FACULTY OF HEALTH SCIENCES
JENDERAL SOEDIRMAN UNIVERSITY
PURWOKERTO
2022
 SCHIZOPHRENIA
Currently mental health has become one of the issues that must be addressed, it's just that the
Indonesian people still often ignore the importance of mental health. One of the most common
mental disorders is schizophrenia. Schizophrenia is a group of psychotic disorders, with a basic
personality disorder, characteristic distortions of mental processes think. Sometimes he has a
feeling that he is being controlled by outside forces. This disorder is generally characterized by
disturbances in thoughts and perceptions that are wrong and distinctive, and blunt effect.
Schizophrenia is a mental disorder characterized by disturbances in thought patterns,
perceptual processes, affection and social behavior (Kopelowicz, Liberman, Wallace, 2003).
Patients diagnosed with schizophrenia usually also show positive symptoms, such as
hallucinations and delusions and negative symptoms, such as social withdrawal, self-neglect,
loss of motivation and initiative and blunted emotions (Picchioni & Murray, 2007).
Traditionally, schizophrenia may involve positive symptoms, such as hallucinations, delusions,
formal thought disorders, and negative symptoms, such as paucity of speech, anhedonia, and
lack of motivation. This activity outlines the evaluation of schizophrenia and explains the role
of the interprofessional team in improving care for patients with this condition.
Bleuler (in Nevid, 2012) adds that schizophrenia can be recognized based on the main
symptoms/4A: (1) Association, namely the relationship between thoughts being disturbed or
commonly referred to as thought disorders and loose associations; (2) Affect, ie emotional
response to be flat or inappropriate; (3) Ambivalence, ie individuals have ambivalent feelings
towards others such as hate and love for their partner; (4) Autism, namely withdrawal into a
private fantasy world that is not bound by the principles of logic. Schizophrenia is a disorder
characterized by positive symptoms (delusions and hallucinations), negative symptoms (apathy
and withdrawal), disorganized symptoms (disorganized thoughts and actions) and cognitive
impairment (memory, attention, working memory, problem solving, processing speed and
social cognition). A person with schizophrenia has a limited and isolated existence, in addition
to high unemployment, low income and poor physical health.
Schizophrenia disorders are divided into 3 types, namely disorganized, catatonic and paranoid
schizophrenia (APA, 2000). This type of disorganization is often described as chaotic behavior,
incoherent speech and disorganized delusions with sexual/religious themes. The hebephrenic
type often appears in the form of slowing of activity that progresses to stupor and even
agitation. The paranoid type is seen with frequent auditory hallucinations and delusions that
cause anxiety or fear (Nevid, 2005).
Patients with schizophrenia in Indonesia itself are increasing every year. There was an increase
in the prevalence of schizophrenia from 1.7% in 2013 to 7% in 2016. The prevalence of
schizophrenia in Indonesian society in 2016 reached around 400,000 people/ 1.7 per 1,000
population (Riskesdas, 2013). Symptoms of schizophrenia generally develop in late
adolescence or early adulthood, starting from the age of 20 years (Harrop & Trower, 2001).
Not only the number of people with schizophrenia is quite large, the number of sufferers who
experience relapse/relapse is also quite large. Relapse is the reappearance of the symptoms of
the disorder after the patient is hospitalized. Patients who relapse have the potential to endanger
themselves and those around them so they must return to hospitalization (Amelia & Anwar,
2013).
Until now, the cause of schizophrenia is not known with certainty. Various factors such as
genetic factors, mental resilience, personality and environmental factors are thought to play a
role in aggravating the number of people with schizophrenia in the world. Genetic factors such
as the role of the overactive neurotransmitter dopamine, which disrupts the work of the brain,
have led to the emergence of major antipsychotic/sedative drugs as a treatment method
schizophrenia. There are also studies regarding the brain volume of schizophrenic patients 5%
smaller than normal people, with the largest reduction in the cerebral cortex (Cowan & Kandel,
2001).
Prevention of relapse in schizophrenic patients can be accomplished with adequate preparation
for discharge and mobilization of existing health care facilities in the community. This is
particularly the participation and support of the family. Families with high emotional
expression will cause a relapse in family members with schizophrenia. Kassim (1998) suggests
that emotional behavior is believed to affect the future of schizophrenic patients.

DEPRESSION
Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest.
The American Psychiatric Association’s Diagnostic Statistical Manual of Mental Disorders,
Fifth Edition (DSM-5) classifies the depressive disorders into Disruptive mood dysregulation
disorder; Major depressive disorder; Persistent depressive disorder (dysthymia); Premenstrual
dysphoric disorder; and Depressive disorder due to another medical condition. The common
features of all the depressive disorders are sadness, emptiness, or irritable mood, accompanied
by somatic and cognitive changes that significantly affect the individual’s capacity to function.
This activity reviews the evaluation and management of depression and the role of
interprofessional team members in collaborating to provide well-coordinated care and enhance
patient outcomes.
Depression is an emotional condition that is usually characterized by extreme sadness, feelings
of meaninglessness and guilt (withdrawal, unable to sleep, loss of appetite, interest in daily
activities), in Gerald C. Davison 2004. According to Rice PL (1992) Depression is a mood
disorder, a prolonged emotional condition that colors all mental processes (thinking, feeling
and behaving) a person. In general, the dominant mood that appears is a feeling of helplessness
and lost hope.
According to Iyus Yosep (2007), depression is a form of mental disorder in the realm of
feelings (affective, mood) which is characterized by moodiness, sadness, lethargy, loss of
passion for life, lack of enthusiasm, and feeling helpless, feeling guilty or sinful, useless. and
despair. Chaplin (2002) defines depression in two conditions, namely in normal people and in
pathological cases. In normal people, depression is a state of depression (sadness,
discouragement) which is characterized by feelings of inadequacy, decreased activity, and
pessimism about the future. Whereas in pathological cases, depression is an extreme
unwillingness toreacts to stimuli, with decreased self-worth, delusions of hopelessness,
inadequacy, and hopelessness.
Meanwhile, according to Kartono (2002), depression is a gloomy heart (pain, sadness, blurry
feelings) that are pathological in nature. Usually arise by; feelings of inferiority, deep hurt, self-
blame and psychological trauma. If depression is psychotic in nature, it is called melancholia.
Based on some of the definitions above, it can be concluded that depression is an emotional
disorder or a bad mood characterized by prolonged sadness, hopelessness, feelings of guilt and
meaninglessness. So that all mental processes (thinking, feeling and behaving) can affect
motivation for activities in daily life and interpersonal relationships.

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest.
The American Psychiatric Association’s Diagnostic Statistical Manual of Mental Disorders,
Fifth Edition (DSM-5) classifies the depressive disorders into:

a) Disruptive mood dysregulation disorder

b) Major depressive disorder

c) Persistent depressive disorder (dysthymia)

d) Premenstrual dysphoric disorder

e) Depressive disorder due to another medical condition

The common features of all the depressive disorders are sadness, emptiness, or irritable mood,
accompanied by somatic and cognitive changes that significantly affect the individual’s
capacity to function.

Because of false perceptions, nearly 60% of people with depression do not seek medical help.
Many feel that the stigma of a mental health disorder is not acceptable in society and may
hinder both personal and professional life. There is good evidence indicating that most
antidepressants do work but the individual response to treatment may vary.

Depression is caused by a combination of several factors. If a person has a family history of

depression, then there is a tendency to experience depression as well. According to Kaplan
(2002) and Nolen - Hoeksema & Girgus (in Krenke & Stremmler, 2002), the factors associated
with the cause can be divided into: biological factors, psychological factors / personality and
social factors. Where these three factors can influence each other.

There are two types of depression, namely:

1. Major Depressive Disorder (MDD)

MDD is characterized by emotional states of sadness and loss ability to enjoy usual activities
performed, together with at least 4 (four) of the symptoms below this:

a) Sleeping too much (10 hours or more) or too little (difficulty falling asleep, waking
frequently).
b) Motor stiffness.
c) Loss of appetite and weight loss drastic or vice versa overeating so heavy body increased
dramatically.
d) Loss of energy, weakness, lack of enthusiasm, no interested in doing anything.
e) Feeling worthless.
f) Difficulty concentrating, thinking, and making decision.
g) Repeated thoughts of death or suicide.

These symptoms appear most of the day, every days, for a minimum of 2 (two) weeks and not
due to a reasonable loss, for example due to husband/wife died. MDD is often called society
commonly referred to as depression.

2. Dysthymic Disorder (Dysthymic Disorder / Dysthymia)

It is a chronic depressive disorder. Individuals who diagnosed with dysthymic depression more
than half of the time from a minimum of 2 (two) years. So, within a period of 2 (two) years,
half of the time the individual is experiencing a depressive condition, at least experiencing 2
(two) of the following symptoms:

a) Loss of appetite or vice versa.

b) Sleeping too much/too little.
c) Feeling worthless.
d) Difficulty concentrating and making decisions.
e) Feeling hopeless

Symptoms are not obvious for more than 2 (two) months. Not there was an episode of MDD
during the first 2 years of symptoms appearing. Symptoms experienced are milder than MDD
but with a longer time.
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