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KAJIAN PUSTAKA TERAPI NON FARMAKOLOGI PADA PENDERITA GANGGUAN AFEKTIF BIPOLAR Oleh : ABRORI FADILLA 201410330311002 FAKULTAS KEDOKTERAN UNIVERSITAS MUHAMMADIYAH MALANG 2020
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  • KAJIAN PUSTAKA

    TERAPI NON FARMAKOLOGI PADA PENDERITA GANGGUAN

    AFEKTIF BIPOLAR

    Oleh :

    ABRORI FADILLA

    201410330311002

    FAKULTAS KEDOKTERAN

    UNIVERSITAS MUHAMMADIYAH MALANG

    2020

  • i

    KAJIAN PUSTAKA

    TERAPI NON FARMAKOLOGI PADA PENDERITA GANGGUAN AFEKTIF

    BIPOLAR

    Oleh:

    ABRORI FADILLA

    201410330311002

    UNIVERSITAS MUHAMMADIYAH MALANG

    FAKULTAS KEDOKTERAN

    2020

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  • vi

    KATA PENGANTAR

    Puji syukur kehadirat Allah SWT karena atas rahmat dan hidayah-Nya, penulisan

    tugas akhir ini dapat diselesaikan dengan baik dan tepat waktu. Shalawat serta

    salam selalu tercurahkan kepada Rasulullah Muhammad Shalallahu Alaihi

    Wasallam, keluarga, para sahabat, dan pengikut beliau yang telah membawa dunia

    ini dari zaman kegelapan menuju zaman terang benderang.

    Penelitian tugas akhir ini berjudul “Terapi Non Farmakologi pada Penderita

    Gangguan Afektif Bipolar”. Tugas akhir ini diajukan untuk memenuhi persyaratan

    Pendidikan Sarjana Fakultas Kedokteran Universitas Muhammadiyah Malang.

    Penulis menyadari tugas akhir ini masih jauh dari kata sempurna, oleh karena itu,

    penulis sangat mengharapkan saran dan masukan yang membangun. Semoga

    karya tulis ini dapat menambah wawasan keilmuan dan bermanfaat bagi semua

    pihak.

    Wassalamu’alaikum Warahmatullahi Wabarakatuh.

    Malang, 29 Juli 2020

    Penulis

  • vii

    UCAPAN TERIMAKASIH

    Pada kesempatan ini, penulis menyampaikan terimakasih yang sebesar besarnya

    kepada:

    1. Dr.dr. Meddy Setiawan, Sp.PD. FINASIM, selaku Dekan Fakultas

    Kedokteran Universitas Muhammadiyah Malang sekaligus selaku

    pembimbing 2 atas kesabaran, kebaikan hati, dan kesediaan waktu untuk

    membimbing serta penyampaian ilmu yang sangat bermanfaat bagi masa

    depan para mahasiswa FK UMM

    2. dr. Moch. Ma’roef, Sp.OG, selaku Wakil Dekan I Fakultas Kedokteran

    UMM yang senantiasa bersabar dalam membimbing dan mengajarkan

    ilmunya kepada kami.

    3. dr. Sri Adila Nurainiwati, Sp.KK, selaku Wakil Dekan II Fakultas

    Kedokteran UMM yang senantiasa bersabar dalam membimbing dan

    mengajarkan ilmunya kepada kami.

    4. dr. Indra Setiawan, Sp.THT-KL, selaku Wakil Dekan III, yang penuh

    semangat dalam menyampaikan ilmu dan motivasi yang membangun

    semangat kami selama menjalani pendidikan di Fakultas Kedokteran.

    5. Dr. dr. Fathiyah Safithri, M.Kes. selaku Ketua Prodi Fakultas Kedokteran

    Universitas Muhammadiyah Malang yang senantiasa bersabar dalam

    membimbing dan mengajarkan ilmunya kepada kami.

    6. dr. Iwan Sys Indrawanto, Sp.KJ., selaku dosen pembimbing I saya yang

    telah memberikan inspirasi, waktu, kesabaran dan masukan yang sangat

    membantu dalam menyelesaikan tugas akhir ini dengan baik.

  • viii

    7. dr. Hanna Cakrawati, M.Biomed, selaku penguji tugas akhir ini, atas segala

    masukan dan arahan yang sangat bermanfaat dalam pengerjaan tugas akhir

    ini dan kesediaan waktu, sehingga tugas ini dapat diselesaikan dengan baik.

    8. Para dosen pengajar FK UMM yang telah memberikan bekal ilmu dan

    pengetahuan.

    9. Para staf Kependidikan FK UMM yang telah banyak membantu dalam

    proses administrasi dan lainnya.

    10. Orang tua tercinta, mama dan papa yang senantiasa memberi dukungan

    moril, materil, motivasi dan rohani serta telah menjadi sumber semangat

    penulis untuk bisa menyelesaikan karya tulis ilmiah ini.

    11. Saudara – saudara saya, Adik, Paman, Bibi, dan Nenek yang senantiasa

    membantu, memberi motivasi, dan mendoakan sehingga penulis bisa

    menyelesaikan karya tulis ilmiah ini.

    12. Sejawat FK UMM angkatan 2014, Medulaspinalis, atas dukungan, bantuan,

    dan kerjasamanya. Semoga semua kelak dapat menjadi dokter profesional

    yang barokah, sukses dunia akhirat, dan senantiasa dalam ketaatan kepada

    Allah Subhanahu Wata’ala.

    Penulis menyadari tugas akhir ini masih jauh dari kata sempurna, oleh

    karena itu, penulis sangat mengharapkan saran dan masukan yang membangun.

    Semoga karya tulis ini dapat menambah wawasan keilmuan dan bermanfaat bagi

    semua pihak.

    Wassalamu’alaikum Warahmatullah Wabarakatuh

  • ix

    Malang, 29 Juli 2020

    Penulis

  • xiv

    DAFTAR ISI

    SAMPUL DALAM .......................................................................................... i

    PRASYARAT GELAR .................................................................................... ii

    LEMBAR PENGESAHAN ............................................................................. iii

    PERNYATAAN ORIGINALITAS ................................................................. iv

    LEMBAR PENGUJI ........................................................................................ v

    KATA PENGANTAR ..................................................................................... vi

    UCAPAN TERIMAKASIH ............................................................................. vii

    RINGKASAN .................................................................................................. x

    SUMMARY ..................................................................................................... xii

    DAFTAR ISI .................................................................................................... xiv

    DAFTAR TABEL ............................................................................................ xvi

    DAFTAR GAMBAR ....................................................................................... xvii

    DAFTAR SINGKATAN ................................................................................. xviii

    DAFTAR LAMPIRAN .................................................................................... xix

    BAB I PENDAHULUAN ........................................................................... 1

    1.1 Latar Belakang ........................................................................... 1

    1.2 Rumusan Masalah...................................................................... 3

    1.3 Tujuan Penulisan ....................................................................... 3

    1.4 Manfaat Penulisan ..................................................................... 3

    BAB 2 TINJAUAN PUSTAKA ...................................................................... 4

    2.1 Definisi Gangguan Bipolar ........................................................ 4

    2.2 Epidemiologi Gangguan Bipolar ............................................... 4

    2.3 Klasifikasi Gangguan Bipolar ................................................... 6

    2.4 Gambaran Klinis Gangguan Bipolar ......................................... 7

    2.4.1 Episode Mania ........................................................... 7

    2.4.2 Episode Depresi .......................................................... 8

    2.4.3 Episode Hipomanik .................................................... 9

    2.4.4 Episode Campuran ...................................................... 9

    2.4.5 Sindrom Psikotik ........................................................ 10

  • xv

    2.5 Etiologi Gangguan Bipolar ........................................................ 10

    2.5.1 Faktor Biologis ........................................................... 11

    2.5.2 Faktor Genetika .......................................................... 11

    2.5.3 Faktor Psikologis ........................................................ 12

    2.5.3.1 Peristiwa Kehidupan dan Lingkungan ..................... 13

    2.5.3.2 Faktor Dukungan Sosial dan Lingkungan ............... 14

    2.5.3.3 Faktor Kepribadian .................................................. 14

    2.6 Diagnosis Gangguan Bipolar ..................................................... 15

    2.6.1 Gangguan Bipolar I ..................................................... 15

    2.6.2 Gangguan Bipolar II ................................................... 21

    2.6.3 Gangguan Siklotimik .................................................. 26

    2.7 Penatalaksanaan Gangguan Bipolar .......................................... 27

    2.7.1 Penatalaksanaan Farmakoterapi .................................. 27

    2.7.2 Penatalaksanaan Non Farmakologi ............................. 31

    BAB III PEMBAHASAN ................................................................................ 42

    BAB IV PENUTUP ......................................................................................... 47

    4.1 Kesimpulan ................................................................................ 47

    4.2 Saran .......................................................................................... 48

    DAFTAR PUSTAKA ...................................................................................... 49

    LAMPIRAN ..................................................................................................... 55

  • xvi

    DAFTAR TABEL

    Nomor Judul Tabel Halaman

    Tabel 2.1 Rekomendasi Farmakologi untuk

    GB-1, Mania Akut

    Tabel 2.2 Rekomendasi Farmakologi Untuk

    GB-1, Depresi Akut

    Tabel 2.3 Rekomendasi Farmakologi Untuk

    GB-I, Rumatan

    Tabel 2.4 Rekomendasi Farmakologi Untuk

    GB-II, Depresi Akut

    Tabel 2.5 Rekomendasi Farmakologi Untuk

    GB-II, Rumatan

  • xvii

    DAFTAR GAMBAR

    Nomor Judul Gambar Halaman

    Gambar 2.1 Contoh Pelaksanaan ECT pada

    Pasien

    Gambar 2.2 Gambaran Pelaksanaan TMS

    Gambar 2.3 Gambaran Pasien dengan Tindakan

    DBS

    Gambar 2.4 Pasien Dengan Terapi Bright Light

  • xviii

    DAFTAR SINGKATAN

    DSM-IV-TR : Diagnostic and Statistical Manual of Mental Disorder-IV-

    text revised

    DSM V : Diagnostic and Statistical Manual of Mental Disorder V

    5-HIAA : 5- hidroksiindolasetat

    HVA : Asam Homovanilat

    MHPG : 3-metoksi-4-hidroksifenilglikol

    PHK : Pemutusan Hubungan Kerja

    CANMAT : The Canadian Network for Mood and Anxiety Disorder

    EKG : Elektrokardiografi

    EEG : Elektroensefalografi

    EMG : Elektromiografi

  • xix

    DAFTAR LAMPIRAN

    Nomor Judul Lampiran Halaman

    Lampiran 1 Jurnal Pembahasan

    Lampiran 2 Buku Pembahasan

  • 49

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    Segal, Zindel V et al. 2012. Mindfullness Based Cognitive Therapy for

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    Amir N. 2018. Buku Ajar Psikiatri edisi 3. Jakarta: Badan Penerbit FKUI

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  • 50

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  • 51

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