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Scientia Psychiatrica
Published by HM Publisher
ISSN : -     EISSN : 27159736     DOI : https://doi.org/10.37275/scipsy
Core Subject : Health, Science,
Health Professions Medicine & Pharmacology Neuroscience Public Health
Scientia Psychiatrica covers the latest developments in various fields of psychiatric : biological psychiatry, neuropsychiatry, child psychiatry, psychiatry of community, psychotherapy, drugs-related mental illness, psychiatry of geriatric, psychosomatics medicine, psychology, cultural psychiatry, military psychiatry, forensic psychiatry, consultation liaison psychiatry and all medicine fields related psychiatry. Genetics, immunology, environmental health, toxicology, bioinformatics and biotechnology as well as multidisciplinary studies. The views of experts on current advances in nanotechnology and molecular/cell biology will be also considered for publication as long as they have a direct clinical impact of psychiatry.
Arjuna Subject : Kedokteran - Psikiatri dan Kesehatan Mental
Articles 128 Documents
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The Impact of Severe Mental Illness (SMI) on Oral Health-Related Quality of Life (OHRQoL): A Mixed-Methods Study in Surabaya, Indonesia Syaifudin Syaifudin; Duru Carissa Neuer; Muhammad Ashraf; Aprilia Sari
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.v6i1.184

Abstract

Introduction: Severe Mental Illness (SMI) often leads to neglect of personal care, including oral hygiene, and may be associated with specific oral health challenges. This study aimed to comprehensively assess the impact of SMI on Oral Health-Related Quality of Life (OHRQoL) in a population in Surabaya, Indonesia. Methods: A cross-sectional study was conducted involving 120 participants with SMI (schizophrenia, bipolar disorder, and major depressive disorder with psychotic features) recruited from a tertiary psychiatric hospital and community mental health centers in Surabaya, and 120 age- and sex-matched controls without SMI. OHRQoL was assessed quantitatively using the Indonesian version of the Oral Health Impact Profile-14 (OHIP-14). Semi-structured interviews were conducted with a subset of 30 participants with SMI to explore their experiences and perceptions regarding oral health. Oral examinations were performed on all participants to assess Decayed, Missing, and Filled Teeth (DMFT) index, Community Periodontal Index (CPI), and presence of oral mucosal lesions. Results: Participants with SMI had significantly higher mean OHIP-14 scores (32.5 ± 8.2) compared to controls (14.1 ± 4.5) (p < 0.001), indicating poorer OHRQoL. The DMFT index was also significantly higher in the SMI group (12.8 ± 3.7) compared to controls (6.2 ± 2.1) (p < 0.001), and CPI scores indicated worse periodontal health in the SMI group. Qualitative analysis revealed key themes: barriers to accessing dental care (financial constraints, fear, lack of transportation), challenges with daily oral hygiene practices (forgetfulness, lack of motivation, side effects of medication), and limited awareness of the importance of oral health. Conclusion: Individuals with SMI in Surabaya, Indonesia, experience significantly poorer OHRQoL compared to the general population. This is associated with poorer objective oral health status and multiple, interlinked barriers to care. Integrated mental health and oral health services, tailored interventions to improve oral hygiene practices, and increased awareness campaigns are crucial to address this disparity.
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 Eye as a Window to Neuroinflammation in Psychiatric Disorders?: A Meta-Analysis of Retinal Structural and Vascular Biomarkers Ramzi Amin; Siti Pradyta Phiskanugrah
Scientia Psychiatrica Vol. 6 No. 4 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i2.186

Abstract

Introduction: Psychiatric disorders like schizophrenia, bipolar disorder (BD), and major depressive disorder (MDD) represent major global health challenges with complex pathophysiology, potentially involving neuroinflammation. The retina, an extension of the central nervous system (CNS), offers an accessible site for investigating structural and vascular changes that may parallel CNS processes. Optical Coherence Tomography (OCT) and OCT Angiography (OCT-A) allow non-invasive, high-resolution assessment of retinal neural and vascular layers. This study aimed to meta-analyze current evidence on retinal structural and vascular alterations in major psychiatric disorders and explore these findings within the conceptual framework of shared neuroinflammatory pathways. Methods: A systematic literature search was conducted in PubMed, Scopus, and Web of Science databases for studies published between January 1st, 2013, and December 31st, 2024. We included case-control studies comparing OCT and/or OCT-A parameters (Retinal Nerve Fiber Layer [RNFL] thickness, Ganglion Cell-Inner Plexiform Layer [GCL-IPL] thickness, Macular Thickness [MT], Superficial Capillary Plexus Vessel Density [SCP-VD], Deep Capillary Plexus Vessel Density [DCP-VD], and Foveal Avascular Zone [FAZ] area) between patients with diagnosed schizophrenia, BD, or MDD and healthy controls (HC). Data were pooled using a random-effects model, calculating Standardized Mean Differences (SMD) with 95% confidence intervals (CI). Heterogeneity was assessed using I² statistics. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS). Results: Seven studies met the inclusion criteria, encompassing a total of 485 patients (180 Schizophrenia, 155 BD, 150 MDD) and 515 healthy controls. Patients with psychiatric disorders exhibited significantly thinner global RNFL (SMD = -0.68; 95% CI [-0.95, -0.41]; p < 0.00001; I²=75%), GCL-IPL (SMD = -0.75; 95% CI [-1.08, -0.42]; p < 0.0001; I²=80%), and reduced macular SCP-VD (SMD = -0.55; 95% CI [-0.88, -0.22]; p = 0.001; I²=72%) compared to HC. DCP-VD also showed a trend towards reduction (SMD = -0.40; 95% CI [-0.85, 0.05]; p = 0.08; I²=79%). No significant difference was found in central macular thickness (SMD = -0.15; 95% CI [-0.45, 0.15]; p = 0.33; I²=60%) or FAZ area (SMD = 0.20; 95% CI [-0.10, 0.50]; p = 0.19; I²=55%). High heterogeneity was observed across most analyses. Study quality varied, with NOS scores ranging from 6 to 8. Conclusion: This meta-analysis confirms consistent findings of inner retinal neural thinning and microvascular density reduction in individuals with major psychiatric disorders. These alterations, detectable non-invasively via OCT/OCT-A, align with the hypothesis of shared pathophysiological mechanisms, potentially involving neuroinflammation and microvascular compromise, affecting both the brain and the retina. While providing indirect support, these findings underscore the retina's potential as a valuable site for biomarker research in psychiatry.
Pediatric Psychiatric Disorders and Retinal Structure: A Systematic Review and Meta-Analysis of OCT Findings in ADHD and Autism Spectrum Disorder Ramzi Amin; Ririn Rahayu MS
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.v6i1.187

Abstract

Introduction: Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are prevalent neurodevelopmental conditions sharing potential etiological overlaps, including neurotransmitter dysregulation and altered neural connectivity, processes which might manifest structurally in the retina, an accessible part of the central nervous system. Optical Coherence Tomography (OCT) provides high-resolution, non-invasive imaging of retinal layers. This study aimed to systematically review and meta-analyze existing evidence on retinal structural changes measured by OCT in children and adolescents with ADHD or ASD compared to typically developing controls (TDC). Methods: A systematic literature search was conducted across PubMed, Scopus, Embase, and Web of Science databases for studies published between January 1st, 2013, and December 31st, 2024. Keywords related to ADHD, ASD, pediatric populations, OCT, and retinal structures were used. Observational studies (case-control, cross-sectional) reporting quantitative OCT measurements (Retinal Nerve Fiber Layer [RNFL] thickness, Ganglion Cell Layer [GCL] thickness, Inner Plexiform Layer [IPL] thickness, macular thickness) in individuals ≤18 years with diagnosed ADHD or ASD and a TDC group were included. Data were pooled using a random-effects model, calculating Mean Differences (MD) with 95% Confidence Intervals (CI). Heterogeneity was assessed using the I² statistic. This meta-analysis synthesized data from seven studies. Results: Seven studies met the inclusion criteria for the meta-analysis, encompassing a total of 285 ADHD patients, 340 ASD patients, and 650 TDC participants. Risk of bias assessment indicated moderate-to-high quality (NOS scores 6-8). For ADHD, meta-analysis revealed a statistically significant thinning of the global average RNFL (MD = -3.15 µm; 95% CI [-4.95, -1.35]; p=0.0006; I²=45%) and GCL thickness (MD = -2.05 µm; 95% CI [-3.10, -1.00]; p=0.0001; I²=30%) compared to TDC. No significant difference was found in average macular thickness. For ASD, a significant thinning was observed in the GCL (MD = -2.50 µm; 95% CI [-3.80, -1.20]; p=0.0002; I²=55%) and IPL (MD = -1.85 µm; 95% CI [-2.90, -0.80]; p=0.0006; I²=40%) compared to TDC. Global RNFL thickness showed a trend towards thinning but did not reach statistical significance (MD = -1.90 µm; 95% CI [-4.10, 0.30]; p=0.09; I²=60%). Macular thickness was not significantly different. Heterogeneity was moderate for most analyses. Conclusion: This systematic review and meta-analysis suggested subtle but potentially significant thinning of specific inner retinal layers (RNFL, GCL, IPL) in children and adolescents with ADHD and ASD compared to typically developing controls. These findings lend support to the hypothesis of shared neurodevelopmental alterations affecting both the brain and retina in these disorders. However, considerable heterogeneity and the limited number of studies underscore the need for larger, longitudinal, well-controlled investigations with standardized protocols before OCT could be considered a reliable biomarker.
Beyond Peer Influence: The Combined Effect of Self-Driven Motivation and Strong Family Bonds on Sexual Decision-Making Irdayani; Widya Apriani; Sri Wahyuni; Nova Ratna Dewi; Hidayana
Scientia Psychiatrica Vol. 6 No. 4 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i2.189

Abstract

Introduction: Adolescent engagement in risky sexual behavior remains a significant public health concern. While peer influence is widely studied, understanding the protective roles of intrinsic factors like self-driven motivation and proximal systems such as strong family bonds is crucial for comprehensive intervention strategies. This study aimed to investigate the combined effect of self-driven motivation and family bonds on sexual decision-making among adolescents in Wih Pesam District, Bener Meriah Regency, Indonesia. Methods: A cross-sectional survey was conducted with 198 adolescents. Standardized questionnaires assessed self-driven motivation (including components of needs, drive, and goals), family bonds (overall family support and its dimensions: informational, appraisal, instrumental, emotional), and engagement in risky sexual behavior. Data analysis included descriptive statistics, bivariate chi-square tests, and multivariate logistic regression. Results: Findings indicated that 45.5% of adolescents engaged in risky sexual behavior. A majority reported high overall self-driven motivation (46.5%) and high overall family support (49.5%). Bivariate analyses revealed significant associations between components of self-driven motivation, family support, and risky sexual behavior (all p < 0.05). The multivariate logistic regression analysis demonstrated that, after controlling for other factors, higher overall self-driven motivation (High vs. Low: OR=0.40, 95% CI [0.20–0.78], p=0.007) and higher overall family support (High vs. Low: OR=0.25, 95% CI [0.12–0.51], p<0.001) were significantly associated with reduced odds of engaging in risky sexual behavior. Family support emerged as a particularly strong protective factor. The overall multivariate model was significant (p < 0.001) and explained approximately 38% of the variance (Nagelkerke R-squared = 0.38). Conclusion: Both self-driven motivation and strong family bonds are significant protective factors against risky sexual behavior among adolescents in this Indonesian context, with family support showing a more dominant influence. These findings underscore the importance of interventions aimed at fostering adolescents' internal resilience and strengthening positive family environments to promote healthier sexual decision-making, thereby looking beyond peer influence as the sole determinant.
Preventing Cognitive Decline in Late-Life Depression: A Longitudinal Study on the Efficacy of Omega-3 Fatty Acid Supplementation in Older Adults in Palembang, Indonesia Sony Sanjaya; Febria Suryani; Pham Uyen; Maria Rodriguez; Muhammad Yoshandi
Scientia Psychiatrica Vol. 6 No. 4 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i2.190

Abstract

Introduction: Late-life depression (LLD) is a prevalent condition in older adults and a significant risk factor for cognitive decline and dementia. In Indonesia, with its aging population and specific dietary patterns, understanding interventions for LLD-associated cognitive impairment is crucial. Omega-3 polyunsaturated fatty acids (PUFAs) offer potential neuroprotective benefits. This study aimed to assess the efficacy of long-term omega-3 PUFA supplementation in mitigating cognitive decline among older adults with LLD in Palembang, Indonesia. Methods: This 24-month, randomized, double-blind, placebo-controlled trial was conducted in Palembang. Three hundred sixty older adults (aged ≥60 years) with a current DSM-5 diagnosis of Major Depressive Disorder (MDD) and subjective cognitive complaints were randomized (1:1) to receive either daily oral supplementation of 2.2 grams of omega-3 PUFAs (containing 1320 mg eicosapentaenoic acid [EPA] and 880 mg docosahexaenoic acid [DHA]) or a matched placebo (corn oil). The primary outcome was the change in the Indonesian version of the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog-INA) score over 24 months. Secondary outcomes included changes in the Montreal Cognitive Assessment-Indonesian version (MoCA-INA), Geriatric Depression Scale (GDS-30), Instrumental Activities of Daily Living (IADL), serum Brain-Derived Neurotrophic Factor (BDNF), and high-sensitivity C-Reactive Protein (hs-CRP). Results: Over 24 months, the omega-3 group exhibited significantly less decline on the ADAS-Cog-INA compared to the placebo group (mean difference: -2.1 points; 95% CI: -3.8 to -0.4; p=0.018). Statistically significant benefits for the omega-3 group were also observed in MoCA-INA scores (mean difference: 1.5 points; p=0.025) and GDS-30 scores (mean difference: -2.5 points; p=0.011). BDNF levels increased significantly in the omega-3 group relative to placebo (p=0.008), while hs-CRP levels showed a non-significant trend towards reduction (p=0.072). Conclusion: Long-term supplementation with 2.2 g/day of EPA-rich omega-3 PUFAs resulted in a modest but statistically significant attenuation of cognitive decline and improvement in depressive symptoms in older adults with LLD in Palembang. These findings suggest that omega-3 PUFAs could be a valuable adjunctive therapeutic strategy in this specific Southeast Asian population.
The Impact of Tuina Massage Therapy on Sensory Processing, Sleep Disturbances, and Maladaptive Behaviors in Young Children with Autism Spectrum Disorder in Jakarta, Indonesia: A Controlled Clinical Study Fatimah Mursyid; Lin Chia; Khairiel Anwar; Istiqomah Putri; Bjorka Alma
Scientia Psychiatrica Vol. 6 No. 4 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i2.191

Abstract

Introduction: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by challenges in social communication, restricted interests, and repetitive behaviors, often accompanied by sensory processing abnormalities, sleep disturbances, and maladaptive behaviors. Current interventions offer variable efficacy, prompting exploration of complementary therapies. Tuina, a form of therapeutic massage in Traditional Chinese Medicine (TCM), has shown potential in pediatric neurodevelopmental issues. This study aimed to investigate the impact of Tuina massage therapy on sensory processing, sleep quality, and maladaptive behaviors in young children with ASD in Jakarta, Indonesia. Methods: A controlled clinical study was conducted with 88 children aged 3-7 years, diagnosed with ASD according to DSM-5 criteria and confirmed using the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). Participants were recruited from specialized pediatric clinics in Jakarta and assigned to either an intervention group (n=44) receiving a standardized Tuina protocol thrice weekly for 12 weeks alongside standard care, or a control group (n=44) receiving standard care only. Standard care included established interventions such as behavioral therapy, speech therapy, occupational therapy, or special education programs. Outcome measures included the Sensory Profile 2 (SP-2), the Children's Sleep Habits Questionnaire (CSHQ), and the Aberrant Behavior Checklist-Community (ABC-C), administered at baseline, week 6, week 12 (post-intervention), and at a 3-month follow-up (week 24). Results: At 12 weeks, the Tuina group demonstrated statistically significant improvements compared to the control group in sensory processing, specifically in auditory filtering (mean difference [MD] -8.5, 95% CI -11.2 to -5.8, p<0.001) and tactile sensitivity (MD -7.9, 95% CI -10.5 to -5.3, p<0.001) on SP-2 quadrant scores. Total CSHQ scores indicated significantly better sleep in the Tuina group (MD -6.8, 95% CI -9.1 to -4.5, p<0.001), particularly in subscales of bedtime resistance and sleep anxiety. ABC-C scores for irritability (MD -5.2, 95% CI -7.0 to -3.4, p<0.001) and hyperactivity (MD -6.1, 95% CI -8.3 to -3.9, p<0.001) were also significantly lower in the Tuina group. These improvements were largely maintained at the 3-month follow-up. No serious adverse events were reported. Conclusion: This study provides evidence that Tuina massage therapy, as an adjunct to standard care, can significantly improve sensory processing, reduce sleep disturbances, and mitigate maladaptive behaviors in young children with ASD in an Indonesian context. These findings suggest Tuina may be a valuable complementary intervention for managing core and associated symptoms of ASD. Further research with larger, diverse samples and longer follow-up periods is warranted.
Peripheral Inflammatory Markers and Suicidal Behavior in Depressive and Anxiety Disorders: A Systematic Review and Meta-Analysis of Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte, and Monocyte-to-Lymphocyte Ratios Ni Made Citra Riesti Wulan; Wayan Wiradana
Scientia Psychiatrica Vol. 6 No. 4 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i2.192

Abstract

Introduction: Suicidal behavior is a major public health crisis, intricately linked with depressive and anxiety disorders. A growing body of evidence implicates systemic inflammation in the pathophysiology of these conditions and suicidality. This systematic review and meta-analysis aims to synthesize the evidence on the association between accessible peripheral inflammatory markers—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR)—and suicidal behavior in patients with depressive or anxiety disorders. Methods: A systematic literature search was conducted in PubMed, Cochrane, ScienceDirect, Ebsco, and SpringerLink for observational studies up to March 2024. Studies comparing NLR, PLR, or MLR between patients with depressive or anxiety disorders with suicidal behavior and those without were included. Data were pooled using a random-effects model. The primary outcomes were the standardized mean difference (SMD) for NLR and mean difference (MD) for PLR and MLR. Results: Thirteen studies comprising 2,392 patients (1,192 with suicidal behavior, 1,200 controls) were included. The analysis revealed that patients with suicidal behavior had significantly higher NLR (Standardized Mean Difference [SMD] = 0.55; 95% CI: 0.26–0.84; p < 0.001), PLR (Mean Difference [MD] = 11.31; 95% CI: 7.48–15.14; p < 0.00001), and MLR (MD = 0.02; 95% CI: 0.01–0.03; p < 0.00001) compared to non-suicidal patients. Significant heterogeneity was observed in the NLR analysis (I2 = 90%). Conclusion: This meta-analysis establishes a significant association between elevated peripheral inflammatory markers (NLR, PLR, MLR) and suicidal behavior in patients with depressive and anxiety disorders. These findings support the inflammatory hypothesis of suicidality. However, substantial heterogeneity and methodological limitations across studies necessitate cautious interpretation. These markers represent promising areas for future research but are not yet suitable for clinical risk prediction.
A Vicious Cycle: Probable Psychological Distress and Maladaptive Cognition as Barriers to Remediation Among Indonesian Medical Students Failing National Licensure Gladys Putri; Mary-Jane Wood; Zahra Amir; Novalika Kurnia
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.v6i2.193

Abstract

Introduction: Failure on high-stakes medical licensing examinations, such as the Indonesian Medical Doctor Competency Examination (UKMPPD), is a significant stressor. This study aims to delineate the current psychological profile of "repeat takers" (students who have failed at least once) to understand the psychological state associated with being in a cycle of academic failure. Methods: A multi-center, matched case-control study was conducted with 300 participants from five Indonesian medical faculties. The 'Case' group (n=150), recruited from remedial preparation courses, comprised students who had failed the UKMPPD at least once. The 'Control' group (n=150) consisted of peers from the same cohort who passed on their first attempt, matched for university, age, and gender. Psychological variables were measured cross-sectionally using the 10-item Connor-Davidson Resilience Scale (CD-RISC 10), the Brief COPE inventory, and the Self-Reporting Questionnaire-20 (SRQ-20) to screen for probable psychological distress. Results: Cases demonstrated a dramatically higher rate of probable psychological distress, with 62.0% of cases screening positive (SRQ-20 score ≥ 8) compared to 18.0% of controls (p < 0.001). Cases also reported significantly lower current resilience (Mean ± SD: 28.5 ± 5.4 vs. 34.1 ± 4.8, p < 0.001) and significantly greater use of avoidant/maladaptive coping (p < 0.001), driven specifically by Self-Blame (p < 0.001) and Behavioral Disengagement (p < 0.001). Binary logistic regression revealed that factors strongly associated with repeat-taker status included probable psychological distress (OR 5.2, 95% CI 3.1-8.7), lower resilience (OR 0.85, 95% CI 0.79-0.91), and Self-Blame (OR 2.1, 95% CI 1.4-3.2). Conclusion: The psychological state following licensure failure is characterized by a triad of high psychological distress, eroded resilience, and a reliance on self-blaming cognitive distortions. This profile, most parsimoniously interpreted as a consequence of initial failure, constitutes a formidable state of crisis and a critical barrier to successful academic remediation.
The Algorithm as an Architect of Anxiety: 'Lucid Dreaming' Content Precipitating Acute Somniphobia in a Preadolescent—A Case Report on the 'Digital Pathogen' Phenomenon and Culturally Responsive Mediation Ni Wayan Saka Rahayu; Putu Risdianto Eka Putra
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.v6i3.194

Abstract

Introduction: The pervasive integration of digital media into pediatric life has shifted the clinical focus from screen time quantity to content quality. Emerging "metaphysical" sub-genres, such as algorithmic "Lucid Dreaming" tutorials, pose unique risks to preadolescents. This case report aims to document a novel presentation of acute sleep anxiety precipitated specifically by "Lucid Dreaming" tutorials. Case presentation: We report the case of a 10-year-old male of Balinese descent presenting with acute sleep onset insomnia (somniphobia), autonomic hyperarousal (resting heart rate 104 bpm), and separation anxiety. The precipitating event was the consumption of "Astral Projection" and "Reality Shifting" content, which the patient, being in the Concrete Operational stage of cognitive development, misinterpreted as a literal biological threat of "soul separation." Assessment via the Spence Children’s Anxiety Scale (SCAS) yielded a score of 46 (98th percentile), indicating severe anxiety. A four-week intervention was implemented, utilizing a Cultural Formulation approach that integrated Balinese spiritual coping with Cognitive Reframing and a Structured Parental Mediation Protocol (restrictive mediation and active co-viewing). Post-intervention analysis showed a statistically significant reduction in SCAS scores to 18 (Reliable Change Index > 1.96) and normalization of sleep onset latency from 140 minutes to 25 minutes. Conclusion: This case identifies specific abstract digital content as a potential cognitive pathogen for vulnerable developmental stages. It highlights the necessity of auditing content quality and validates the efficacy of culturally responsive parental mediation in resolving digitally induced psychopathology.

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