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All Journal Sinergi International Journal of Psychology
Ahadiah, Hayyunah Rohmatul
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Compulsive Sexual Behavior as a Maladaptive Coping Mechanism in Bipolar Affective Disorder: A Case Report Shafly, Moch Syafirul Nur; Ahadiah, Hayyunah Rohmatul; Syadza, Lailatus; Algristian, Hafid; Setyorini, Dian
Sinergi International Journal of Psychology Vol. 3 No. 3 (2025): August 2025
Publisher : Yayasan Sinergi Kawula Muda

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61194/psychology.v3i3.785

Abstract

Compulsive Sexual Behavior (CSB) is increasingly acknowledged as a comorbid feature in individuals with Bipolar Affective Disorder (BAD), particularly during manic episodes. It often presents as a maladaptive coping mechanism for affective instability and unresolved trauma. This case report describes a 31-year-old male diagnosed with BAD and exhibiting chronic compulsive pornography use, social withdrawal, and dependent personality traits. The patient’s compulsive behavior persisted beyond mood episodes and was characterized by a persistent inability to control sexual urges, leading to distress and impaired daily functioning. Developmental history revealed early exposure to family conflict, emotional neglect, and an overdependent relationship with his mother, which contributed to insecure attachment and limited autonomy. The patient used pornography as an emotional escape, particularly during episodes of anxiety, loneliness, or boredom. Psychiatric evaluation confirmed comorbidity with Compulsive Sexual Behavior Disorder (CSBD) based on ICD-11 criteria. Therapeutic intervention included Cognitive Behavioral Therapy (CBT) tailored to address compulsive behavior, emotion regulation deficits, and trauma-related triggers. The patient responded favorably to structured psychoeducation and behavioral strategies, although long-term outcomes remain uncertain due to limited follow-up. This case underscores the complex interplay between CSB and BAD, with implications for diagnosis, treatment planning, and long-term management. It highlights the importance of early recognition of CSB symptoms, the role of trauma-informed care, and the need for integrative therapeutic approaches in patients with dual diagnoses. Clinicians are encouraged to assess compulsive behaviors beyond the scope of mood symptoms and address them as independent therapeutic targets to enhance functional recovery.
Antipsychotic Switching in Bipolar Disorder with Metabolic Comorbidities: A Case Report Syadza, Lailatus; Ahadiah, Hayyunah Rohmatul; Shafly, Moch. Syafirul Nur; Algristian, Hafid; Huda, Miftakhul
Sinergi International Journal of Psychology Vol. 3 No. 3 (2025): August 2025
Publisher : Yayasan Sinergi Kawula Muda

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61194/psychology.v3i3.782

Abstract

Bipolar disorder is a chronic psychiatric condition marked by alternating episodes of mania, hypomania, and depression, often with psychotic features. Treatment resistance and adverse metabolic effects from long-term antipsychotic use pose significant challenges. This case report presents a 31-year-old male in Indonesia with bipolar disorder and metabolic comorbidities, including type 2 diabetes mellitus and dyslipidemia. Initially treated with clozapine, the patient experienced metabolic decompensation, prompting an urgent switch to quetiapine. Post-switch, he exhibited improved mood stability and remission of psychotic symptoms, though residual depressive symptoms persisted. Lithium and sertraline were introduced to address these, with careful monitoring. The case highlights the importance of individualized switching strategies in bipolar disorder, particularly in patients with metabolic risks. Antipsychotic selection should consider both psychiatric efficacy and metabolic safety. Despite pharmacological improvement, functional recovery was incomplete, emphasizing the role of psychosocial interventions and culturally informed care. The integration of religious values and family support proved essential in this context. Although effective in symptom stabilization, the switch strategy remains limited by the lack of long-term follow-up and generalizability. This report underscores the need for structured protocols for antipsychotic switching and holistic treatment models, especially in resource-limited settings. Future research should explore integrative approaches that address both psychiatric and physical health dimensions, ensuring continuity of care beyond pharmacological intervention.
Delirium in Bipolar Disorder as a Triggering Factor to Cognitive Decline: A Case Report and Neuroprogression Insight Ahadiah, Hayyunah Rohmatul; Syadza, Lailatus; Shafly, Moch Syafirul Nur; Asikah; Algristian, Hafid
Sinergi International Journal of Psychology Vol. 3 No. 4 (2025): November 2025
Publisher : Yayasan Sinergi Kawula Muda

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61194/psychology.v3i4.784

Abstract

Bipolar disorder is a major contributor to global disability, affecting not only mood regulation but also cognitive function, and its impact is often exacerbated by metabolic comorbidities such as type 2 diabetes mellitus, hypertension, and dyslipidemia. These comorbid conditions can lead to poorer clinical outcomes and increase the risk of neuropsychiatric complications such as delirium and cognitive impairment, which are frequently overlooked in clinical practice. This article aims to describe and analyze the case of a 31-year-old male with a history of bipolar disorder who presented with a hyperglycemic crisis and pneumonia, followed by the onset of acute delirium and subsequent cognitive decline. Through a descriptive clinical approach, the patient’s medical and psychiatric history, laboratory findings, and treatment course are reviewed to explore the complex interaction between mood disorders and metabolic dysfunction. The analysis reveals a strong link between metabolic dysregulation and worsening neuropsychiatric outcomes. This case underscores the importance of early detection and an integrated, multidisciplinary management approach to prevent long-term cognitive deterioration in patients with psychiatric disorders accompanied by metabolic conditions, offering important implications for future clinical practice.
Co-Authors Algristian, Hafid Asikah Miftakhul Huda Setyorini, Dian Shafly, Moch Syafirul Nur Shafly, Moch. Syafirul Nur Syadza, Lailatus