Korelasi Antara Domain Kognitif dengan Kemampuan Fungsi Sosial Pasien Skizofrenia di RSJ Grhasia, Yogyakarta

WIKAN ARDININGRUM, dr. Cecep Sugeng Kristanto, Sp.KJ(K); Dr. dr. Carla R. Marchira, Sp.KJ(K)

2015 | Tesis | SP PSIKIATRI

Latar belakang: Berdasarkan WHO-DAS-M, kurang lebih 64% pasien skizofrenia mengalami disabilitas tingkat berat sampai dengan sangat berat. Disabilitas akibat disfungsi dalam kemampuan fungsi sosial pasien skizofrenia mempunyai implikasi penting terhadap perkembangan, perjalanan dan outcome skizofrenia. Prediktor yang baik dan konsisten terhadap kemampuan fungsi sosial pasien skizofrenia adalah fungsi kognitif. Kurang lebih 84% pasien skizofrenia mengalami defisit kognitif, sehingga diperlukan penanganan yang tepat. Terapi remediasi kognitif, sebagai salah satu bentuk penanganan defisit kognitif pada pasien skizofrenia, akan meningkat kefektifannya jika domain kognitif yang terganggu dapat teridentifikasi dan menjadi target terapi. Oleh karena itu penting untuk mengetahui keterkaitan antara domain kognitif dengan kemampuan fungsi sosial pasien skizofrenia. Tujuan: Untuk mengetahui korelasi domain kognitif dengan kemampuan fungsi sosial pasien skizofrenia di RSJ Grhasia, Yogyakarta Metode: Penelitian non eksperimental dengan rancangan cross-sectional analitik dilakukan terhadap 112 pasien skizofrenia rawat jalan psikiatri RSJ Grhasia, Yogyakarta. Domain kognitif dinilai dengan menggunakan instrumen CAI (Cognitive Assessment Interview); kemampuan fungsi sosial dinilai dengan menggunakan instrumen PSP (Personal and Social Performance). Analisis data menggunakan uji Spearman�¢ï¿½ï¿½s rank correlation. Hasil: Domain memori kerja berkorelasi lemah dengan kemampuan fungsi sosial pasien skizofrenia (r = -0,3 dan -0,318, p<0,05). Domain atensi/kewaspadaan berkorelasi sedang dengan kemampuan fungsi sosial pasien skizofrenia (r = -0,479 dan -0,535, p<0,05). Domain pembelajaran dan memori verbal berkorelasi lemah dengan kemampuan fungsi sosial pasien skizofrenia (r = -0,370 dan -0,397, p<0,05). Domain pertimbangan dan pemecahan masalah berkorelasi sedang dengan kemampuan fungsi sosial pasien skizofrenia (r = -0,578 dan -0,596, p<0,05). Domain kecepatan pemrosesan berkorelasi sedang dengan kemampuan fungsi sosial pasien skizofrenia (r = -0,538, p<0,05). Domain kognisi sosial berkorelasi sedang dengan kemampuan fungsi sosial pasien skizofrenia (r = -0,541, p<0,05). Kesimpulan: Terdapat korelasi yang bermakna antara domain kognitif dengan kemampuan fungsi sosial pasien skizofrenia di RSJ Grhasia, Yogyakarta dengan kekuatan korelasi setiap domain kognitif bervariasi dari lemah hingga sedang.

Background: According to WHO-DAS-M, approximately 64% of patients with schizophrenia experiencing disability from severe to very severe level. The disability caused by a dysfunction in the social functioning of patients with schizophrenia has important implications for the development, course and outcome of schizophrenia. A predictor that is good and consistent for the social functioning of patients with schizophrenia is the cognitive functions. Approximately 84% of patients with schizophrenia experience cognitive deficits, so it requires proper treatment. The effectiveness of cognitive remediation therapy, a form of treatment of cognitive deficits on patients with schizophrenia, will increase if impaired cognitive domain can be identified and become the therapeutic targets. Therefore, it is important to know the correlation between the cognitive domains with the social functioning of patients with schizophrenia. Objective: To study the correlation of the cognitive domains with the social functioning of patients with schizophrenia in the Grhasia Mental Hospital, Yogyakarta Methods: A non-experimental study with analytic, cross-sectional design was conducted on 112 outpatients with schizophrenia in Grhasia Mental Hospital, Yogyakarta. The cognitive domains were assessed by using CAI instrument (Cognitive Assessment Interview); the social functioning was assessed by using the PSP instrument (Personal and Social Performance). The data were analyzed by using the Spearman's rank correlation test. Results: The domain working memory had a weak correlation with the social functioning of patients with schizophrenia (r = -0,3 and -0,318, p<0,05). The domain attention/vigilance had a moderate correlation with the social functioning of patients with schizophrenia (r = -0,479 and -0,535, p<0,05). The domain verbal learning and memory had a weak correlation with the social functioning of patients with schizophrenia (r = -0,370 and -0,397, p<0,05). The domain reasoning and problem solving had a moderate correlation with the social functioning of patients with schizophrenia (r = -0,578 and -0,596, p<0,05). The domain speed of processing had a moderate correlation with the social functioning of patients with schizophrenia (r = -0,538, p<0,05). The domain social cognition had a moderate correlation with the social functioning of patients with schizophrenia (r = -0,541, p<0,05). Conclusion: There was a significant correlation between the cognitive domains with the social functioning of patients with schizophrenia in the Grhasia Mental Hospital, Yogyakarta and the strength of correlation varied from weak to moderate among the cognitive domains.

Kata Kunci : domain kognitif, kemampuan fungsi sosial, skizofrenia/cognitive domains, social functioning, schizophrenia