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All Journal Jurnal Psikiatri Surabaya (Surabaya Psychiatry Journal)
Bessing, Yulia Fatima
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Health Professions Medicine & Pharmacology

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Very Late Onset Schizophrenia Like Psychosis: A Case Report Victoria, Vini; Bessing, Yulia Fatima; Yulianti, Erikavitri; Salma Nur Fadhilah
Jurnal Psikiatri Surabaya Vol. 14 No. 1 (2025): May
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jps.v14i1.47755

Abstract

Introduction: With the growth of the aging population, we need to ensure that elderly people can live the rest of their lives with a satisfactory quality of life. However, the occurrence of psychosis in the elderly, especially at a later age, is a risk for decreased quality of life and a high risk of morbidity and mortality. The first episode of psychosis in age 60 or over is called very late-onset schizophrenia-like psychosis (VLOSLP) and needs to be distinguished from secondary psychosis such as Alzheimer’s Disease (AD) with psychotic symptoms. Case: A 77-year-old woman was brought by her family to the geriatric psychiatry clinic due to strange behavior such as hearing voices and obeying the voices’ commands since the last 6 months that worsened in the last month. In the last month, the patient also had sleeping difficulty, pacing at night, and accusing family of trying to harm her. After one month of therapy with Risperidone, the patient was showing improvement in the reduction of the voices. Discussion: The patient was assessed as VLOSLP with the first episode of psychosis with schizophrenia spectrum core symptoms such as paranoid delusion and auditory-verbal hallucination.  Conclusion: In this case, clinicians work with insufficient additional examination data, and that could also apply to clinicians in the remote area with no access to more comprehensive modalities to differentiate early stages of AD with psychosis and VLOSLP from clinical symptoms. However, more data is needed to establish clinical criteria regarding VLOSLP.
Cognitive Impairment Associated with Schizophrenia: A Case Report Jessica, Lia; Bessing, Yulia Fatima; Yulianti, Erikavitri; Salma Nur Fadhilah
Jurnal Psikiatri Surabaya Vol. 14 No. 1 (2025): May
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jps.v14i1.49488

Abstract

Introduction: First-generation antipsychotics could reduce the positive symptoms of schizophrenia but also impair cognitive function. Cognitive and negative symptoms in schizophrenia could be a significant burden experienced both by the patients and caregivers. Thus the treatment of cognitive impairment associated with schizophrenia should be addressed properly. The purpose of writing this article is to increase awareness in administering antipsychotics to elderly patients with schizophrenia, especially in the cognitive aspect and how to overcome possible cognitive decline. Case: An outpatient female schizophrenic patient who was on first-generation antipsychotic treatment complained of forgetfulness. The complaint started 5 years after she received her treatment. While she could still perform her activities of daily living independently, her instrumental activities of daily living were impaired. Her food got burnt while she was cooking, and she also took her medicine excessively because she forgot about it. Both of those events could be very dangerous for her. Discussion: Antipsychotics are the first-line pharmacotherapy for the treatment of schizophrenia but could also cause cognitive impairment. Management of cognitive impairment associated with schizophrenia could be performed both non-pharmacologically, by giving cognitive remediation therapy or physical exercise, and pharmacologically, by giving cholinergic agents such as donepezil. Conclusions: Cognitive impairment associated with schizophrenia should be managed as well as psychotic symptoms.
Early Onset Dementia and Non Pharmalogical Treatment: A Case Report Kusuma, Susana anggar; Bessing, Yulia Fatima; Yulianti, Erikavitri
Jurnal Psikiatri Surabaya Vol. 14 No. 2 (2025): November
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jps.v14i2.44374

Abstract

Introduction: Early-onset dementia (EOD), defined as dementia occurring before the age of 65, leads to progressive cognitive and functional decline that disrupts patients’ productivity, family roles, and social well-being. With limited pharmacological efficacy, non-pharmacological approaches are increasingly recognized as essential to improve patients’ quality of life. Methods: This report describes a 59-year-old female presenting with severe cognitive impairment and daily functional decline. Clinical evaluation involved psychiatric interviews, physical examinations, and standardized cognitive assessments, including the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), and Barthel Index. Written consent was obtained from the family. Results: The patient displayed severe memory loss, disorientation, and inability to perform basic activities. Cognitive testing confirmed MMSE: 0, CDR: 18, and Barthel Index: 40, indicating severe dementia with high dependence. No prior psychiatric or neurological illness was reported. Non-pharmacological interventions, such as cognitive rehabilitation, stimulation, and training, were identified as effective in maintaining residual abilities, delaying progression, and improving well-being. Conclusion: EOD requires early recognition and comprehensive management due to its profound personal and social impact. Although curative options are unavailable, non-pharmacological therapies offer meaningful benefits by enhancing cognitive function, supporting independence, and improving quality of life for patients and families.
Co-Authors Jessica, Lia Kusuma, Susana Anggar Salma Nur Fadhilah Victoria, Vini Yulianti, Erikavitri