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All Journal Jurnal Psikiatri Surabaya (Surabaya Psychiatry Journal) Medicor : Journal of Health Informatics and Health Policy
Tiwik Koesdiningsih
Unknown Affiliation
Health Professions Medicine & Pharmacology Public Health

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Suicide Attempt in Schizophrenia Harikha, Igha Vinda; Nalini Muhdi; Tiwik Koesdiningsih
Jurnal Psikiatri Surabaya Vol. 11 No. 1 (2022): May
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jps.v11i1.20597

Abstract

Suicide is a very important sosial phenomenon and requires attention not only from psychiatrists but also the general public. The phenomenon of suicide has spread to almost all parts of the world, both in countries with advanced technology and in developing countries, from rich countries to poor countries. The risk of suicide among people with schizophrenia is higher than the general population. Attempted suicide is an act of self-injury that is done intentionally and aims to die, but does not cause death. These actions represent psychological difficulties and there are several risk factors associated with suicide attempts. Schizophrenia is a chronic and severe psychiatric disorder with a huge global health burden. Among those suffering from schizophrenia, the lifetime suicide rate is around 5% and suicide is the leading cause of premature death.Keywords: Suicide, Suicide Attempt, Schizophrenia
Evaluation of Childhood Psychosis Negligence: Cultural Influences in Treatment Process: Case Report T, Maria; Royke Tony Kalalo; Tiwik Koesdiningsih; Justina Evy Tyaswati
Jurnal Psikiatri Surabaya Vol. 11 No. 2 (2022): November
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jps.v11i2.36307

Abstract

Background: Childhood psychosis is a rare condition. In Indonesia, strong cultural influences how people perceive mental disorders. Culture and knowledge interact dynamically in mental health in Indonesia. Lack of mental health knowledge, resulting abandonment among psychosis patients, especially in their first episode. This negligence leads to no medical treatment associated with a worse disease course. Case: 27 years old male with the third episode of psychosis. He presented with schizoaffective disorder mixed type. The earliest suspected psychosis episode was at the age of 12 years old, was not treated medically. The patient was only treated after his second episode of psychosis at the age of 26 but exhibited non-adherence to the treatment later, which caused a relapse. After discharged, the patient was currently in the stabilization phase for 5 months with oral antipsychotics and long-acting antipsychotic injections. Besides medical treatment, this patient also sought spiritual treatment from psychics and religious treatment. Discussion: The challenges related to the psychosocial aspects faced in this case are lack of knowledge, strong influences of cultural belief on the patient for the cause, and treatment-seeking for the illness, which needs regard for the treatment process. Conclusion: Negligence of psychosis during childhood, which is not medically treated, could progress to worse episodes in later periods of life, but the protective factors influenced by culture are dynamism of belief related to the illness, endorsed multiple causations for the illness including natural and supernatural attribution, local wisdom to perceive a mental disorder, including in this case cultural-psychological concept.
Vitamin B6, B9, and B12 Supplementation in Antipsychotic-Induced Akathisia: A Case Report and Comprehensive Review Quddus Salam; Tiwik Koesdiningsih; Widyantari, Maya; Algristian, Hafid
Medicor : Journal of Health Informatics and Health Policy Vol. 3 No. 4 (2025): October 2025
Publisher : Indonesian Scientific Publication

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61978/medicor.v3i4.983

Abstract

Schizophrenia and related psychotic disorders pose a substantial global health burden, with treatment often complicated by antipsychotic-induced extrapyramidal side effects. Akathisia, characterized by profound inner restlessness and repetitive movements, is particularly distressing and frequently leads to medication non-adherence and relapse. This case report and comprehensive review details the management of a 30-year-old woman with schizoaffective disorder who developed severe akathisia following three months of risperidone therapy, resulting in treatment discontinuation. Upon readmission, a multimodal therapeutic strategy was implemented: risperidone was switched to aripiprazole, and adjunctive therapy included clobazam, trihexyphenidyl, folic acid (B9), and mecobalamin (B12). The clinical rationale extended beyond conventional management to incorporate targeted nutritional support, based on evidence that vitamin B6 modulates dopaminergic, serotonergic, and GABAergic pathways, while folate and B12 are crucial for one-carbon metabolism, homocysteine regulation, and neuroprotection. Following this integrated intervention, the patient's akathisia resolved, daily functioning stabilized, and treatment adherence was restored. This report provides an in-depth discussion of the synergistic neurobiological mechanisms through which B vitamins may alleviate akathisia, situates the findings within the broader context of nutritional psychiatry, and highlights the socio-economic relevance of this low-cost, low-risk adjunctive strategy for resource-limited settings. While current evidence remains preliminary, this case underscores the importance of early akathisia recognition and supports the integration of nutritional assessment and B-vitamin supplementation into personalized treatment plans for patients intolerant to standard therapies. Further randomized controlled trials are warranted to establish standardized dosing and identify patient subgroups most likely to benefit.
Co-Authors Algristian, Hafid Harikha, Igha Vinda Justina Evy Tyaswati Muhdi, Nalini Quddus Salam Royke Tony Kalalo T, Maria Widyantari, Maya