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Cipta DA, Kusumadewi I, Siste K, Werdhani RA, Diatri H. Factors associated with Indonesian family physicians' knowledge of depression: A cross-sectional study. Malays Fam Physician 2023; 18:18. [PMID: 37139475 PMCID: PMC10150326 DOI: 10.51866/oa.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Introduction Depression is a common mental disorder in primary care settings both globally and locally. Even with considerable impacts on patients' quality of life and public healthcare costs, most people with depression do not receive evidence-based treatment. Integrating mental healthcare services into primary care is essential to address the treatment gap for depression. As counsellors and care coordinators, family physicians have a vital role in providing primary mental healthcare services. This study aims to assess Indonesian family physicians' knowledge of depression and identify the associated factors. Method This cross-sectional observational study included a total of 83 family physicians from the Association of Indonesian Family Physicians. Data were collected using online questionnaires, including demographic and knowledge assessment instruments and the Care Coordinator Scale (CCS). Descriptive and multiple linear regression analyses were performed. Results The knowledge of depression, particularly in terms of prevention, diagnosis, pharmacological treatment, and post-referral treatment, was insufficient among the family physicians. The medication education (P=0.006) and follow-up care plan (P=0.04) domains of the CCS were associated with the family physicians' knowledge of the management of depression in the linear regression analysis (R2=0.077). Conclusion Interventions to improve Indonesian family physicians' knowledge of depression, focusing on medication/pharmacological treatment and considering them as care coordinators, are essential.
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Affiliation(s)
- Darien Alfa Cipta
- MD, MSc, Department of Psychiatry, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jalan Pangeran Diponegoro, Jakarta, Indonesia.
| | - Irmia Kusumadewi
- MD, Department of Psychiatry, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jalan Pangeran Diponegoro, Jakarta, Indonesia
| | - Kristiana Siste
- MD, PhD, Department of Psychiatry, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jalan Pangeran Diponegoro, Jakarta, Indonesia
| | - Retno Asti Werdhani
- MD, PhD, Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jalan Pegangsaan Timur, Jakarta, Indonesia
| | - Hervita Diatri
- MD, PhD, Department of Psychiatry, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jalan Pangeran Diponegoro, Jakarta, Indonesia
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Ramadianto AS, Kusumadewi I, Agiananda F, Raharjanti NW. Symptoms of depression and anxiety in Indonesian medical students: association with coping strategy and resilience. BMC Psychiatry 2022; 22:92. [PMID: 35130862 PMCID: PMC8820032 DOI: 10.1186/s12888-022-03745-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/31/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Depression and anxiety are prevalent mental health issues among medical students due to the various challenges during medical education. These issues affect not only their quality of life, but also their academic and professional development. Coping strategy and resilience are two factors that may influence students' mental health outcomes. Data of medical student mental health in Indonesia is scarce, hampering efforts to systematically address the problem. Hence, this study aims to estimate the prevalence of depressive and anxiety symptoms in Indonesian medical students, and their association with coping strategy and resilience. METHODS Undergraduate medical students from each year of study (Preclinical Year 1 to 4, Clinical Year 1 and 2) in the Faculty of Medicine Universitas Indonesia were randomly selected to participate in this cross-sectional study. The study questionnaire included sociodemographic characteristics, Depression Anxiety Stress Scale (DASS) to measure symptoms of depression and anxiety, Brief COPE to measure coping strategy, and Connor-Davidson Resilience Scale (CD-RISC) to measure resilience. Scores of depression and anxiety symptoms were analyzed by comparing them between different sociodemographic groups and by measuring their correlation with coping strategies and resilience. Multiple regression analyses were conducted to identify predictors of depression and anxiety symptoms. RESULTS Among 532 respondents, 22.2% reported symptoms of depression and 48,1% reported anxiety, including 3.0% and 8.1% with extremely severe depression and anxiety, respectively. Students not living with immediate family had higher depression score; female students and those in Preclinical Year 1 and Clinical Year 1 showed higher anxiety scores. Dysfunctional coping strategies and lower resilience are predictors of higher depression and anxiety symptoms. CONCLUSIONS Students show different levels of depressive and anxiety symptoms, signifying different levels of mental health support needs from universal mental health promotion to psychiatric treatment. Prevention programs can be targeted towards students with risk factors, such as not living with immediate family, undergoing first year of preclinical studies or clinical rotations, coping with dysfunctional strategies, and having low resilience. Additionally, medical educators must be aware of other, non-student factors that may impact student mental health, such as curriculum design and learning experience.
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Affiliation(s)
- Adhitya Sigit Ramadianto
- Department of Psychiatry, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
| | - Irmia Kusumadewi
- grid.9581.50000000120191471Department of Psychiatry, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Feranindhya Agiananda
- grid.9581.50000000120191471Department of Psychiatry, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Natalia Widiasih Raharjanti
- grid.9581.50000000120191471Department of Psychiatry, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Agastya IGN, Siste K, Nasrun MWS, Kusumadewi I. Cybersex addiction: an overview of the development and treatment of a newly emerging disorder. Med J Indones 2020. [DOI: 10.13181/mji.rev.203464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Cybersex addiction is a non-substance related addiction that involves online sexual activity on the internet. Nowadays, various kinds of things related to sex or pornography are easily accessible through internet media. In Indonesia, sexuality is usually assumed taboo but most young people have been exposed to pornography. It can lead to an addiction with many negative effects on users, such as relationships, money, and psychiatric problems like major depression and anxiety disorders. A few instruments may be used to detect cybersex behavior. This review was aimed to provide a comprehensive discussion about cybersex addiction in Indonesian society and the importance of its screening for this condition to enable its early detection and subsequent management.
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Hanafi E, Siste K, Kurniawan A, Nasrun MWS, Kusumadewi I. Perception of internet addiction among psychiatric residents in an urban area in Indonesia. Med J Indones 2019. [DOI: 10.13181/mji.v28i4.3316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND In the last two years, many suspected cases of internet addiction have been reported by the media. However, many physicians do not have comprehensive knowledge of internet addiction. Currently, there has been no study conducted among psychiatric residents. This study was aimed to determine the perception of internet addiction among psychiatric residents.
METHODS This cross-sectional study was done from April to May 2018. Subjects were recruited by a total sampling method consisting of all psychiatric residents of the Faculty of Medicine, Universitas Indonesia. Perceptions of internet addiction were measured using the illness perception questionnaire revised version for addiction. The calculation of subscales was based on the algorithms available for this instrument. The Mann–Whitney U test was used to determine the association of different years of psychiatric education and the perception of internet addiction.
RESULTS Fifty-two subjects completed the survey, and 85% of them reported feeling that they did not have adequate knowledge of internet addiction. They believed that their current knowledge was not sufficient to make diagnosis and management decisions. Junior residents had significantly lower consequence scale scores, with mean (standard deviation) scores of 4.1 (0.54) for juniors and 4.4 (0.48) for seniors (p = 0.021).
CONCLUSIONS Psychiatric residents perceived internet addiction as emotionally stressful, understandable, and cyclical, but difficult to control. Senior psychiatric residents had a better perception internet addiction consequences compared with their juniors, who have received only basic knowledge about addiction without clinical exposure, but the perceptions could still be improved.
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Hanafi E, Siste K, Wiguna T, Kusumadewi I, Nasrun MW. Temperament profile and its association with the vulnerability to smartphone addiction of medical students in Indonesia. PLoS One 2019; 14:e0212244. [PMID: 31295256 PMCID: PMC6622469 DOI: 10.1371/journal.pone.0212244] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 06/29/2019] [Indexed: 11/23/2022] Open
Abstract
Two dimensions of temperament, namely, (high levels of) novelty seeking and (low levels of) harm avoidance are related to substance addictions. However, their implications for smartphone addiction remain unexplored. Medical students are heavy smartphone users. Accordingly, screening for the risk of smartphone addiction based on individual differences in temperament can facilitate the identification of the best possible prevention strategy. Therefore, the present study aimed to examine the relationship between temperament and the vulnerability to smartphone addiction among medical students in Jakarta, Indonesia. The research study adopted a cross-sectional research design and used a simple random sampling technique. The Indonesian versions of the Temperament and Character Inventory and the Smartphone Addiction Scale were used to measure the study variables. Logistic regression analysis was conducted to examine the relationships between demographic factors, patterns of smartphone use, temperament, and vulnerability to smartphone addiction. A majority of the 185 participants were found to have the following temperament profile: low levels of novelty seeking and high levels of reward dependence and harm avoidance. The average duration of daily smartphone use was 7.83 hours (SD = 4.03) and the age at first smartphone use was 7.62 years (SD = 2.60). The respondents used smartphone to communicate with other people and access social media. A high level of harm avoidance was significantly associated with the risk of smartphone addiction (Odds Ratio [OR] = 2.04, 95% Confidence Interval [CI] = 1.12, 3.70). The findings suggest that smartphone addiction is comparable to other addictive behaviors. Further, harm avoidance increases the risk of smartphone addiction. Therefore, the risk of smartphone addiction among medical students must be ascertained based on their temperament profiles.
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Affiliation(s)
- Enjeline Hanafi
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, DKI Jakarta, Indonesia
- * E-mail:
| | - Kristiana Siste
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, DKI Jakarta, Indonesia
| | - Tjhin Wiguna
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, DKI Jakarta, Indonesia
| | - Irmia Kusumadewi
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, DKI Jakarta, Indonesia
| | - Martina Wiwie Nasrun
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, DKI Jakarta, Indonesia
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Schwab SG, Kusumawardhani AAAA, Dai N, Qin W, Wildenauer MDB, Agiananda F, Amir N, Antoni R, Arsianti T, Asmarahadi A, Diatri H, Djatmiko P, Irmansyah I, Khalimah S, Kusumadewi I, Kusumaningrum P, Lukman PR, Mustar L, Nasrun MW, Naswati S, Prasetiyawan P, Semen GM, Siste K, Tobing H, Widiasih N, Wiguna T, Wulandari WD, Benyamin B, Wildenauer DB. Association of rs1344706 in the ZNF804A gene with schizophrenia in a case/control sample from Indonesia. Schizophr Res 2013; 147:46-52. [PMID: 23590871 DOI: 10.1016/j.schres.2013.03.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 02/26/2013] [Accepted: 03/18/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND Association of rs1344706 in the ZNF804A gene (2q32.1) with schizophrenia was first reported in a genome wide scan conducted in a sample of 479 cases and replicated in 6666 cases. Subsequently, evidence by replication was obtained in several samples with European- and Asian ancestral background. METHODS We report ascertainment, clinical characterization, quality control, and determination of ancestral background of a case control sample from Indonesia, comprising 1067 cases and 1111 ancestry matched controls. Genotyping was performed using a fluorescence-based allelic discrimination assay (TaqMan SNP genotyping assay) and a newly designed PCR-RFLP assay for confirmation of rs1344706 genotypes. RESULTS We confirmed association of the T-allele of rs1344706 with schizophrenia in a newly ascertained sample from Indonesia with Southeast Asian ancestral background (P=0.019, OR=1.155, 95%, CI 1.025-1.301). In addition, we studied several SNPs in the vicinity of rs1344706, for which nominally significant results had been reported. None of the association P values of the additional SNPs exceeded that of rs1344706. CONCLUSION We provide additional evidence for association of the ZNF804A gene with schizophrenia. We conclude that rs1344706 or a yet unknown polymorphism in linkage disequilibrium is also involved in conferring susceptibility to schizophrenia in samples with different (Asian) ancestral backgrounds.
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Affiliation(s)
- Sibylle G Schwab
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany.
| | | | - Nan Dai
- Western Australian Institute for Medical Research & Centre for Medical Research, University of Western Australia, Nedlands, Australia; School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, Australia
| | - WenWen Qin
- Western Australian Institute for Medical Research & Centre for Medical Research, University of Western Australia, Nedlands, Australia; School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, Australia
| | - Mutiara D B Wildenauer
- Western Australian Institute for Medical Research & Centre for Medical Research, University of Western Australia, Nedlands, Australia; School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, Australia
| | | | - Nurmiati Amir
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | - Ronald Antoni
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | - Tiana Arsianti
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | | | - Hervita Diatri
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | - Prianto Djatmiko
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | | | - Siti Khalimah
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | - Irmia Kusumadewi
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | | | - Petrin R Lukman
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | - Lukman Mustar
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | - Martina W Nasrun
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | - Safyuni Naswati
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | | | - Gerald M Semen
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | - Kristiana Siste
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | - Heriani Tobing
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | - Natalia Widiasih
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | - Tjhin Wiguna
- Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | | | | | - Beben Benyamin
- Queensland Brain Institute, University of Queensland, St. Lucia, Australia
| | - Dieter B Wildenauer
- Western Australian Institute for Medical Research & Centre for Medical Research, University of Western Australia, Nedlands, Australia; School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, Australia; Centre for Clinical Research in Neuropsychiatry, Graylands Hospital, Claremont, Australia
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