KAJIAN PUSTAKA
TERAPI NON FARMAKOLOGI PADA PENDERITA GANGGUAN
AFEKTIF BIPOLAR
Oleh :
ABRORI FADILLA
201410330311002
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH MALANG
2020
i
KAJIAN PUSTAKA
TERAPI NON FARMAKOLOGI PADA PENDERITA GANGGUAN AFEKTIF
BIPOLAR
Oleh:
ABRORI FADILLA
201410330311002
UNIVERSITAS MUHAMMADIYAH MALANG
FAKULTAS KEDOKTERAN
2020
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vi
KATA PENGANTAR
Puji syukur kehadirat Allah SWT karena atas rahmat dan hidayah-Nya, penulisan
tugas akhir ini dapat diselesaikan dengan baik dan tepat waktu. Shalawat serta
salam selalu tercurahkan kepada Rasulullah Muhammad Shalallahu Alaihi
Wasallam, keluarga, para sahabat, dan pengikut beliau yang telah membawa dunia
ini dari zaman kegelapan menuju zaman terang benderang.
Penelitian tugas akhir ini berjudul “Terapi Non Farmakologi pada Penderita
Gangguan Afektif Bipolar”. Tugas akhir ini diajukan untuk memenuhi persyaratan
Pendidikan Sarjana Fakultas Kedokteran Universitas Muhammadiyah Malang.
Penulis menyadari tugas akhir ini masih jauh dari kata sempurna, oleh karena itu,
penulis sangat mengharapkan saran dan masukan yang membangun. Semoga
karya tulis ini dapat menambah wawasan keilmuan dan bermanfaat bagi semua
pihak.
Wassalamu’alaikum Warahmatullahi Wabarakatuh.
Malang, 29 Juli 2020
Penulis
vii
UCAPAN TERIMAKASIH
Pada kesempatan ini, penulis menyampaikan terimakasih yang sebesar besarnya
kepada:
1. Dr.dr. Meddy Setiawan, Sp.PD. FINASIM, selaku Dekan Fakultas
Kedokteran Universitas Muhammadiyah Malang sekaligus selaku
pembimbing 2 atas kesabaran, kebaikan hati, dan kesediaan waktu untuk
membimbing serta penyampaian ilmu yang sangat bermanfaat bagi masa
depan para mahasiswa FK UMM
2. dr. Moch. Ma’roef, Sp.OG, selaku Wakil Dekan I Fakultas Kedokteran
UMM yang senantiasa bersabar dalam membimbing dan mengajarkan
ilmunya kepada kami.
3. dr. Sri Adila Nurainiwati, Sp.KK, selaku Wakil Dekan II Fakultas
Kedokteran UMM yang senantiasa bersabar dalam membimbing dan
mengajarkan ilmunya kepada kami.
4. dr. Indra Setiawan, Sp.THT-KL, selaku Wakil Dekan III, yang penuh
semangat dalam menyampaikan ilmu dan motivasi yang membangun
semangat kami selama menjalani pendidikan di Fakultas Kedokteran.
5. Dr. dr. Fathiyah Safithri, M.Kes. selaku Ketua Prodi Fakultas Kedokteran
Universitas Muhammadiyah Malang yang senantiasa bersabar dalam
membimbing dan mengajarkan ilmunya kepada kami.
6. dr. Iwan Sys Indrawanto, Sp.KJ., selaku dosen pembimbing I saya yang
telah memberikan inspirasi, waktu, kesabaran dan masukan yang sangat
membantu dalam menyelesaikan tugas akhir ini dengan baik.
viii
7. dr. Hanna Cakrawati, M.Biomed, selaku penguji tugas akhir ini, atas segala
masukan dan arahan yang sangat bermanfaat dalam pengerjaan tugas akhir
ini dan kesediaan waktu, sehingga tugas ini dapat diselesaikan dengan baik.
8. Para dosen pengajar FK UMM yang telah memberikan bekal ilmu dan
pengetahuan.
9. Para staf Kependidikan FK UMM yang telah banyak membantu dalam
proses administrasi dan lainnya.
10. Orang tua tercinta, mama dan papa yang senantiasa memberi dukungan
moril, materil, motivasi dan rohani serta telah menjadi sumber semangat
penulis untuk bisa menyelesaikan karya tulis ilmiah ini.
11. Saudara – saudara saya, Adik, Paman, Bibi, dan Nenek yang senantiasa
membantu, memberi motivasi, dan mendoakan sehingga penulis bisa
menyelesaikan karya tulis ilmiah ini.
12. Sejawat FK UMM angkatan 2014, Medulaspinalis, atas dukungan, bantuan,
dan kerjasamanya. Semoga semua kelak dapat menjadi dokter profesional
yang barokah, sukses dunia akhirat, dan senantiasa dalam ketaatan kepada
Allah Subhanahu Wata’ala.
Penulis menyadari tugas akhir ini masih jauh dari kata sempurna, oleh
karena itu, penulis sangat mengharapkan saran dan masukan yang membangun.
Semoga karya tulis ini dapat menambah wawasan keilmuan dan bermanfaat bagi
semua pihak.
Wassalamu’alaikum Warahmatullah Wabarakatuh
ix
Malang, 29 Juli 2020
Penulis
xiv
DAFTAR ISI
SAMPUL DALAM .......................................................................................... i
PRASYARAT GELAR .................................................................................... ii
LEMBAR PENGESAHAN ............................................................................. iii
PERNYATAAN ORIGINALITAS ................................................................. iv
LEMBAR PENGUJI ........................................................................................ v
KATA PENGANTAR ..................................................................................... vi
UCAPAN TERIMAKASIH ............................................................................. vii
RINGKASAN .................................................................................................. x
SUMMARY ..................................................................................................... xii
DAFTAR ISI .................................................................................................... xiv
DAFTAR TABEL ............................................................................................ xvi
DAFTAR GAMBAR ....................................................................................... xvii
DAFTAR SINGKATAN ................................................................................. xviii
DAFTAR LAMPIRAN .................................................................................... xix
BAB I PENDAHULUAN ........................................................................... 1
1.1 Latar Belakang ........................................................................... 1
1.2 Rumusan Masalah...................................................................... 3
1.3 Tujuan Penulisan ....................................................................... 3
1.4 Manfaat Penulisan ..................................................................... 3
BAB 2 TINJAUAN PUSTAKA ...................................................................... 4
2.1 Definisi Gangguan Bipolar ........................................................ 4
2.2 Epidemiologi Gangguan Bipolar ............................................... 4
2.3 Klasifikasi Gangguan Bipolar ................................................... 6
2.4 Gambaran Klinis Gangguan Bipolar ......................................... 7
2.4.1 Episode Mania ........................................................... 7
2.4.2 Episode Depresi .......................................................... 8
2.4.3 Episode Hipomanik .................................................... 9
2.4.4 Episode Campuran ...................................................... 9
2.4.5 Sindrom Psikotik ........................................................ 10
xv
2.5 Etiologi Gangguan Bipolar ........................................................ 10
2.5.1 Faktor Biologis ........................................................... 11
2.5.2 Faktor Genetika .......................................................... 11
2.5.3 Faktor Psikologis ........................................................ 12
2.5.3.1 Peristiwa Kehidupan dan Lingkungan ..................... 13
2.5.3.2 Faktor Dukungan Sosial dan Lingkungan ............... 14
2.5.3.3 Faktor Kepribadian .................................................. 14
2.6 Diagnosis Gangguan Bipolar ..................................................... 15
2.6.1 Gangguan Bipolar I ..................................................... 15
2.6.2 Gangguan Bipolar II ................................................... 21
2.6.3 Gangguan Siklotimik .................................................. 26
2.7 Penatalaksanaan Gangguan Bipolar .......................................... 27
2.7.1 Penatalaksanaan Farmakoterapi .................................. 27
2.7.2 Penatalaksanaan Non Farmakologi ............................. 31
BAB III PEMBAHASAN ................................................................................ 42
BAB IV PENUTUP ......................................................................................... 47
4.1 Kesimpulan ................................................................................ 47
4.2 Saran .......................................................................................... 48
DAFTAR PUSTAKA ...................................................................................... 49
LAMPIRAN ..................................................................................................... 55
xvi
DAFTAR TABEL
Nomor Judul Tabel Halaman
Tabel 2.1 Rekomendasi Farmakologi untuk
GB-1, Mania Akut
Tabel 2.2 Rekomendasi Farmakologi Untuk
GB-1, Depresi Akut
Tabel 2.3 Rekomendasi Farmakologi Untuk
GB-I, Rumatan
Tabel 2.4 Rekomendasi Farmakologi Untuk
GB-II, Depresi Akut
Tabel 2.5 Rekomendasi Farmakologi Untuk
GB-II, Rumatan
xvii
DAFTAR GAMBAR
Nomor Judul Gambar Halaman
Gambar 2.1 Contoh Pelaksanaan ECT pada
Pasien
Gambar 2.2 Gambaran Pelaksanaan TMS
Gambar 2.3 Gambaran Pasien dengan Tindakan
DBS
Gambar 2.4 Pasien Dengan Terapi Bright Light
xviii
DAFTAR SINGKATAN
DSM-IV-TR : Diagnostic and Statistical Manual of Mental Disorder-IV-
text revised
DSM V : Diagnostic and Statistical Manual of Mental Disorder V
5-HIAA : 5- hidroksiindolasetat
HVA : Asam Homovanilat
MHPG : 3-metoksi-4-hidroksifenilglikol
PHK : Pemutusan Hubungan Kerja
CANMAT : The Canadian Network for Mood and Anxiety Disorder
EKG : Elektrokardiografi
EEG : Elektroensefalografi
EMG : Elektromiografi
xix
DAFTAR LAMPIRAN
Nomor Judul Lampiran Halaman
Lampiran 1 Jurnal Pembahasan
Lampiran 2 Buku Pembahasan
49
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