Pendekatan Farmakoterapi Dan Psikososial Pada Pasien Skizofrenia Hebefrenik Dengan Disorganisasi Berat: Laporan Kasus

Abstract

Hebephrenic schizophrenia is characterized by disorganized thinking, flat or inappropriate affect, and disorganized behavior. This condition typically appears in late adolescence to young adulthood and is associated with a poor prognosis due to early onset and social functioning. Severe disorganization can lead to persistent decline in social and occupational functioning, especially if treatment is inadequate or not sustained. A 20-year-old man came to the Emergency Department in Hospital accompanied by his family, complaining of unusual behavior. The complaints began in 2019, including disorganized behavior such as talking and laughing to himself without any apparent stimulus, irrelevant responses when spoken to, climbing roof tiles, jumping from the second floor, picking up cigarette butts along the street, taking money without permission, and leaving the house naked. The patient had undergone several months of psychiatric treatment in 2021, but therapy was discontinued. A mental status examination revealed severe disorganized thinking and behavior, flat affect, impaired attention and cognitive function, and auditory hallucinations characterized by talking and laughing to oneself. The patient was diagnosed with hebephrenic schizophrenia and received pharmacological therapy consisting of the atypical antipsychotics Clozapine 1 x 100 mg and Quetiapine 2 x 200 mg combined with Valproic Acid 2 x 500 mg, Lorazepam 2 x 1 mg, and Trihexylphenidyl 2 x 2 mg. Additionally, psychosocial interventions were provided, including psychoeducation. Severe disorganization in hebephrenic schizophrenia is a clinical challenge that requires a sustained multimodal approach encompassing pharmacological therapy and psychosocial interventions. Continuity of pharmacological therapy and psychosocial interventions is crucial for improving social functioning and preventing relapse.