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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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Journal : Scientia Psychiatrica

 1 
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.
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