Jiwa Koas
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1
PSYCHOSIS
MANAGEMENT ? MULTIMODAL
RSPAD
GS
PREVENTION
SPECIFIC BIOLOGICALRISK (GENE)
NEURODEVELOPMENT/DEGENE-RATIVE
CHILD PSYCHOLOGICALTRAUMA
SPECIFIC RISKCONDITIONS (POVERTY,
ILLNESS, DRUGABUSE)
TREATMENT/REHABILITA
TION
PRODROMAL-ACUTE-CHRONIC
MEDICATION, T SYMPT,SE
DENIAL, COMPLIANCE,RELAPSING
AGITATION-SUICIDE
CBT, FAM TH/, SOCIALINTERVENTION
EARLY DETECTIONASSESSMENT
PSYCHOLOGICAL PROTECTOR/BUFFERPSYCHOEDUCATION. P SOLVING.
RESILIENCE. COPING M
PSYCHOLOGICALREADINESS/FUNCTIONAL
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PREVENTION
2
ELIMINATERISK
FACTORS
# GENETIC 70-80%
## NON GENE20-30%
PREMORBID-NEURODEVELOPMENT
OBSTETRICCOMPLICATION
ENVIRONTMENTPRE-PERINATAL
DEGENERATIVE P
PSYCHOLOGICAL
SOCIAL-CULTURE
PARENTING
MENTAL HEALTHCARE
SPECIALEDUCATION
PSYCHOLOGICALBUFFER
SYMPTOMS
PSYCHOSIS
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MENTAL HEALTHSPECTRUM
MENTALWELL-BEING
MENTALDISORDERS
PSYCHOLOGICAL DISTRESS
BURDENSINVESTMENT
RISKS PRODUCTIVITY AVOIDED LOST
(MENTALCAPACITY
SOCIAL-ECONOMICLOST OPPORTUNITY
LOST
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PSYCHOPATHOGENESIS
FAKTORSOSIAL-BUDAYA
FAKTOR PSIKO-EDUKATIF
FAKTORORGANO-BIOLOGIK
KEPRIBADIAN
LINGKUNGAN
ADAPTIF
(Sehat)
eg.Well-being
+Productive
MAL-ADAPTIF
(Sakit)
eg.Distress+Disabi
lity
COPINGMECHANISM
TRAIT(G!"!#$%B!&'$*)
ABILITY(S+$
B!&'$*)
CHARACTER(M*' B!&'$*)
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NON GENETIC -0
PREGNANCY AND BIRTHCOMPLICATION
PERINATAL AND EARLY CHILHOODBRAIN DAMAGE
FOETAL MALDEVELOPMENT
SEASON OF BIRTH
HEAVY METAL Pb H! A" C $
DRUG ADDICTION
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TREATMENT /REHABILITATION
&
VERY EARLY-EARLY ONSET 11PRODROMAL PHASEFIRST EPISODE OF
PSYCHOSIS
MEDICATIONSCOGNITIVE BEHAVIORAL THERAPY
PSYCHOLOGICAL SUPPORT
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EARLY ONSET PSYCHOSIS
7
ETIOLOGYGENETIC, NON GENE
FACTS SR.. 2 #&, . 34 5 6/- 7.7
BRAIN --------------------------------DNA
ASSESSMENTPRODROMAL INSIDIOUS FIRST EPISODE
MANAGEMENT
INTERVENTIONMEDICATION-PSYCHOTHERAPY-
SOCIAL INTFOCUS MENTAL HEALTH
(PREVENTION)HOLISTIC APPROACH
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BRAIN '''
8
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THEORIES OF SR DINAMIK I8-!9-:;
BIOLOGIK FUNGSI OTAK
- NEURODEGENERATIVE /ABNORMAL BRAIN DEVELOPMENTAL
PRENATAL,VIRUS,TO=IC,INFECTION, AUTOIMUN , STRAVATION, ANO=IA,TRAUMA, STRESS ...DST
- BIOMOLECULAR(GENE PROGRAMMING)
4 KUNCI UNTUK PEMBENTUKAN PROTEINKONEKSITAS DAN
SINAPTOGENESIS
> BDNF(BRAIN DERIVED NEUROTROPC FACTOR)
> DYSBINDIN (DYSTROBREVIN BINDING PROTEIN-3)SINAPSIS
> NEUREGILINNEURONAL MIGRATION,GENESIS GLIA,
MIELINISASI
> DISC-1(DISRUPTED IN SR-3)NEUROGENESIS, MIGRATION,DENDRITIC
ORGANIATION - DOPAMINERGIC-GLUTAMINERGIC PATHWAY
SOSIAL BEBAN HIDUP (STRESSOR PSIKOSOS)
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S(I)OFRENIA *DISREGULASI+,ARAS DOPAMINERGI('
MESOLIMBIK HIPERFUNGSI POSITIFSIMTOM
MESOKORTIKAL (DLPFC)
HIPOFUNGSI
KOGNITIF SIMTOM DAN NEGATIF SIMTOM
MESOKORTIKAL (VMPFC)HIPOFUNGSIAFFEKTIF SIMTOM DAN NEGATIF SIMTOM
NIGROSTRIATAL NORMAL
TUBEROINFUNDIBULAR NORMAL
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@ARAS GLUTAMAT(DESENDING PATHWAY) -@ARAS DOPAMIN (ASENDING P'#&')??
POSITIF SIMTOM DI MESOLIMBIK HIPOFUNGSI GLUTAMINERGIC (CORTICO-BRAINSTEM PRO@ECTION)HIPERFUNGSI DOPAMINERGIC WAHAM
HALUSINASI
HIPO AKTIF DOPAMINERGIC DI MESOKORTIKAL NMDA RECEPTORNEGATIF SIMTOM, KOGNITIF SIMTOM,AFEKTIF SIMTOM.
@ARAS GLUTAMAT DESENDING PATHWAY ( KORTEKS KE BATANG OTAK) #'+)
NEURON SEL GLIA, SEL PIRAMIDALIS
RESEPTORNYA NMDA (N METYL-8-ASPARTAT) MENGANDUNG GLISIN /8SERINE (GLIA SEL) , GLISIN DIPENGARUHI OLEH 8-SERINE. 8-AMINO ACIDO=YDASE ACTIVATOR (DAOA) MEMECAH 8-SERIN 8'" HYDRO=YPYRUVATE .DAOA (REGULATOR GENE)/NEURODEVELOPMENTAL
ADA 7 @ARAS GLUTAMINERGIC DI PREFRONTAL KORTEKS DARI SEL-SELPIRAMIDALIS SEBAGAI MASTER SWITH HIPOFUNGSI GLUTAMAT DANNMDA RESEPTOR SEBAGAI HIPOTESA DARI SKIOFRENIA . NEGATIFSIMTOM SR TER@ADI HIPOFUNGSI CORTICO-CORTICAL GLUTAMIC PATHWAY
GLUTAMAT MERUPAKAN E=ITATOR MERANGSANG RESEPTOR NMDA IONOTROPIC "9 #!* P#!"#$' (LTP) ,C' 66 !"$"9+'# PLASTISITAS
SINAPTIK DAN E=CITOTO=ICITY
'
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O./.N./..456.
B!*! B$*#& 9
S.6 :.44N./!..""I6;/. N./M!/; < D=./.;. >5. ?
N./
S>;5!..""
N./;4S.4.:
A?./ B/@
D=./.; M>.4; S>;5!..""
:65.. E46;
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NEURODEVELOPMENT
DISC I DISC I
S#! C! S!!%#$" M$9*'#$"D$M!$"'#$"
NRG NRG D>"bDGSDAOA
S"'
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M!::'9! !!%#*$%'/%&!$%' R!%!
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OBAT RESEPTOR DOPAMIN(D),SEROTONIN (7HTA), @ARAS
GLUTAMAT(NMDA RECEPTOR)
TYPI(AL BLO(ADE D2 RESEPTORMESOLIMBI(
ATYPICALBLO(ADE PARTIAL D2RESEPTOR MESOLIMBI(
HT2A HIPO DOPAMINERGI(
HT2A MESO(ORTI(AL
GLUTAMINERGIC DOPAMINERGIC
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F;:$" ' :"';5: .":4." @ @../. ./6;4 6.6b/;. ; "b".. /.4.;". ?:@.6:;4 .//;"6./ @. ">;5: :4.? S>;5:.":4." 6. @. ; ; b /.4.;". "." @.5/.-">;5: 6.6b/;. ; .":4.-6.6b/;. 5/." -
SNARE ; ;/!.-6.6b/;. 5/." -SNARE" T@"SNARE :654. ./;:" @ b@ NSF N-.@>46;4.6.S.". F" 5/. ; SNAP S4b4. NSF A;:@6.P/." ?/6 ; ?" :654. A: 5.;45/5;!; :." :;4:6 ; @. 5/.-">;5:6.6b/;. @:@ ; ATP @>/4>"" b> NSF/."4" ";"".6b4> ? @. SNARE :654. ; 6.6b/;.?" F44! .//;"6./ /.4.;". ">;5: .":4.6.6b/;. :65." ;/. /.:>:4. ; ; .:>:5/:.""
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BRAIN CIRCUITSSYMPTOM
28
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BRAIN DEVELOPMENT
NEURON GENES PROTSYNTHESIS
SYNAPSIS PRESYNAP POSTSYNAP
RECEPTOR 123
EN)YM
PATHJAY DOPAMINERGIC
PATJAY GLUTAMINERGIC
2K
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STRESS INVOLVED TO SOMATIC SYMPTOMS
30
HARMFUL STIMULUS
( STRESS)
ADAPTATIONSYNDROME
DISEASES OFADAPTATION
PROTEIN + FATDEPOTS
HEPATICGLYCOGEN
BLOODSUGAR
TISSUES
TrophicHarmone
CEREBRALCORTE!"CONFLICT#
ANTERIORPITUITARY
Epin
eph
rine
H>5@;4;6"
S
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BIOPSYCHOSOCIAL STRESSOR
31
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-METABOTROPIC
32
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SYNAPTOGENESISLEARNING EMOTIONALMATURITY COGNITIVE DEVELOPMENTAL MOTOR
S(ILLS THROUGHOUT LIFE
33
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MESSAGE SIGNAL TONEURON
3
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SPEED 00 (MH/
3
NEURODEGENERATIVE
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NEURODEGENERATIVEI. ASYMTOMATIC 37 T& GENETIC AT RISKII. PRODROMAL/NEGATIVE SYMPTOMS 37 - T& SOSIAL WITHDRAWLIII. ACUTE PHASE 4 FIRST-SECOND...EPISODE .. FULLSYNDROMESIV. NEGATIVE/COGNITIVE SYMPTOMS 4 5 T& RESISTENCY TH/
E=CITOTO=IC (GENE PROG,PRENATAL ANO=IA,TO=INS,INFECTION) DEMENTIA,PARKINSONS 8,ALS
3&
NEURODEGENERATIVE THEORIES OF SR
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NEURODEGENERATIVE THEORIES OF SRNMDA RECEPTORN-METHYL-8 ASPARTATEPOSITIF SIMTOM AKHIRNYA NEGATIFSIMTOM
37
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CELLULAR STRUCTURES
38
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MITO(HONDRIA GENES NEUROTRANSMITTER
3K
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MOLECULER PSYCHIATRY
0