Scientia Psychiatrica

Risk Factors of Perioperative Anxiety Levels in Sectio Caesarea Patients: A Cross-Sectional Study in Single Center, Bali, Indonesia

Anak Agung Angga Pringga Dana — 2024-12-09

Introduction: Anxiety is a prevalent emotional response in patients undergoing surgical procedures, including cesarean sections. Perioperative anxiety can negatively impact patient outcomes, affecting physiological parameters and postoperative recovery. This study aimed to identify the prevalence and risk factors associated with perioperative anxiety levels in patients undergoing cesarean section at Prof. Dr. I.G.N.G. Ngoerah Hospital, Bali, Indonesia.

Methods: This cross-sectional study involved 37 patients scheduled for elective cesarean section at Prof. Dr. I.G.N.G. Ngoerah Hospital. Anxiety levels were assessed using the Perioperative Anxiety Scale (PASS), a validated instrument for measuring anxiety related to surgery. Data on sociodemographic characteristics, obstetric history, and medical history were collected through a questionnaire. Descriptive statistics and logistic regression analysis were used to analyze the data.

Results: The majority of participants (59.5%) experienced mild to moderate anxiety levels. Age, occupation, education level, history of emergency surgery, previous surgical history, and gravidity were identified as potential risk factors associated with higher anxiety levels. Patients aged 25-29 years, housewives, those with a high school education, a history of emergency surgery, previous surgical experience, and primiparity were more likely to report mild to moderate anxiety.

Conclusion: Mild to moderate anxiety is prevalent among cesarean section patients. Identifying risk factors associated with perioperative anxiety can aid healthcare providers in implementing targeted interventions to reduce anxiety and improve patient well-being.

Impact of Maternal Anxiety and Stress During Pregnancy on Fetal Neurodevelopment: A Longitudinal Cohort Study in Jakarta, Indonesia

Leonardo Simanjuntak — 2025-02-06

Introduction: Maternal anxiety and stress during pregnancy are increasingly recognized as significant factors influencing fetal neurodevelopment. This study investigated the impact of maternal anxiety and stress levels during pregnancy on various aspects of fetal neurodevelopment in a cohort of pregnant women in Jakarta, Indonesia.

Methods: A longitudinal cohort study was conducted at three major hospitals in Jakarta, involving 500 pregnant women in their first trimester. Maternal anxiety and stress levels were assessed using the State-Trait Anxiety Inventory (STAI) and the Perceived Stress Scale (PSS) at three time points: first trimester (10-14 weeks), second trimester (20-24 weeks), and third trimester (30-34 weeks). Fetal neurodevelopment was assessed using fetal movement counting, fetal heart rate variability (using Doppler ultrasound), and later, infant neurodevelopmental assessments at 6 and 12 months postpartum using the Bayley Scales of Infant Development III. Data analysis involved correlation and regression analyses to examine the relationship between maternal anxiety/stress and fetal/infant neurodevelopmental outcomes.

Results: The study found a significant positive correlation between maternal anxiety and stress levels across all trimesters. Higher maternal anxiety and stress, particularly in the second and third trimesters, were associated with reduced fetal movement counts (p < 0.05) and altered fetal heart rate variability patterns (p < 0.01). Furthermore, higher maternal anxiety and stress during pregnancy were associated with lower scores on the cognitive and motor scales of the Bayley Scales at both 6 and 12 months (p < 0.001). Specifically, maternal anxiety in the third trimester was the strongest predictor of lower cognitive scores at 12 months.

Conclusion: Maternal anxiety and stress during pregnancy, particularly in the second and third trimesters, have a demonstrable impact on fetal neurodevelopment and subsequent infant development. These findings highlight the importance of screening for and managing maternal anxiety and stress during pregnancy to promote optimal fetal and infant neurodevelopment. Interventions targeting stress reduction and anxiety management should be integrated into routine prenatal care.

The Impact of Trauma-Informed Care on Mental Health Outcomes for Incarcerated Youth: A Longitudinal Study in Bandung, Indonesia

Dedi Affandi — 2025-02-07

Introduction: Incarcerated youth represent a vulnerable population with disproportionately high rates of trauma exposure and mental health disorders. This study investigated the longitudinal impact of a trauma-informed care (TIC) program on mental health outcomes for incarcerated youth in Bandung, Indonesia.

Methods: A quasi-experimental design was employed, comparing a group of incarcerated youth who received TIC with a control group receiving standard care. Participants (n=200) were assessed at baseline, 6 months, and 12 months using validated instruments measuring PTSD symptoms, depression, anxiety, and behavioral problems. Data analysis included repeated measures ANOVA and correlational analyses.

Results: Youth in the TIC group demonstrated significant reductions in PTSD symptoms, depression, and anxiety over time compared to the control group. Improvements in behavioral problems were also observed in the TIC group. These positive changes were sustained over the 12-month period.

Conclusion: This study provides evidence for the effectiveness of TIC in improving mental health outcomes for incarcerated youth. Implementing TIC programs in juvenile detention facilities is crucial for addressing the mental health needs of this vulnerable population.

The Impact of Severe Mental Illness (SMI) on Oral Health-Related Quality of Life (OHRQoL): A Mixed-Methods Study in Surabaya, Indonesia

Syaifudin Syaifudin — 2025-02-10

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 — 2025-02-11

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.