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Nama Dermaga : Psychiatry

ABULIA

The word abulia has similarities with lazy and futur. Abulia itself is a word
that is widely used in the scientific field of psychology, the meaning of the word
abulia itself is an anxiety, worry, or inability to make pathological decisions. While
lazy has the meaning of not wanting to work or doing something, being reluctant,
not liking, and not lusting. The word futur means to be cut off from the routine of
doing or stopping from activities (Syafri, 2021).

A more severe form of apathy called abulia is thought to include a lack of

self-initiation, self-regulation of purposeful behavior and concern, and a severely
diminished capacity for communication. According to a Delphi study of British
neurologists conducted in 2002, abulia has eight distinct characteristics which are
diminished emotional responsiveness and spontaneity, difficulties initiating and
maintaining intentional movements, poor spontaneous movements, reduced
spontaneous speaking, increased response time, apathy, limited social contact,
and decreased interest in routine activities (Starkstein and Brockman, 2018).

Abulia is defined as reduced motivation and goal-directed behavior.

Willpower impairment appears to be a major negative symptom in schizophrenia,
because in this disease the goal-setting and reward systems are disrupted. The
patient can experience pleasure from a particular moment in the present, but
without extrapolating it to the future, this is known as the anhedonia paradox
(Mosolov and Yaltonskaya, 2020).

There have been numerous causes of abulia proposed. Although there is

considerable disagreement regarding the disease's efficacy, specialists are in
agreement that lesions on the forehead, not the cerebellum or brainstem, are
what cause abulia. Due to mounting evidence that the limbic and midbrain
cortical dopamine systems are crucial to motivation and reward responsiveness,
abulia may be a dopamine related disorder. Additionally, a number of brain
traumas that cause personality changes, such as B. Dementia, injury, or an
intracerebral hemorrhage (stroke), particularly one that leaves the right
hemisphere with diffuse damage (Thiago, 2022).

The pathophysiology of abulia, apathy, and akinetic mutism is believed to

be connected to a number of neurotransmitters, particularly dopamine, that are
active in the cortico-striatalpallidal-thalamic network, while not being entirely
understood. Abulia is highly difficult to diagnose since it can be mistaken for
akinesia or less severe forms of the condition, both of which affect motivation. By
 Nama : Mayra Agrandia
Nama Dermaga : Psychiatry

mistaking the case for an abulia, the patient may not receive the correct care.
When confused with indifference, it necessitates a powerful source of motivation
for success but can result in attempts to include the patient in physical therapy or
other interventions that are still insufficient. A typical antipsychotics, like IM
olanazapine, have produced a therapeutic response in apathetic individuals with
NCD who have akinetic mutism and probable abulia, for whom oral medicine
administration is either impractical or contraindicated (i.e., due to the potential
danger of aspiration pneumonia). However, because this class of drugs has been
linked to major adverse effects, such as an increased risk of death, it is not
advised to use antipsychotics extensively in NCD (Spiegel et al., 2018; Thiago,
2022).

The majority of modern abulia treatments involve the use of

pharmaceuticals, notably antidepressants. Observational Open Access
Alternative treatments are now available because antidepressant therapy hasn't
always worked. Preliminary evaluation of the patient's overall health and attention
to issues that can be quickly resolved are necessary for the treatment of abulia or
other DDM to be successful. This could entail managing seizures or headaches,
setting up cognitive or physical therapy for cognitive and sensorimotor loss, or
making sure hearing, vision, and speech are at their best. These fundamental
actions encourage patients since their physical health has improved, increasing
their function, desire, and vitality, which raises their expectations for successful
initiative and effort (Spiegel et al., 2018; Thiago, 2022).

References

Mosolov, S.N. and Yaltonskaya, P.A. 2020. Concept, classification and clinical
differentiation of negative symptoms inschizophrenia, Sovrem Psih
Rasstrojstv, 1, pp.2-14.

Spiegel, D.R., Warren, A., Takakura, W. Servidio, L. and Leu, N., 2018. Disorders
of diminished motivation: what they are, and how to treat them, Current
Psychiatry, 17, pp.10-18.

Starkstein, S.E. and Brockman, S. 2018. The neuroimaging basis of apathy:

empirical findings and conceptual challenges, Neuropsychologia, 118,
pp.48-53.

Syafri, F.A. 2021. Simtomatologi: Prokrastinasi Manisfestasi Abulia (MALAS),

Journal of Early Childhood Islamic Education, vol.4, no.2, p. 174-186.
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Nama Dermaga : Psychiatry

Thiago, S.R. 2022. Symptoms, causes, diagnosis and treatment of abulia, Global
Journal of Neurology and Neurosurgery, 10, 1, pp. 1-2.