Muhammad Zikri Nurhakim

Mental Disorder

Is a syndrome or pattern of behavior, or psychological clinics someone who is quite significant, and are typically associated with a symptom of pain or disturbance in one or more essential functions of humans. In addition, it was concluded that the dysfunction is a dysfunction in terms of behavior, psychological or biological, and disorders that are not located solely within the relationship between man and society (Rusdi Maslim, 1998).

Classification of Mental Disorders
Classification of psychiatry involves differentiation of normal from abnormal behavior. In this case the normal and abnormal may mean that healthy and sick, but it can also be used in another sense. A number of psychiatric symptoms differ sharply from the normal and almost always indicate disease: Mental disorders are divided into two major mental disorders, if mental illness and mental disabilities. Mental disability which includes a state of intellectual deficit and have been since birth or at an early age. Mental disease implies that the previous health, developing a disorder or a disorder that manifests later in life
1. Mental illness in principle divided into psychoneurosis and psychosis. This category in accordance with the lay of the anxiety and madness. Psychoneurosis a common condition whose symptoms can be understood and emphatic. Psychosis is a disease whose symptoms can not be understood and not emphatic and clients often lose contact with reality.
2. The term functional and organic diseases showed etiology and used to divide psychosis. Functional psychosis is a disorder of function, with no pathological abnormalities that can be proven

Causes of Mental Disorders
The main symptoms or prominent symptoms of mental disorders contained in mental element, but perhaps the main cause of loss (somatogenic), in the social environment (sociogenic) or psychological (psychogenic), (Maramis, 1994). Usually there is no single cause, but some of the causes and the various elements that affect each other or accident occur together, then become mental disorders.
 1. Biological
For example for schizophrenia, no studies in the family DNA samples to find evidence of a defective gene, located on chromosome 5. But the research that examines family with high incidence found no evidence of a link between chromosome 5 and schizophrenia.  Schizophrenia is a group of disorders that produce similar symptoms but have different biological causes Dopamine, neurochemistry, and differences in brain structure irregularities. 
2. Social and psychological
Poverty populated houses, malnutrition, educationàlow socioeconomic /  is not complete, inadequate parenting, lack of time for the family, no sense of security and comfort. Full of criticism / anger, communication, confusing communication 
Traumatic events 
¬ stressful environmental conditions
¬ Modeling
¬ negative self-concept, low confidence, the ability of low social relations
¬ Poor to adjust and deal with environmental

Picture 2. Me (left) & client with mental disorder (right)
Location: Under Pasopati Bridge, Bandung

Type of Mental Disorders
Mental disorders means that the prominent symptoms are the psychological from the psychic element (Maramis, 1994). Various kinds of mental disorders (Rusdi Maslim, 1998): organic mental disorders and symptomatic, schizophrenia, disturbances and disorders skizotipal supposition, feeling mood disorders, neurotic disorders, somatoform disorders, behavioral syndromes associated with physiological disturbances and physical factors, personality disorders and adulthood behavior, mental retardation, developmental disorders psychological, behavioral and emotional disorders with onset during childhood and adolescence. 

1). Schizophrenia.
Schizophrenia is a form of functional psychosis the most severe, and caused disorganization of the biggest personalities. Schizophrenia is also a form of psychosis that is often found everywhere from time immemorial. Nevertheless our knowledge about the causes and pathogenesis very less (Maramis, 1994). In severe cases, clients do not have contact with reality, so that abnormal thinking and behavior. Course of the disease will gradually towards chronicle, but can occasionally arise attacks. Rarely perfect recovery can occur spontaneously and if not treated usually end up with a damaged personality "defects".

2). Depression
Depression is a disturbance of human functions related to the natural feelings of sadness and symptoms, including changes in sleep patterns and appetite, psychomotor, concentration, fatigue, despair and helplessness, and suicidal ideas (Kaplan, 1998). Depression can also be interpreted as a form of psychological disorder in nature which is marked by feelings of depression, freedom, absence of passion, feeling useless, hopeless and so forth. Depression is a feeling of sadness and suffering associated with. Attacks can be directed at oneself or feelings of deep anger. Depression is a pathological disturbance of mood has the characteristics of a variety of feelings, attitudes and beliefs that a person living alone, pessimism, despair, lack empowerment, low self-esteem, guilt, negative expectations and fear of impending danger. Depression is sadness that resembles a normal feelings that arise as a result of certain circumstances such as death of a loved one. Instead of losing a sense of knowing someone will refuse to lose and show signs of sadness with depression (Rawlins et al., 1993). Individuals who suffer from mood feeling (mood) that depression will usually lose interest and excitement, and reduced energy leading to the state of tiredness and reduced activity. Depression is considered normal for a lot of stress and abnormal life only if he is not worth the cause and the event continues until the point where most people begin to recover. (Atkinson, 2000).

3). Anxiety
Psychic experience of anxiety as a normal and natural, ever experienced by everyone in order to spur individuals to overcome the problems facing the best, Maslim (1998). A state of a person to feel worried and afraid as a form of reaction from non-specific threats (Rawlins et al., 1993). The cause and source is usually not known or not recognized. The intensity of anxiety is distinguished from mild anxiety to severe levels. According to Sundeen (1995) identifies a range of responses into four levels of anxiety which include, mild, moderate, severe anxiety and panic. 

4). Personality Disorder
Clinic showed that the symptoms of personality disorder (psikopatia) and nerosa symptoms similar shape to those with high or low intelligence. So arguably the personality disorders, and disruption nerosa the bulk of intelligence does not depend on one another or are not correlated. Classification of personality disorders: paranoid personality, affective or siklotemik personality, schizoid personality, explosive personality, anakastic or obsessive personality-compulsive, hysterical personality, asthenia personality, antisocial personality, passive aggressive personality, personality inadequate, Maslim (1998).

5). Organic Mental Disorder
Is a psychotic mental disorder or non-psychotic disorders caused by brain tissue function (Maramis, 1994). Malfunctioning of the brain tissue can be caused by physical disease of the brain primarily or mainly outside the brain. When the affected part of the brain was extensive, the basic disturbance of mental function is the same, not depending on the disease caused when only part of the brain with specific functions are impaired, then this is what determines the location of symptoms and syndrome, not a disease that causes it. The division became psychotic and not psychotic more show severe brain disorder in a particular disease rather than the division of acute and chronic.
6). Psychosomatic disorders
Is a psychological component that followed bodily dysfunction (Maramis, 1994). It often happens that neurotic developments reveal a lot or simply because malfunctioning organs controlled by the vegetative nervous system. Psychosomatic disorders can be equated with what is called the first neurosa organs. Since usually only the affected faal function, so often called psycho-physiologic disorders.

7). Mental retardation
Mental retardation is a state of mental development is interrupted or incomplete, which mainly characterized by the occurrence during the development of skills, so the impact on the overall level of intelligence, such as cognitive ability, language, motor and social (Maslim, 1998).

8). Behavioral Problems In Children and Youth.
           Children with behavioral disorders who do not behave in accordance with the request, habits or norms of society (Maramis, 1994). Children with behavior disorders may cause difficulties in the care and education. Behavior disorders may come from a child or perhaps from the environment, but ultimately both of these factors affect each other. Given that the character and shape of the body as well as general personality traits that can be derived from parent to child. In brain disorders such as head trauma, encephalitis, neoplasm can cause personality changes. Environmental factors can also affect children's behavior, and often more decisive because the environment can be changed, then the behavioral disturbances so it can be affected or prevented.

Here are the signs of people at greater risk for mental disorders / mental illness:
1. Feeling depressed, sad or high levels of stress constantly.
2. Often thinking / dreaming of the ordinary (delusions).
3. Difficulty to perform work or daily tasks, although work has been undertaken for many years.
4. Paranoid (anxiety / fear) in the ordinary things that for normal people not to fear or worry.
5. Like to use drugs just for fun.
6. Have thought to end the life or suicide.
7. Self change significantly.
8. Have emotions or feelings are easily changeable.
9. Pattern of dietary changes.
10. Sleep patterns do not change as usual. (Depkes, 1993)
According to the understanding of health, mental illness, if someone said he was no longer able to function normally in everyday life, at home, at school / college, at work and in social environments. Someone who has a mental disorder will experience an inability to function optimally in daily life.  (Adel, 2009)
Statistical data presented by WHO-World Health Organization (1990) mentions that at any time, 1% of the world's population are in need of help and treatment for a mental disorder. Meanwhile, 10% of the population need mental medical assistance at one time in his life.

1. Internal
a.   In Feelings
Anxious, sad, unhappy, bitter, low self-esteem, unstable emotion, frustration.? Be careful with: learned helplessness
b.   In Mind / Intelligence
Hard to concentrate on important things, easily forgotten, decreased ability to think, less able to use the intelligence dimilki (less lost his composure soul).
Be careful with: Pattern / power convergent thinking (one way) because the loss of creativity, spontaneity and originality
c.   On Behavior
Isolate themselves, suddenly become silent, often daydreaming, expression of anger is not natural (not in accordance with the stimulus) both in themselves and to others, because of dissatisfaction with himself and conflicts that are not channeled. Be careful with: the desire to keep himself aloof
d.  On Physical Health
Psychosomatic: physical pain caused by mental problems, such as blood pressure increases / decreases, migraine, diarrhea, ulcers, allergies, etc.. Be careful with: psychosomatic which "legalized"

2. External
a. To Couple
Reduce the quality of relationships, communication, intimacy, commitment, spreading confusion, hurt, anger, terror, domestic violence
b. To Children 
Being a model is VERY BAD, a confused child, loved but hated, hated, but loved, shake his personality, turning facts play, destroy faith development, making children with low emotional intelligence, cutting the child's identity formation, domestic violence (Domestic Violence) will produce children with mental disorders are more severe.
c. In Employment
Decreased task completion until incapacitated. Low problem solving, cooperation decreases, especially for synergy.

  1. Mental Disorder Light
Consultation with the concerned friend, counselor, clergy Relaxation, Stress management exercise routine regularly, spiritual activity
  1. Mental Disorder Medium
Consultation with a psychologist, a trained counselor, a trained spiritual leaders Relaxation, Stress management  exercise routine regularly, spiritual activity and stronger
  1. Serious Mental Disorder
Treatment with a psychiatrist, who primarily for farmako-therapy, psychotherapy and consultation to psychologists to support the family and the environment.
 routine activities of the discipline and control that have been planned (Godam, 2009)

Muhammad Zikri Nurhakim

Signs And Symptoms Of Mental Disorders

Cognition disorders.
Mental processes of an individual to realize and maintain good relationship with the environment in the environment and external environment. Disturbance of perception of illusions, hallucinations. Hallucinations are divided into several types such as auditory hallucinations, visual hallucinations, hallucinations olfactory, gustatory hallucinations, tactile hallucinations, sexual hallucination, hallucination kinesthetic, visceral hallucinations, depersonalization, de realization (Yosep, 2007).

Attention Disorder

Attention is the centralization and concentration of energy rate in a cognitive process that comes from the outside due to a stimulation. There are 3 requirements that must be fulfilled that is inhibitory, apersepsi, and adaptation. Some form of attention disorder
1. Distractibility, attention easily distracted by stimuli that does not mean (eg, mosquito sounds, vehicles, passersby)
2. Aprosexia, diligently watching the inability of the situation / circumstances without regard to the importance of the problem.
3. Hyperprosexia, state the concentration of excessive concentration so that narrow the existing perceptions.

Picture 1. Me (right) & patient with mental disorder (left) Uncensored:p

 Location: Near Ikopin Bridge, Jatinangor

Memory disorders
Memory is the ability to record, store, and produce content and signs of consciousness. So the memory process consists of recording, storing, and recalling. Influential factor is age, fatigue, anxiety. Kinds of memory disorders are:
1. Amnesia, unable to recall the experience there. Retrograde or ante grade are also psycho gen.
2. Hypernemsia, calling it an excessive return on past events  detail. often occurs in mania, paranoia, and catatonic.
3. Paramnesia, disturbance of memory distortion known good long. This distortion occurs due to the calling process paramnesia useful as a protection against fear. Type, namely: confabulation, retrospective falsification, déjà vu, de Jamais vu.

Association Disorder
Association is the mental process with a lemon, impression, or the memory representation tends to give the impression or the memory of previous responses related. Factor, namely: environmental conditions, new events occur, lessons and previous experience, expectations and habits of a person, needs and emotional history.
Forms of interference associations:
1. Retardation, the association that lasted more slowly than usual.
2. Poverty of ideas, there is a lack of association used
3. Perseverasi, the association started again, unable to let go of ideas that have been spoken.
4. Flight of ideas, the flow of associations happened very quickly, looking from the change content of the conversation and thought. The idea of a not yet completed, followed by other ideas.
5. Incoherence, the flow of associations is not related to each other. Shaped as a "word salad" or neologisms (creation of new words that do not mean).
6. Blocking, failure to form associations, ranging from the situation as a result of strong emotional reactions.

Considerations Disorders
Consideration is the mental process to compare or evaluate several options in a framework to deliver value to decide the purpose and objectives of an activity. Three things that support the functioning of the consideration of sensory apparatus, memory, and motor apparatus. Classified as noise interference considerations thought process (supposition).

Thought Disorder
The normal thinking process flow contains ideas, symbols, and associations that focus on the goal and raised by a problem or task that can lead to a solution-oriented reality. Factors that influence the thinking process of somatic factors (brain disorders and fatigue), psychological factors (emotional disorders and psychosis), social factors (noise and a certain social circumstances).
Some form of disturbance of thinking process:
1. Disturbance of mind, including deviations from rational thinking, logic, and focus on a goal.
a. Deristic mind, the thought-form which there is no relationship between the experience of mental processes that are running. Here the mental processes do not fit with reality
b. Autistic mind, disorders of the failure to distinguish the line between reality and fantasy. Someone wants to satisfy a fantasy.
c. Non-realistic mind, the prominent symptoms of schizophrenia in addition hebephrenic behavior childish.
d. Obsessive thoughts, the ideas always come over and over, irrational, and consciously do not want, but can not be eliminated.
e. Confabulation, disruption of one's mind to unite things that are not related to fill vacancies arising because of the thought of memory loss.

2. Interference currents or way of thinking and the rate includes ways of thinking processes such as association, flight of ideas, retardation, persevarasi, circumstantialities, incoherence, blocking, logorrhea, neologisms, irrelevant, aphasia.
3. Disturbance thoughts
a. Supposition Trust stunned that can not be corrected on the basis of facts. Must be maintained, pathological and not related to local culture.
b. Phobia. An irrational fear of an object or situation that can not be eliminated or suppressed by the patient even though we realize that it is irrational.
c. Ideas of reference, a condition where the conversation of people, objects, or events connected with himself.
d. Pre Occupation, thought that fixed only on one idea, usually associated with strong emotional state.
e. Thought Insertion, feeling that there are thoughts from the outside that is inserted and incorporated into his brain.
f. Thought broadcast. The feeling that his thoughts have been broadcast on radio, television, wire electrical clay, and light.

Emotion and Affective Disorders
Emotion is the experience of conscious and exert influence on the activities of the body and produces organic and kinetic sensations. Affects the life of feeling or tone of one's emotional feelings, pleasant or not that accompanies thoughts, usually long and often accompanied by physiological components. Forms of emotional and affective disorders:
a. Euphoria, a pleasant emotions cheerful, happy, happy, happy that excessive and inappropriate when considered abnormal circumstances.
b. Elation, excessive euphoria is often accompanied by motor labile emotions and often become irritable.
c. Exaltation, excessive elation accompanied by his greatness
d. Inappropriate affect, a clear distinction between emotions that seemed to situations that cause it, such as a disaster laugh
e. Ecclesia, excessive passion with a sense of security, peace, calm, associated with strong religious feelings
f. Affects the rigid, state where and needles will be retained despite there are stimuli that cause excessive emotional reactions.
g. Labile emotions, symptoms of a variety of emotional instability, rapid emotional changes from one to the other emotions
h. Anxiety and depression, symptoms appear from the face or the expression of behavior
i. Ambivalence, the emotions and affects arising opposite together in person, object, situation, hate but miss.
j. Apathetic, less or none at all in a state of emotional reaction that should lead to emotions.

Psychomotor Disturbances
Psychomotor body movements that are influenced by the state of the soul, so is the affect with which the body and soul. Also includes motor condition and motor aspects of a behavior. Type of psychomotor disturbances:
a. Increased activity,
1. Hyperactivity, hyper-kinetic, excessive activity by the intensity of the response increased
2. Hyper-tonicity, increased muscle tone handle
3. Noisy, restless catatonic, motor activity does not seem to aim many times, and seemed not to be influenced by external stimuli.

b. Activity decreased
1. Hypo-activity, hypo-kinetic, activities and movement intensity decreases with a decreasing response
2. Motor inertia, overall decreased activity, for example in the catatonic stupor.
3. Atonucit, state tone and abnormal muscle contraction, can be completely or partially.
4. Paralyses, loss of muscle function in whole or in part only.

c. Activity disrupted or not in accordance
1. Ataxia, there is no coordination in the movement in his legs or feet
2. Apraxia, unable to manipulate objects in a directed
3. Atetosys, continuous movement, diffuse, such as legs and felt pain.
4. Choreiform movements, irregular movements continuously will not occupied
5. Spasm, muscle contraction, auto part or all of which are not controlled by the will
6. Tremor, contraction of muscle fibers are light and rhythmic, which can not be controlled, can be slow, fast, rough or smooth, regular or irregular
7. Convulsions, seizures continued in large areas of the body and usually with loss of consciousness

d. Activity repeatedly
1. Cataleptic, rigidly maintaining a certain body position
2. Flexibility serea, one form cataleptic, which created the position of the body others maintained
3. Stereotype, one body movements over and over without a clear purpose

e. Automatism, the commands according to a command automatically without conscious
1. Automatism, to do something automatically as a symbolic expression of unconscious activity
2. Echopractia, directly copying another person's movements when he saw

3. Echolalia, a direct repeat or imitate what others are saying

f. Negativism, psychological defense is concerned with the fight or argue against what they were told. there are 2 kinds of active and passive.
g. Aversi, an aggressive reaction and shown to strongly resist, envy, hate, non-cooperative, refuse, and sometimes stupor reaction (Yosep, 2007).

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WHO-World Health Organization (1990)