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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    27

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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