Article Per Year (5 Year)
p-Index From 2020 - 2025
0.408
P-Index
This Author published in this journals
All Journal Medicor : Journal of Health Informatics and Health Policy Sinergi International Journal of Psychology
Septina, Egy Atthahirah
Unknown Affiliation
Education Health Professions Public Health Social Sciences

Published : 2 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 2 Documents
Search

 1 
Rapid Cycling Bipolar and Trauma-Related Personality Traits: Bridging the Gap Between Affective Dysregulation and Early-Life Adversity Septina, Egy Atthahirah; Halimatus Sakdyah; Pramesta, Linda Ramadhanty; Muhammad Ikhsan; Alsa Shafira; Budi Cahyono; Hafid Algristian
Medicor : Journal of Health Informatics and Health Policy Vol. 3 No. 1 (2025): January 2025
Publisher : Indonesian Scientific Publication

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61978/medicor.v3i1.740

Abstract

Rapid cycling bipolar disorder (RCBD) represents a severe and treatment-resistant subtype of bipolar disorder in which patients experience at least four mood episodes within a year, often accompanied by greater psychiatric comorbidity, functional impairment, and suicide risk compared to non-rapid cycling cases. Childhood trauma and early-life adversity have been identified as critical contributors to emotional dysregulation, impulsivity, and treatment resistance, yet their role is frequently underrecognized in clinical practice. This case report describes a 30-year-old woman diagnosed with RCBD and a history of emotional and physical abuse in childhood, aiming to illustrate the complex interaction between trauma and affective instability while integrating neurobiological, psychological, and clinical perspectives. The patient underwent four weeks of inpatient evaluation that included structured interviews, collateral history from caregivers, psychometric assessments using the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D), and Difficulties in Emotion Regulation Scale (DERS), as well as daily multidisciplinary observation. Over the past year, she experienced six distinct mood episodes with severe deficits in emotional clarity and impulse control, elevated DERS scores, and only partial response to pharmacological treatment with valproate and quetiapine. Clinical patterns and supporting literature suggest that trauma-induced dysregulation, involving amygdala hyperactivation and hypothalamic–pituitary–adrenal (HPA) axis disruption, played a central role. Improvement was achieved only after trauma-focused psychotherapy and psychosocial support were incorporated into her care. This case highlights the necessity of early trauma screening and integrative, trauma-informed management to improve diagnostic accuracy, treatment engagement, and long-term outcomes in complex bipolar presentations.
Hormonal Influence on Mood Dysregulation: A Case of Bipolar Disorder with Endometriosis Sakdyah, Halimatus; Septina, Egy Atthahirah; Pramesta, Linda Ramadhanty; Ikhsan, Muhammad; Shafira , Alsa; Nurhayati , Endi; 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.v3i4.829

Abstract

Bipolar disorder often coexists with gynecological conditions such as endometriosis, presenting clinical challenges due to overlapping hormonal and neuropsychiatric influences. The impact of hormonal therapy on mood stability in women with affective disorders remains underexplored. We report the case of a 30-year-old woman with bipolar II disorder, stable for nearly two years on lamotrigine, who developed mood destabilization after initiating hormonal treatment for stage III endometriosis. Sequential regimens—dienogest, norethisterone, and ethinylestradiol–levonorgestrel—were temporally associated with new or worsening mixed affective symptoms, including agitation, insomnia, irritability, and emotional lability, despite adherence to mood stabilizers. Her Hamilton Depression Rating Scale score increased from 9 to 21 within three months, with laboratory evaluation showing elevated estradiol and suppressed luteinizing hormone, supporting a hormone-related mechanism. A structured literature review (PubMed, Scopus, Google Scholar, 2000–2024) identified limited but consistent evidence that synthetic progestins may exacerbate psychiatric symptoms in mood-vulnerable populations through neuroendocrine and neurotransmitter modulation. This case underscores the importance of recognizing hormonally induced mood dysregulation in women with pre-existing psychiatric disorders and highlights the need for proactive management strategies. We recommend pre-treatment psychiatric screening, structured and longitudinal mood monitoring throughout hormonal therapy, and close interdisciplinary collaboration between gynecology and psychiatry to optimize outcomes. Integrated care approaches may reduce the risk of mood destabilization, enhance safety, and improve quality of life for women facing the dual burden of bipolar disorder and endometriosis.
Co-Authors Algristian, Hafid Algristian, Hafid Alsa Shafira Budi Cahyono Halimatus Sakdyah Muhammad Ikhsan Nurhayati , Endi Pramesta, Linda Ramadhanty Sakdyah, Halimatus Shafira , Alsa