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All Journal Scientia Psychiatrica Indonesian Community Empowerment Journal Sriwijaya Journal of Obstetrics and Gynecology Sriwijaya Journal of Neurology
Wisnu Wardhana Putra
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Religion Humanities Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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Gut-Brain Axis Dysfunction in Parkinson's Disease: Early Biomarkers and Therapeutic Potential in Jakarta, Indonesia Zahra Amir; Wisnu Wardhana Putra; Linda Purnama; Saurie Hernandez; Adolfo Rawlings; Immanuel Simbolon
Sriwijaya Journal of Neurology Vol. 1 No. 2 (2023): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i1.27

Abstract

Introduction: Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms. Increasing evidence suggests a crucial role of gut-brain axis dysfunction in PD pathogenesis. This study aimed to investigate the gut microbiome composition, identify potential early biomarkers, and explore the therapeutic potential of targeting the gut-brain axis in PD patients in Jakarta, Indonesia. Methods: This cross-sectional study involved 50 PD patients and 50 age-matched healthy controls from Jakarta. Stool and blood samples were collected for 16S rRNA gene sequencing to analyze gut microbiome composition, and serum inflammatory markers (TNF-α, IL-6, and CRP) were measured using ELISA. Clinical data, including disease duration, severity, and non-motor symptoms, were assessed using standardized scales. Results: PD patients exhibited significant alterations in gut microbiome composition compared to controls, with a decrease in beneficial bacteria (e.g., Faecalibacterium prausnitzii) and an increase in pro-inflammatory bacteria (e.g., Enterobacteriaceae). Elevated levels of serum inflammatory markers were also observed in PD patients. Correlation analysis revealed associations between specific gut microbiota, inflammatory markers, and disease severity. Conclusion: This study provides evidence of gut-brain axis dysfunction in PD patients in Jakarta, Indonesia. Alterations in gut microbiome composition and increased systemic inflammation may serve as potential early biomarkers and therapeutic targets for PD. Further research is needed to explore the causal relationship and develop targeted interventions.
Factors Influencing the Success Rates of In Vitro Fertilization (IVF) in Indonesian Couples: A Multicenter Study Sony Sanjaya; Wisnu Wardhana Putra; Theresia Putri Sinaga; Tanvir Ahmed
Sriwijaya Journal of Obstetrics and Gynecology Vol. 2 No. 1 (2024): Sriwijaya Journal of Obstetrics and Gynecology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjog.v1i2.85

Abstract

Introduction: In vitro fertilization (IVF) has become an increasingly important assisted reproductive technology for infertile couples in Indonesia. However, success rates remain variable. This multicenter study aimed to identify the factors influencing IVF success rates in Indonesian couples. Methods: A retrospective cohort study was conducted involving 1,245 couples who underwent IVF at three fertility centers in Indonesia between January 2019 and December 2022. Data were collected on demographic characteristics, infertility diagnoses, IVF protocols, and treatment outcomes. The primary outcome was live birth rate per embryo transfer. Multivariable logistic regression analysis was performed to identify independent predictors of IVF success. Results: The overall live birth rate per embryo transfer was 32.7%. Female age was a significant predictor of live birth, with success rates declining steadily after age 35. Other factors associated with higher success rates included the use of intracytoplasmic sperm injection (ICSI), blastocyst transfer, and a higher number of oocytes retrieved. Male factor infertility, endometriosis, and a history of previous failed IVF attempts were associated with lower success rates. Conclusion: This study identified several key factors influencing IVF success rates in Indonesian couples. Female age, ICSI utilization, blastocyst transfer, and oocyte yield were significant predictors of live birth. These findings can help clinicians counsel patients and optimize treatment strategies to improve IVF outcomes.
White-Matter Hyperintensities and Cognitive Decline in Late-Life Depression: A Longitudinal Neuroimaging Study in Medan, Indonesia Taryudi Suharyana; Jason Willmare; Despian Januandri; Brenda Jaleel; Wisnu Wardhana Putra
Scientia Psychiatrica Vol. 6 No. 1 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i1.185

Abstract

Introduction: Late-life depression (LLD) is often associated with cognitive impairment and structural brain changes, particularly white-matter hyperintensities (WMH). This longitudinal study investigated the relationship between WMH burden, cognitive decline, and depressive symptoms in a cohort of older adults with LLD in Medan, Indonesia. Methods: A prospective, longitudinal study was conducted with 120 participants aged 60 years and older. Participants underwent baseline and 3-year follow-up assessments, including structural MRI, neuropsychological testing, and depression severity. Statistical analyses included mixed-effects models to examine longitudinal changes and correlations. Results: At baseline, the LLD group exhibited significantly higher WMH volume compared to controls (p < 0.001). Over the 3-year follow-up, the LLD group showed a significantly greater increase in WMH volume (average increase of 0.4 Fazekas points) compared to controls (average increase of 0.1 Fazekas points, p < 0.001). Greater WMH burden at baseline was associated with worse performance on all cognitive domains in both groups (p < 0.05). In the LLD group, the increase in WMH volume was significantly correlated with a decline in global cognition (r = -0.45, p < 0.001), executive function (r = -0.38, p = 0.003), and processing speed (r = -0.41, p = 0.001). Changes in depression severity were also correlated with WMH progression (r = 0.32, p = 0.012). Conclusion: This study provides evidence that WMH burden is significantly increased in LLD and that WMH progression contributes to cognitive decline and may exacerbate depressive symptoms over time. These findings highlight the importance of assessing and potentially targeting WMH in the management of LLD.
Developing and Validating a Novel, Culture-Fair Assessment of Fluid Intelligence: A Multimodal Approach Combining Neuroimaging and Behavioral Measures in Indonesia Eva Naritawati; Vita Amanda; Wisnu Wardhana Putra; Moon Kaeun
Sriwijaya Journal of Neurology Vol. 3 No. 1 (2025): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v2i2.182

Abstract

Introduction: Fluid intelligence (Gf) is a critical cognitive ability, but its assessment is often biased by cultural and educational factors. Existing Gf tests developed in Western contexts may not be valid in diverse populations like Indonesia. This study aimed to develop and validate a novel, culture-fair Gf assessment tool (the "Indonesian Fluid Intelligence Scale" - IFIS) for Indonesian adults, utilizing a multimodal approach combining behavioral testing with neuroimaging (fMRI and EEG). Methods: A mixed-methods design was employed. Phase 1 involved the development of the IFIS, drawing on culturally relevant materials and minimizing reliance on language and formal education. Phase 2 involved a cross-sectional study with 300 Indonesian adults (aged 18-45) with varying educational backgrounds and socioeconomic statuses, recruited from urban and rural areas. Participants completed the IFIS, a standardized Gf test (Raven's Progressive Matrices - RPM), and underwent fMRI and EEG recordings during cognitive task performance. Statistical analyses included correlational analyses, confirmatory factor analysis (CFA), and machine learning techniques to explore the relationship between IFIS scores, RPM scores, and neural activity patterns. Results: The IFIS demonstrated good internal consistency (Cronbach's alpha = 0.85) and test-retest reliability (r = 0.88). CFA supported a single-factor structure for the IFIS. IFIS scores correlated significantly with RPM scores (r = 0.68, p < 0.001), but showed weaker correlations with years of education (r = 0.35, p < 0.001) compared to RPM (r = 0.52, p < 0.001). fMRI revealed that higher IFIS scores were associated with increased activation in the frontoparietal network (FPN), particularly the dorsolateral prefrontal cortex (dlPFC) and posterior parietal cortex (PPC), during task performance. EEG analysis showed increased theta and alpha power in frontal and parietal regions during IFIS task performance, correlating with higher scores. Machine learning models, using combined fMRI and EEG data, could predict IFIS scores with high accuracy (AUC = 0.89). Conclusion: The IFIS provides a promising, culture-fair assessment of Gf in Indonesian adults. The multimodal approach, combining behavioral and neuroimaging data, provides strong evidence for the construct validity of the IFIS. The findings highlight the importance of considering cultural context in cognitive assessment and demonstrate the potential of neuroimaging to validate cognitive measures.
Bridging the Digital Divide: A Mixed-Methods Evaluation of the Efficacy, Accessibility, and Impact of Web-Based Mental Health First Aid Training for Community Health Volunteers (Kader) in Rural Indonesia Zahra Amir; Ni Made Nova Indriyani; Iis Sugandhi; Husin Sastranagara; Muhammad Rusli; Wisnu Wardhana Putra
Indonesian Community Empowerment Journal Vol. 5 No. 2 (2025): Indonesian Community Empowerment Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/icejournal.v5i2.46

Abstract

Significant disparities in mental health service access persist in rural Indonesia, where community health volunteers (known as Kader) represent a vital but undertrained resource. Digital training platforms offer a scalable solution to build mental health literacy, yet their efficacy and accessibility in low-resource, digitally diverse settings remain under-evaluated. This study aimed to evaluate the efficacy, accessibility, and user experience of a novel, web-based Mental Health First Aid (MHFA) training program for Kader in rural Indonesia. We employed a convergent parallel mixed-methods design with a single-group, pre-test/post-test framework. A total of 165 Kader from 15 rural districts across North Sumatra, West Sumatra, and South Sumatra provinces were recruited. Participants completed a 4-week, self-paced, web-based MHFA course. Quantitative data were collected using the Mental Health Knowledge Questionnaire (MHKQ), the Community Attitudes toward the Mentally Ill (CAMI) scale, and the System Usability Scale (SUS) at baseline and post-intervention. Qualitative data were gathered through semi-structured focus group discussions (FGDs) with a purposive subsample of 32 participants to explore user experience and perceived impact. The intervention yielded a highly significant improvement in mental health knowledge, with mean MHKQ scores increasing from 48.5 (SD=10.2) at pre-test to 89.7 (SD=8.8) at post-test (t(164) = -35.1, p < 0.001). Stigmatizing attitudes significantly decreased, as reflected by an increase in mean CAMI scores from 55.3 (SD=12.5) to 81.4 (SD=11.9) (t(164) = -18.9, p < 0.001). The platform's usability was rated favorably, with a mean SUS score of 81.2 (SD=13.4), indicating excellent user-friendliness. Qualitative analysis revealed three primary themes: (1) Digital Empowerment and Overcoming Barriers; (2) Cultural Resonance and Practical Skill Acquisition; and (3) The Emergence of a Supported Community of Practice. In conclusion, web-based MHFA training is an effective, accessible, and well-accepted modality for empowering Kader in rural Indonesia. This digital approach successfully bridges geographical and educational divides, significantly enhancing mental health literacy and reducing stigma. Scaling this model holds immense potential for strengthening community-based mental health services and narrowing the treatment gap in Indonesia and similar low- and middle-income countries.
The ‘Untreatable’ Fear: A Mixed-Methods Study on the Psychosocial Burden and Catastrophic Cognition in Patients Diagnosed with Multi-Drug Resistant (MDR) Neisseria gonorrhoeae Felicia Sari; Muhammad Yusuf; Mahmood Abbas; Nadia Khoirina; Wisnu Wardhana Putra; Abdullah Assagaf
Scientia Psychiatrica Vol. 6 No. 2 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i2.195

Abstract

Introduction: The global emergence of multi-drug resistant (MDR) Neisseria gonorrhoeae threatens a return to the pre-antibiotic era. While the microbiological resistance mechanisms are well-documented, the psychopathological sequelae of being diagnosed with a potentially incurable sexually transmitted infection remain underexplored. This study aims to assess the psychosocial burden and catastrophic cognition in patients with MDR N. gonorrhoeae compared to those with drug-susceptible strains. Methods: We employed a sequential explanatory mixed-methods design. A sample of 200 patients (100 MDR vs. 100 Susceptible) was recruited based on an a priori power analysis to ensure sufficient sensitivity for detecting medium effect sizes. Participants completed the adapted Pain Catastrophizing Scale (PCS), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Subsequently, 20 MDR-positive participants underwent in-depth semi-structured interviews analyzed via Interpretative Phenomenological Analysis (IPA). Results: The MDR group exhibited significantly higher mean scores for catastrophic thinking (PCS: 38.4 versus 14.2, p<0.001), anxiety (GAD-7: 16.5 versus 8.1, p<0.001), and depression (PHQ-9: 14.8 versus 6.5, p<0.001). The adapted PCS showed high internal consistency (Cronbach’s a= 0.94). Qualitative analysis revealed core themes of stigma ("The Leper of the Modern Age") and systemic fear ("The Ticking Time Bomb"). Conclusion: A diagnosis of MDR N. gonorrhoeae precipitates a unique and severe psychological syndrome characterized by high catastrophizing and psychosocial distress. Integrated psychiatric care and cognitive behavioral interventions are essential components of the clinical management for this demographic.
Elevated IL-6 and TNF-α Associated with Treatment-Resistant Depression in Virally Suppressed HIV Patients: A Cross-Sectional Biomarker Study Wisnu Wardhana Putra; Muhammad Yusuf; Mahmood Abbas; Nadia Khoirina; Felicia Sari; Abdullah Assagaf
Scientia Psychiatrica Vol. 6 No. 3 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i3.196

Abstract

Introduction: Despite effective antiretroviral therapy (ART), major depressive disorder (MDD) remains highly prevalent in people living with HIV (PLWH). A subset of these patients develops treatment-resistant depression (TRD), creating a significant clinical burden. The "cytokine hypothesis" proposes that residual immune activation drives this resistance. This study aimed to evaluate whether serum interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) constitute a distinct biological signature of TRD, independent of viral load and smoking status. Methods: We conducted a cross-sectional case-control study (N=120) between January 2023 and June 2025. Participants were virally suppressed HIV-positive individuals stratified into three groups (n=40 each): (1) TRD (non-response > 2 antidepressants); (2) Treatment-responsive depression (T-Resp); and (3) Non-depressed controls (NDC). Smoking status (pack-years) was quantified. Cytokines were measured via high-sensitivity ELISA. Data were normalized using Log-10 transformation. We employed ANCOVA (adjusting for age, BMI, and smoking) and multivariate logistic regression to assess associations. Results: The TRD group exhibited significantly higher serum IL-6 and TNF-α compared to the T-Resp and NDC groups (p < 0.001). Although smoking prevalence was higher in the TRD group (45%), ANCOVA confirmed that depression status remained significantly associated with elevated cytokines after adjusting for smoking (F(2,116) = 42.5, p < 0.001). Logistic regression identified IL-6 as a robust correlate of TRD (Adjusted OR 2.15; 95% CI 1.45–3.18) with no multicollinearity (VIF=1.32). ROC analysis indicated high diagnostic accuracy for IL-6 (AUC=0.88). Conclusion: Elevated proinflammatory cytokines are strongly associated with TRD in PLWH, independent of viral replication and nicotine use. These findings support the potential utility of IL-6 as a stratification biomarker for immunomodulatory adjunctive therapies.
Co-Authors Abdullah Assagaf Adolfo Rawlings Brenda Jaleel Despian Januandri Eva Naritawati Felicia Sari Husin Sastranagara Iis Sugandhi Immanuel Simbolon Jason Willmare Linda Purnama Mahmood Abbas Moon Kaeun Muhammad Rusli MUHAMMAD YUSUF Nadia Khoirina Ni Made Nova Indriyani Saurie Hernandez Sony Sanjaya Tanvir Ahmed Taryudi Suharyana Theresia Putri Sinaga Vita Amanda Zahra Amir