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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 ‘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.
Beyond the Canopy Cover: A Comparative Mediation Analysis of Green Space Quality versus Quantity on Mental Well-being and Social Cohesion in High-Density Low-Income Neighborhoods Jasmila Tanjung; Maya Enderson; Taufiq Indera Jayadi; Eva Naritawati; Nurul Hanifah; Maximillian Wilson
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.v6i3.197

Abstract

Introduction: Rapid urbanization in the Global South has precipitated a mental health crisis, particularly in high-density, low-income neighborhoods where environmental stressors are endemic. While the association between urban green space (UGS) and mental well-being is well-documented, a critical knowledge gap remains regarding the differential impacts of green space quantity (availability) versus quality (usability/biodiversity) and the mediating role of social cohesion. Methods: This cross-sectional study employed a comparative mediation analysis involving 1,240 residents across 15 high-density districts in Jakarta, Indonesia. UGS quantity was measured using satellite-derived Normalized Difference Vegetation Index (NDVI), while quality was assessed using the Quality of Public Open Space Tool (POST). Mental well-being was evaluated using the WHO-5 Index, and physiological stress was quantified via salivary cortisol. Structural Equation Modeling (SEM) was utilized to test the mediating pathways of social cohesion and physical activity. Results: UGS quality demonstrated a significantly stronger direct effect on mental well-being (β = 0.42, p < 0.001) compared to UGS quantity (β = 0.15, p < 0.05). Social cohesion fully mediated the relationship between UGS quality and well-being (Indirect Effect = 0.18, 95% CI [0.12, 0.25]), whereas salivary cortisol levels were inversely associated primarily with UGS quality (β = -0.33, p < 0.001). Conclusion: In resource-constrained urban environments, the quality of green space—defined by safety, amenities, and aesthetics—is a more critical determinant of public mental health than mere vegetative cover.
Quantifying the Boiling Point: A Distributed Lag Non-Linear Analysis of Heatwave Intensity and the 'Thermal Distress' Threshold for Psychiatric Morbidity in an Indonesian Metropolis Taufiq Indera Jayadi; Eva Naritawati; Nurul Hanifah; Maximillian Wilson; Khairiel Anwar; Febria Suryani; Zaki Ahmad
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.v6i3.198

Abstract

Introduction: The Indonesian archipelago sits at the forefront of the climate crisis, yet the intersection of heat stress and mental health in this equatorial region remains under-researched. Unlike temperate climates, where heatwaves are sporadic, Indonesian cities face a chronic thermal load exacerbated by the Urban Heat Island effect. Methods: We conducted a retrospective ecological time-series analysis in Jakarta, Indonesia, spanning the period from January 1st, 2014, to December 31st, 2024. Daily psychiatric Emergency Department admissions (Total N = 48,210) were aggregated from three referral hospitals. We utilized a Distributed Lag Non-linear Model combined with a quasi-Poisson regression to correlate admissions with meteorological data from the Indonesian Agency for Meteorology, Climatology, and Geophysics, adjusting for holidays, day of the week, and particulate matter 2.5. Results: The Thermal Distress Threshold was identified at a Wet Bulb Globe Temperature of 29.8°C, reflecting a high degree of physiological acclimatization. Beyond this tipping point, the cumulative Relative Risk for acute psychiatric episodes rose to 1.21 (95% Confidence Interval: 1.14–1.29) at lag 0–3 days. Schizophrenia spectrum disorders showed the highest vulnerability (Relative Risk = 1.26) during the transition season heat spikes. Conclusion: The study establishes a localized thermal threshold for psychiatric emergencies in Indonesia. The findings suggest that high ambient humidity, characteristic of the Indonesian climate, significantly amplifies the psychiatric risk of heat. These results necessitate the integration of psychiatric protocols into the BPJS Kesehatan national health strategy for climate adaptation.
Loneliness as a Lethal Risk Factor: A Five-Year Prospective Survival Analysis of All-Cause Mortality Among Elderly Residents in Indonesian Vertical Public Housing Dedi Sucipto; Brenda Jaleel; Aline Hafidzah; Oliva Azalia Putri
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.v6i3.199

Abstract

Introduction: Rapid urbanization in Indonesia has necessitated a shift from horizontal settlements (kampung) to vertical public housing (Rusunawa). While providing shelter, these environments may exacerbate "crowded isolation”. This study investigates the synergistic impact of loneliness, depression, and vertical living constraints on all-cause mortality among the elderly. Methods: We conducted a multi-center, prospective cohort study (2018–2023) involving 1,450 elderly residents (> 60 years) in Jakarta and Surabaya. Loneliness was assessed annually using the UCLA Loneliness Scale, and depression via the GDS-15. The primary environmental exposure was "vertical constraint," defined as living above the 3rd floor (Floors 4–12). We utilized Kaplan-Meier survival curves and Multivariable Cox Proportional Hazards models with time-dependent covariates to estimate Hazard Ratios (HR), adjusting for sociodemographic factors and a composite Socioeconomic Status (SES) index. Results: Of 1,398 baseline participants, 218 deaths occurred over 6,890 person-years (15.6% mortality). Severe loneliness was an independent predictor of mortality (Adjusted HR: 1.89; 95% CI: 1.42–2.51). A significant interaction was observed between loneliness and vertical constraint (p=0.003). While residents on higher floors had lower baseline mortality due to selection bias (the "healthy resident effect"), loneliness in this subgroup amplified mortality risk substantially (Interaction HR: 1.76; 95% CI: 1.21–2.55), effectively negating their physical survival advantage. Conclusion: Loneliness is a potent predictor of mortality in Indonesian vertical slums, with lethality accelerated by the physical entrapment of high-floor living. Structural interventions are urgently required to mitigate this "vertical isolation."
Psychobiological Mechanisms of Resilience in the Pesantren Ecology: A Comparative Structural Equation Modeling of Distress, Coping, and Salivary Cortisol between Boarding and Non-Boarding Santri in East Java Winata Putri; Irna Nettles; Theresia Putri Sinaga; Vidhya Sathyakirti; Sari Sulistyoningsih
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.v6i3.200

Abstract

Introduction: The Pesantren (Islamic boarding school) represents a unique educational ecosystem in Indonesia that imposes distinct psychosocial demands on students (Santri). While the academic outcomes of this system are well-documented, the psychobiological divergences between boarding (Mukim) and non-boarding (Kalong) students regarding stress adaptation remain under-researched. Methods: This cross-sectional comparative study involved 500 adolescents (ages 15-18) from four large Pesantrens in East Java, stratified into Boarding (n = 250) and non-boarding (n = 250) groups. Participants completed the Kessler Psychological Distress Scale (K-10), the Connor-Davidson Resilience Scale (CD-RISC-25), and the Brief-COPE. Additionally, morning salivary cortisol samples were collected to assess hypothalamic-pituitary-adrenal (HPA) axis activity. Data were analyzed using MANCOVA and Structural Equation Modeling (SEM). Results: Boarding students exhibited significantly higher baseline psychological distress (p < 0.001) and elevated cortisol levels compared to non-boarders. However, they also demonstrated significantly higher resilience scores and utilization of adaptive religious coping strategies. SEM analysis revealed that while boarding status is a predictor of physiological stress, its impact on psychological distress is fully mediated by adaptive coping mechanisms and community integration. Conclusion: Boarding students face heightened physiological stress loads but possess superior compensatory resilience mechanisms driven by religious coping. Interventions should focus on strengthening these adaptive pathways.
Buffering Effects of Extended Family: A Moderated Mediation Analysis of Maternal Depression, Parenting Stress, and Early Childhood Development in West Java, Indonesia Habiburrahman Said; Novalika Kurnia; Aline Hafidzah; Vania Delma; Fachrudin Sani
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.v6i2.201

Abstract

Introduction: In low- and middle-income countries (LMICs), maternal mental health significantly impacts early childhood development (ECD). West Java, Indonesia, presents a unique cultural context where extended family involvement is ubiquitous. This study aims to elucidate the mechanism linking maternal depressive symptoms to early childhood developmental delays, focusing on the mediating role of parenting stress and the moderating role of social support from extended family. Methods: A cross-sectional analytical study was conducted in five regencies of West Java (N = 842 mother-child dyads). Children were aged 12–36 months. We utilized the Edinburgh Postnatal Depression Scale (EPDS) for depressive symptoms, the Parenting Stress Index-Short Form (PSI-SF) for stress, the Multidimensional Scale of Perceived Social Support (MSPSS) adapted for extended family, and the Ages and Stages Questionnaire (ASQ-3) for developmental monitoring. A moderated mediation model (Hayes Model 7) was tested using Structural Equation Modeling (SEM) with 5,000 bootstrap samples. Results: High maternal depressive symptoms were significantly associated with lower ECD scores (β = -0.42, p < 0.001). Parenting stress partially mediated this relationship (Indirect Effect = -0.18, 95% CI [-0.24, -0.13]). Crucially, extended family support moderated the path between depression and parenting stress (β = -0.15, p < 0.01). Specifically, the impact of depression on parenting stress was significantly dampened in households with high extended family engagement compared to those with low support. Conclusion: Parenting stress is a critical pathway through which maternal depression compromises child development. However, the collectivist family structure in West Java serves as a protective buffer. Interventions should target not only the mother but also mobilize the extended family network as a resource for 'kalyana mitra' (supportive friends/family).
The Screen as a Shield: Internet Addiction as a Maladaptive Defense Against Childhood Emotional Neglect in a Left-Behind Adult Made Citra Riesti Wulan; Wayan Wiradana
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.v6i2.202

Abstract

Introduction: Internet addiction (IA) is frequently conceptualized as an impulse control disorder driven by dopaminergic dysregulation. However, in the context of left-behind children—those raised by grandparents due to parental migration—IA may function as a complex psychodynamic defense mechanism. This study aims to elucidate the role of the smartphone as a digital shield against the resurfacing trauma of Childhood Emotional Neglect (CEN) and attachment deficits. Case presentation: We report the case of a 23-year-old female in Eastern Bali presenting with acute dysphoria, elective mutism, and total insomnia following the confiscation of her smartphone. Assessment included the Internet Addiction Test (IAT), clinical interviews utilizing written communication during the mute phase, and family system analysis. The patient scored 58 on the baseline IAT, indicating moderate addiction. Clinical inquiry revealed a history of split-parenting, where the patient was reared by emotionally distant grandparents. The smartphone served a specific function of displacement, seeking safety in online relationships, and dissociation, used to numb loneliness. The device confiscation triggered a traumatic re-enactment of early childhood abandonment, resulting in physiological hyperarousal incompatible with the moderate IAT score. Treatment involved Fluoxetine (20mg), Clobazam (10mg), and psychodynamic psychotherapy focusing on attachment repair. At the 4-week follow-up, the IAT score decreased to 32, and verbal communication was fully restored. Conclusion: IA in young adults with developmental trauma functions as a maladaptive defense mechanism (The Digital Shield). Clinicians must address the underlying attachment wound rather than focusing solely on digital detoxification to achieve sustainable remission.

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