JAKARTA – Mental health challenges such as Bipolar Disorders (GB) and Skizophrenia, which used to be thought to only attack adults, now also affect children and adolescents with alarming levels. Some studies and experience at the practice table show that cases that arise early or early-onset occur at younger ages.
In handling it, there are many obstacles and challenges that must be faced. Prof. Dr. dr. Tjhin Wiguna, SpKJ, SubSp. AR (K), MIMH, Professor of Child and Youth Subspecials FKUI-RSCM stated that they are often not diagnosed due to lack of awareness or misinterpretation of symptoms as common adolescent behavior. Mental health conditions like this can interfere with developments, education, and youth relationships if not treated properly.
Some obstacles and challenges in handling GB and Skizophrenia in children and adolescents include: symptoms that overlap with symptoms from other mental disorders such as symptoms of ADHD, autism, etc.; sometimes considered a natural child’s behavior even though they have shown early signs; child communication barriers that may not be able to express what they feel or think; lack of study and management that is standard specifically for children and adolescents; non-compliance with treatment; to the stigma of parents and people who feel mental disorders are still taboo so they tend to deny or hide these conditions,” explained Prof. Tjhin.
Prof. Tjhin again explained that GB or Skizophrenia in children and adolescents is a chronic condition. However, even so with effective treatments such as appropriate and appropriate comprehensive management, it can certainly help to cope with symptoms, and improve the quality of life of children and adolescents significantly.
“With proper handling, children and adolescents can learn to manage changes in their feelings so that they can recover and live a life that remains productive in society,” he said.
Therefore, the role of compliance or compliance and optimal treatment in the recovery of pediatric and adolescent patients with GB and Skizophrenia is very crucial and has a direct impact on long-term prognosis, condition stability, and quality of life.
“Those who obey generally rarely experience recovery, can improve social relations, follow education normally, and are more consistent in carrying out their responsibilities as children or adolescents. However, the main challenges in handling cases of GB and Skizophrenia so far are ‘compliance with treatment’ and ‘optimal implementation’ because in Indonesia there are still many people who are afraid of bad stigma, lack of mental health literacy, as well as concerns about the long-term drug influence on the development and growth of children and adolescents,” explained Prof. Tjhin.
Prof. Tjhin added, family and the surrounding environment, or referred to as support system, have an important role for children and adolescents with GB and Skizophrenia. This support has a direct impact on meaningful emotional stabilization and psychological strengthening, increasing compliance with treatment, helping to reduce negative stigma and social isolation, as well as encouraging social recovery and the academic function of children and adolescents.
“Therefore, family and the surrounding environment as the first support system, must be willing to expand their knowledge and understanding, namely continuing to learn related to GB and Skizophrenia in children and adolescents, want to be directly involved in managing management, and be a reminder so that children and adolescents can seek regular treatment, take drugs according to the rules given, and undergo regular psychosocial therapy. Likewise with the surrounding environment. The point is, handling does require an eklectic, holistic, and multidisciplinary approach. ” he said.
On the same occasion, Dr. dr. Khamelia Malik, SpKJ(K), FKUIRSCM Mental Medicine Specialist explained, similar to the conditions in children and adolescents, GB and Skizophrenia in adults will certainly reduce their quality of life. GB in adults is also characterized by extreme changes in the atmosphere of feelings or mood, energy, and level of activity, which often alternate between the manic period (or hypomanian) and depression or the mixture of both.
“This mood change can have a significant impact on a person’s ability to live their daily lives, work, and social relationships. People withkizophrenia (ODS) are also like that, at an adult age, they usually start to emerge between the end of adolescence to the early 30s, with symptoms that can include hallucinations, bawah orrtimony, and behavioral changes that certainly interfere with social and work functions.
GB and Skizophrenia incidences in adults are far more highlighted and highlighted than pediatric and adolescent patients. But in reality, even though the numbers are greater at an adult age, there are still many adult patients who have been diagnosed and understand their illness but are constrained in undergoing long-term therapy so they do not comply with treatment.
“In Indonesia, it can be said that non-compliance with treatment is common in GB and Skizophrenia, even though this is known to increase the risk of poor clinical outcomes. This is the biggest problem that needs to be overcome in the field of psychology and other chronic diseases. Some studies show that non-compliance with treatment remains an important concern in the treatment of GB andkizophrenia disorders,” he explained.
In the end, non-compliance will have enormous consequences, especially for adults. At GB, non-compliance is associated with a higher level of recurrence, increased hospitalization, and greater suicide risks. For Schizophrenia, non-compliance not only worsens the symptoms ofnicity but also increases the risk of self-harm and others. These findings highlight the importance of compliance with treatment to prevent comorbidities and improve the quality of life for individuals, explained Dr. Khamelia.
GB and Skizofrenia adult patients are still able to carry out productive activities and have good quality of life as long as they want to carry out treatment consistently.
Optimals in therapeutic compliance are associated significantly with higher quality of life. Usually they are less obedient due to poor illness, side effects, mood fluctuations, and bad stigma. Regarding side effects in particular, it is still a challenge in daily clinical practice. Sometimes they experience effects such as severe drowsiness of sedimentation, weight gain, and body movement problems so that they are difficult to comply with. Whereas nowadays there are innovative drugs that minimize such side effects,” said Dr. Khamelia.
He also added, apart from compliance, GB and Skizofrenia adult patients can still be productive if they focus on adaptive coding strategies, such as seeking support and learning strategies to solve problems, stress management training, etc. Next, they can actively carry out psychosocial therapy such as education about disease, routine screening of the emergence of ideas for suicide, can also use technology such as applications for mood monitoring, quality sleep, drug reminders, and psychotherapy to always be stable. That way, adult patients will be able to carry out their activities better,” he explained.
For successful treatment, it also depends on family and environmental support. Psychoeducation in families and the environment can help families understand and support their loved ones better. This support serves to increase expectations and support the ability of patients, personal empowerment, and inclusion in social environments,” he concluded.
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