GANGGUAN WAHAM MENETAP
DISUSUN OLEH : INGE SANDRIE PHUTRI 100100158
PEMBIMBING : dr. M. SURYA HUSADA, M.Ked.K.J., S.K.J.
DEPARTEMEN ILMU KESEHATAN JIWA !AKULTAS KEDOKTERAN UNI"ERSITAS SUMATERA UTARA MEDAN #015
KATA PENGANTAR
P$%& d'( )*$+$r +e'd&r'- T$'( Y'( M'' E)', +'re(' '-') r'/'- d'( +'r$(&'N*', e($&)'( /'+'' 2G'($'( W''/ Me(e-'3 &(& d''d&)ee)'&+'(. M'+'' &(& d&'%$+'( $(-$+ /ee(+'& -$') +e'(&-r''( +&(&+ )e(&4r De'r-e/e( I/$ Ke)e'-'( J&' !K USU. D& d''/ /'+'' &(& d&''r+'( &(64r/')& /e(e('& e(er-&'( '($'( ''/ /e(er-' )'/'& 7''&/'(' /e('('(& )e)e4r'( *'( /e(der&-' '($'( ''/ /e(e-' -er)e7$-) e7''& /'-er& +$)$) d& 7'&'( I/$ Ke)e'-'( J&' !K USU. Me)+&$( d''/ e/7$'-'( /'+'' &(& 7'(*'+ /e(''/& +e)$&-'(, ('/$( +'re(' 'd'(*' e-$(%$+, /'+' /'+'' &(& d''- d&)ee)'&+'( de('( 7'&+. P'd' +e)e/'-'( &(&, e($&) &(&( /e($'+'( -er&/' +')& +e'd' : 1. J'%'r'( d4)e( )-'6 e('%'r !K USU, +$)$)(*' De'r-e/e( I/$ Ke)e'-'( J&' *'( -e' /e/7er&+'( 7'(*'+ e(e-'$'( /e(e('& -$&)'( &(& )er-' /e/7er&+'( d4r4('( d'( /4-&9')&. #. Re+'(re+'( *'( -$r$- /e/7er&+'( /')$+'(, )'r'( d'( 7'(-$'( d''/ /e(*ee)'&+'( /'+'' &(&. A+&r +'-', ''7&' e($&)'( /'+'' &(& 7'(*'+ -erd''- +e)'''(, e($&) /e/44( /''6. U(-$+ &-$, +r&-&+ d'( )'r'( d'r& 7er7''& &'+ $(-$+ /e(*e/$r('+'( /'+'' &(&.
Med'(, J'($'r& #015
Pe($&);
DAFTAR ISI
KATA PENGANTAR .................................................................................. & DA!TAR ISI ............................................................................................ &&
BAB I. PENDAHULUAN ........................................................................ 1 1.1
L'-'r Be'+'( ..................................................................... 1
BAB II. PEMBAHASAN........................................................................... # #.1 #.#
De6&(&)& G'($'( W''/ Me(e-'...................................... # E&de/&44& G'($'( W''/ Me(e-'.............................. #
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T&eT&e G'($'( W''/ Me(e-' ................................. =
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D&'(4)&) G'($'( W''/ Me(e-'................................... ?
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D&'(4)&) B'(d&( G'($'( W''/ Me(e-' ................... ?
#.8
Pe('-''+)'(''( G'($'( W''/ Me(e-'........................ 8
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Pr4(4)&) G'($'( W''/ Me(e-'.................................. @
BAB III. KESIMPULAN .......................................................................... 10 <.1 Ke)&/$'( ............................................................................ 10
DA!TAR PUSTAKA
BAB I
PENDAHULUAN
1.1
L'-'r Be'+'(
G'($'( ''/ /e(e-' d&de6&(&)&+'( )e7''& )$'-$ '($'( )&+&'-r&+ d&/'(' e%'' $-'/' 'd'' ''/. G'($'( ''/ /e(e-' /$(+&( -&/7$ )e7''& re)4( (4r/' -er'd' e(''/'( '7(4r/' d&d''/ &(+$('( '-'$ )&)-e/ )'r'6 $)'-.= Me+'(&)/e ')-& d'r& '($'( ''/ /e(e-' 7e$/ d&+e-'$&, ('/$( 'd' 7e7er'' -e4r& /e(e('& ' -er)e7$-, *'&-$ 'd'(*' $7$('( de('( 6'+-4r e(e-&+ d'( 7&44&+' *'( d&)e7'7+'( 4e 'd'(*' +e-&d'+)e&/7'('( (e$r4-r'()/&--er d&4-'+. A(+' +e%'d&'( '($'( ''/ /e(e-' '(*' 7er+&)'r 0,0< d'r& )e$r$ '($'( )&+&'-r&+ '&((*'. D&/'(' '($'( &(& e7& )er&( /e(e('& ere/$'( d'r&'d' '+&'+&, de('( r'-&4 er7'(d&('( <:1.= Se'&( 6'+-4r $)&' d'( %e(&) +e'/&(, 6'+-4r 7$d'*' d&)'(+'+'( 7er$7$('( de('( -er%'d&(*' '($'( &(&. D&/'(' 7e7er'' +e7$d'*''( 7er'(''( 7'' 'd'(*' ''/ /er$'+'( 7'&'( d'r& 'd'- &)-&'d'- d'( 7$d'*' d& )$'-$ d'er'. A(+' +e/'-&'( 'd' e(*'+&- &(& 'd'' )e+&-'r 0,05 )'/'& 0,1.# P')&e( de('( '($'( ''/ /e(e-' 7&')'(*' /e/&&+& 6$()& *'( 7'&+ d&d''/ +e$'r'(*' d'( e+er%''((*'. D&/'(' '($'( &(& 7er7ed' de('( )+&46re(&' *'( /$(+&( /e/&&+& +e-&d'+/'/$'( d''/ /e(%''(+'( 6$()&(*'. W''/ *'( d&/&&+& $( 7er7ed', d&/'(' 'd' ')&e( '($'( ''/ /e(e-', ''/(*' /$(+&( -&d'+ d''- d&er'*', ('/$( d''- -er%'d& d&+e&d$'( &(&. 5
1.#
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BAB II PEMBAHASAN
#.1 De6&(&)& G'($'( ''/ /e(e-' 'd'' )$'-$ '($'( )&+&'-r&+ d&/'(' e%'' *'( $-'/' 'd'' ''/.= #.# E&de/&44& Pe/er&+)''( '+$r'- -e(-'( e&de/&44& '($'( ''/ /e(e-' d&''(& 4e re'-&6 %'r'((*' '($'( &(&. Se'&( &-$ %$' +'re(' ')&e( de('( '($'( ''/ /e(e-' %'r'( /e('r& '($'( )&+&'-er +e$'& 7&' d&'+)' 4e +e$'r'(*'. W''$$( 'd'(*' +e-er7'-')'( -er)e7$-, &-er'-$r /e(d$+$( e(d''- 7'' '($'( ''/ /e(e-', ''$$( /er$'+'( )$'-$ '($'( *'( %'r'(/ ('/$( /e/'( 'd' d''/ 4$')& de('( '(+' *'( -&d'+ -e-'. = Pre9'e()& -er%'d&(*' '($'( ''/ /e(e-' d& A/er&+' Ser&+' 7erd')'r+'( DSMI"TR 'd'' )e+&-'r 0,0<, d&/'(' '(+' &(& %'$ d&7'' '(+' +e%'d&'( )+&46re(&' 1; d'( '($'( /44d 5;. 1,= I()&de()& -'$('( '($'( ''/ /e(e-' 'd'' 1 )'/'& < +')$) 7'r$ er 100.000 4$')&, *'&-$ +&r'+&r' = d'r& )e/$' er''-'( er-'/' ')&e( )&+&'-r&+. U)&' r'-'r'-' 'd'' +&r'+&r' =0 -'$(, -e-'& re(-'( $)&' $(-$+ 4()e-(*' 'd'' 7er+&)'r '(-'r' 18 -'$( )'/'& @0 -'$(. = N'/$(, )-$d& '&( *'( d&'+$+'( d& S'(*4 'd' -'$( #008 7erd')'r+'( re+'/ /ed&) d& )$'-$ r$/' )'+&-, /e(d''-&
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re9'e()& -er%'d&(*' '($'( ''/ /e(e-' =,8;, d&/'(' '($'( ''/ /e(e-' e7& )er&( -er%'d& 'd' )e)e4r'( de('( r&'*'- +e$'r' /e(der&-' e(*'+&- *'( )'/' '-'$ /e(der&-' )+&46re(&'. Se'&( &-$ %$' -erd''- -e4r& 7&44&+' *'( /e($7$(+'( +e%'d&'( '($'( ''( /e(e-' '+&7''d'(*' +e-&d'+)e&/7'('( (e$r4-r'()/&--er d& 4-'+. ?,#
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1. S-'-$) Me(-' '.
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M44d, Per')''( d'( A6e+
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#. Se()4r&$/ d'( K4(&)& '. Or&e(-')& d'( D'*' I('P')&e( de('( '($'( ''/ /e(e-' 7&')'(*' -&d'+ /e/&&+& +e'&('( d''/ 4r&e(-')&, )er-' d'*' &('- d'( r4)e) +4(&-&6 '&((*' -&d'+ -er'($. = 7. Pe(e(d'&'( I/$) K&(&) 'r$) /e/er&+)' ')&e( de('( '($'( ''/ /e(e-' $(-$+ /e(e(-$+'( 'd' '-'$ -&d'+ '')'( '-'$ re('(' /e'+$+'( /'-er&'
''/(*' de('( 7$($ d&r&, /e/7$($ '-'$ /e'+$+'( -&(d'+'( +e+er')'(. I()&de()&(*' -&d'+ d&+e-'$& 'd' e(*'+&- &(&. = . Per-&/7'('( d'( T&&+'( P')&e( de('( '($'( ''/ /e(e-' '/&r )e$r$(*' -$d'+ /e/&&+& -&&+'( -er'd' +4()&)& /ere+' d'( '/&r )e$r$(*' d&7'' +e r$/' )'+&4e +e$'r', er$)'''( '-'$ 4&)&.= d. Ke%$%$r'( P')&e( de('( '($'( ''/ /e(e-' 7&')'(*' d''- d&er'*' d''/ &(64r/')&(*'.=
#.5
T&eT&e
Terd''- 7e7er'' -&e 'd' '($'( ''/ /e(e-', *'&-$ : '.
T&e Ke%'r Per)e$-4r* T*e;
T&e &(& 'd'' -&e '($'( ''/ /e(e-' *'( '&( )er&( d&%$/'&. 1 W''/ +e%'r /$(+&( )eder'(' '-'$ -erer&(& d'( 7&')'(*' 7er$' -e/' -$(' '-'$ )e%$/' -e/' *'( 7er$7$('(, )eer-& d&)e+4(+4&, d&$r'(&, d&/'-'/'-'&, d&&+$-&, d&r'$(&, d&6&-(' )e'r' +e%'/, d&$)&+ '-'$ d&''(''(& d''/ /e(''& -$%$'( %'(+' '(%'(. H&(''( +e& d''- /e(%'d& 7e)'r d'( /e(%'d& $)'- )&)-e/ ''/. Or'( de('( ''/ +e%'r )er&(+'& /e/7e(&, /'r', d'( /$(+&( /ere+' /e'+$+'( +e+er')'( -er'd' 4r'( '&( *'( d&*'+&(&(*' '+'( /e(*er'( d&r&(*'. Y'( /e/7ed'+'((*' de('( -&e +e%'r 'd' )+&46re(&' 'd'' ''/ 'd' '($'( ''/ /e(e-' $/$/(*' -er)&)-e/'-&)')&, +4ere( d'( d''- d&7e('r+'( )e'r' 4&+'. Ser&(+'& 4r'( de('( ''/ +e%'r /e(4'+ $(-$+ /e('r& 7'(-$'(.= Se)e4r'( de('( '($'( ''/ -&e &(& '+'( /$d' /'r', /$d' -er)&($( d'( -er+'d'( d''- 7er)&+' 're)&6 7'+'( )'/'& /e'+$+'( -&(d'+'( e/7$($'(. ?
7.
T&e Er4-4/'(&' Er4-4/'(& T*e;
G'($'( ''/ /e(e-' -&e &(& /e/&&+& 7e7er'' ('/' '&( )eer-& )&(dr4/' De Ce'/7'$- '-'$ )*4)e '))&4(ee.8 P'd' -&e er4-4/'(&+, ''/ &(-&
'd'' 7'' ')&e( d&&(-'& /'-&/'-&'( 4e )e)e4r'(, d&/'(' 4r'( *'( d&7'(*'(+'((*' 7&')'(*' 7er')' d'r& )-r'-' )-'-$) *'( e7& -&(& d'r&(*', )eer-& 7&(-'( 6&/ '-'$ '-')'( +er%', '-'$ d''- $' )e)e4r'( *'( )$d' /e(&+' '-'$ )e)e4r'( *'( -&d'+ /$(+&( d&''&. 1 P')&e( de('( ''/ er4-4/'(&+ 'd'' )$/7er '($'( 7er/'+(' -er'd' /')*'r'+'-. = O()e- e%'' d''- /e(d'd'+ d'( +e/$d&'( /e(%'d& +r4(&) )e&(' )er&(+'& /e(%'d& $)'- er'-&'( $-'/' 'd' +e&d$'( )e)e4r'( *'( -er+e('. U)'' $(-$+ 7er$7$('( de('( 47%e+ ''/, 7'&+ /e'$& -ee4(, )$r'-, 'd&', +$($%('( 7'+'( /e('')& )'/'& /e(&+$-& 'd'' )er&(. P')&e( *'( -er+e(' 7&')'(*' 'd'' '(&-', /e)+&$( d&d''/ )'/e 64re()&+ )e7'&'( 7e)'r 'd'' '+&'+&. Or'( *'( -er+e(' )er&(+'& d&-e/$+'( &d$ /e(*e(d&r&, /e('r&+ d&r& d'r& /')*'r'+'-, /e/&&+& +4(-'+ )e+)$' -er7'-') d'( /e/&&+& e9e )4)&' re(d' '-'$ e+er%''( *'( )eder'('. A(+' +e%'d&'( '($'( ''/ -&e &(& 'd'' 1#. <
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T&e Ke7e)'r'( Gr'(d&4)e T*e;
G'($'( ''/ /e(e-' -&e &(& %$' d&)e7$- /e'4/'(&'. Be(-$+ '&( $/$/ d'r& ''/ +e7e)'r'( 'd'' +e*'+&('( 7'' d&r&(*' /e/&&+& '')'( '-'$ 7'+'- *'( $'r 7&')' -e-'& -&d'+ d&+e-'$&, '-'$ /e/7$'- e(e/$'( e(-&(, d&/'(' ')&e( -e' d&7'' +e 7er7''& 7'd'( e/er&(-''( )eer-& !BI. W''/ *'( e7& %'r'( 'd'' 7'' e(der&-' /e/&&+& $7$('( +$)$) de('( )e)e4r'( *'( -er+e/$+' '-'$ &)& ''/ re&&$), d&/'(' e(der&-' /e(%'d& e/&/&( )e+-e re&&$).=
d.
T&e Ce/7$r$ Je'4$) T*e;
G'($'( ''/ /e(e-' -&e &(& %$' d&+e(' de('( 4(%$' 'r'(4&' d'( )&(dr4/' O-e4. W''/ -&e &(& e7& )er&( -er%'d& 'd' '+&'+& d'r&'d' '(&-'. W''/ &(& %'r'( d&%$/'&, '(*' )e+&-'r +$r'( d'r& 0,# d'r& )e/$' ')&e( )&+&'-r&+. O()e-(*' )er&(+'& /e(d'd'+ d'( e%''(*' '+'( /e(&'( '(*' )e-e' er&)''( '-'$ +e/'-&'( ')'('((*'.= W''/ e/7$r$ d''-
/e(*e7'7+'( e(*&+)''( 9er7' d'( 6&)&+ *'( 7er/'+(' -er'd' ')'('((*' d'( 7'+'( d''- /e(*e7'7+'( e/7$($'(. ?
e.
T&e S4/'-&+ S4/'-& T*e;
W''/ -&e &(& %$' d&+e(' )e7''& )&+4)&) &4+4(dr&'+' /4(4)&/-4/'-&+. Per7ed''( '(-'r' &4+4(dr&')&) de('( '($'( ''/ /e(e-' -&e )4/'-&+ -ere-'+ 'd' der'%'- +e*'+&('( *'( d&/&&+& ')&e( -e(-'( '(''( 'd'(*' e(*'+&- d''/ d&r&(*'.= Ke)'d'r'( ')&e( 7&')'(*' 7'&+ d'( e%'' *'( d&-&/7$+'((*' -&d'+ 7er$7$('( de('( e(*'+&- $/$/ *'( /e(d')'r&(*' '-'$ e(*'+&- )&+&'-r& '&((*'. W''/ -&e &(& d''- -er%'d& )e'r' er''(''( '-'$ -&7'-&7'. P'd' )e7'&'( ')&e(, e(*'+&-(*' -&d'+ 7er$'( /e)+&$( der'%'+e'r''( ''/ &(& 7er6$+-$')&. Kee/')'( d'( +e')'d''( *'( 7ere7&'( 'd'' +'r'+-er&)-&+ d'r& ''/ &(&. 8 W''/ *'( '&( )er&( d&der&-' 'd'' &(6e+)& /&)'(*' 7'+-er&, 9&r$), 'r')&-;, d&)/4r64647&' /&)'(*' 7e(-$+ *'( -&d'+ )e)$'& 'd' &d$(, '*$d'r';, ''/ -e(-'( 7'$ 7'd'( *'( 7er')' d'r& +$&-, /$$- '-'$ 9'&(', '-'$ ''/ 7'' 7'&'( -$7$ -er-e(-$ )eer-& $)$) 7e)'r, -&d'+ 7er6$()&. D''- -er%'d& '$)&(')& -'+-& *'( 7e$7$('( de('( -e/' ''/, /&)'(*' ')&e( /er')' 'd' /er'*' d&7'' +$&-(*'. =
6.
T&e C'/$r'( M&ed T*e;
P')&e( /e($(%$++'( e7& d'r& )'-$ -&e ''/ d&'-') d'( -&d'+ 'd' )'-$ -e/' ''/ *'( /e(4(%4. 1
.
U()e&6&ed T*e;
P')&e( /e($(%$++'( -e/' ''/ *'( -&d'+ /e/e($& )'' )'-$ ''/ d&'-'). Se7''& 4(-4 /&)&de(-&6&+')& )&(dr4/', )eer-& )&(dr4/' C'r'), *'&-$ +e'd''( *'( d&+'r'+-er&)-&+'( d&/'(' ')&e( er'*' 7'' '(4-' +e$'r'(*' -e' d& '(-&+'( de('( )e4r'( e(&$ $$(. 1,?
#.>
D&'(4)&)
U(-$+ /e(d&'(4)' )$'-$ '($'( ''/ /e(e-', d''- d&$('+'( +r&-er&' 7erd')'r+'( DSMI"TR, *'&-$= : A : W''/ *'( -&d'+ '(e *'&-$ /e&7'-+'( )&-$')& *'( -er%'d& d&d''/ +e&d$'( (*'-', )eer-& )ed'( d&&+$-&, d&r'$(&, d&-$'r& 9&r$), d&&(-'& d'r& %'r'+ %'$ '-'$ d&+&'('-& 4e ')'('( '-'$ +e+')& '-'$ /e(der&-' )$'-$ e(*'+&-; )e'/' )e+$r'((*' 1 7$'(. B : Kr&-er&' A $(-$+ )+&46re(&' -&d'+ -ere($& ')e&( -&d'+ /e($(%$++'( e%'' '$)&(')& *'( d4/&('(, 7&'r' -erd&)4r'(&)')&, e%'' (e'-&6 )eer-& '6e+ d'-'r;. C'-'-'( : '$)&(')& -'+-& d'( &$/ /$(+&( d&-e/$+'( 'd' '($'( de$)&4(' %&+' 7er$7$('( de('( ''/. C : Tere) d'r& '($'( ''/ ''/; '-'$ er'7'('((*', 6$()& 'd'' -&d'+ -er'($ de('( %e') d'( er&'+$ -&d'+ %e') '(e '-'$ +''$. D : J&+' e&)4de /44d -e' -er%'d& )e'r' 7er)'/')'/' de('( ''/, '/' -4-'(*' 'd'' re'-&6 )&(+'- d&7'(d&(+'( '/' er&4de ''/. E : G'($'( 'd'' 7$+'( +'re(' e6e+ 6&)&44&) '()$( d'r& )$'-$ '/&)'(*' 47'- *'( d&)''$('+'(, )$'-$ /ed&+')&; '-'$ )$'-$ +4(d&)& /ed&) $/$/. !r4/ A/er&'( P)*&'-r& A))4&'-&4( : D&'(4)-& '(d S-'-&)-&' M'($' 46 Me(-' D&)4dred, =- Ed. W')&(-4(, DC : A/er&'( P)*&'-r& A))4&'-&4( 1@@=, &- er/&))&4(.
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D&'(4)&) B'(d&(
D&'(4)&) 7'(d&( *'( '&( /e(de+'-& '($'( ''/ /e(e-' 'd'' )+&46re(&' -&e 'r'(4&d.= D&/'(' *'( /e/e7ed'+'((*' de('( '($'( ''/ /e(e-' 'd'' +$'&-') ''/. S+&46re(&' -&e 'r'(4&d /e/&&+& ed4/'( d&'(4)-&+ )e7''& 7er&+$-> : 1.
Me/e($& +r&-er&' $/$/ d&'(4)&) )+&46re(&'.
#.
Se7''& -'/7''( : '. H'$)&(')& d'(F'-'$ ''/ 'r$) /e(4(%4 : •
S$'r')$'r' '$)&(')& *'( /e('('/ ')&e( '-'$ /e/7er&
er&(-', '-'$ '$)&(')& '$d&-4r&+ -'(' 7e(-$+ 9er7' 7er$' 7$(*& $&&)-&(;, /e(de($( $//&(; '-'$ 7$(*& -'' '$&(;.
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W''/ d''- 7er$' '/&r )e/$' %e(&), -e-'& ''/ d&+e(d'&+'(
de$)&4( 46 4(-r4;, d&e('r$& de$)&4( 46 &(6$e(e; '-'$ 2'))&9&-*3 de$)&4( 46 '))&9&-*; d'( +e*'+&('( d&+e%'r+e%'r *'( 7er'(e+' r''/ 'd'' *'( '&( +'). 7. G'($'( '6e+-&6, d4r4('( +ee(d'+ d'( e/7&'r''( )er-' e%'' +'-'-4(&+ )e'r' re'-&6 -&d'+ (*'-'F-&d'+ /e(4(%4.
#.8
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