Ns. Thika Marliana, M.Kep., Sp.Kep.
J
Riwayat Pendidikan
1. S3 Fakultas Imu Keperawatan
Universitas Indonesia
2. Sp-1 Spesialis Keperawatan Jiwa UI
3. S2 Keperawatan FIK UI
4. Profesi Ners FIK UI
5. S1 Keperawatan FIK UI
Sertifikasi
1. Certified Hypnotis & Hypnotherapy (CH,
CHt) from IBH
2. Cognitive Behaviour Therapy (CBT) from
Beck Depression Institute
3. Stabilisasi Emosi from PP HIMPSI
4. Psychological First Aid (PFA) from WHO-
Puskris UI
5. Neuro Linguistic Program (NLP) from ESQ
6. TOT Dementia Care from International
Federation for Dementia Care (IFDC)
7. Certified Trainer from BNSP
Pekerjaan dan Organisasi
1. Dosen Tetap FIKes URINDO (sekarang)
2018-skrg 2 Perawat Pelaksana RSJ Propinsi Jabar (RSJ Cimahi,
red.) 2007-2011
2012 3. Sekjend Pengurus Pusat Ikatan Perawat Kesehatan
2010 Jiwa Indonesia (IPKJI )2016-skrg
2006 4. Kolegium Keperawatan Jiwa Indonesia 2018-2020
2002 5. Anggota Perhimpunan Asuhan Demensia Indonesia
(PADI) 2019
6. Anggota Centre of Aging and Family Studies (CEFAS)
2018
7. Anggota Pusat Pengembangan dan Pelayanan
Keperawatan Jiwa Bencana (P3KJB) 2015 member of
World Society of Disaster Nursing (WSDN)
Relawan Kesehatan Jiwa
• Tsunami Aceh 2004, Rehabilitasi Program Lon
Sayang Aceh 2006
• Gempa Merapi 2006 Posko Bantul Desa Grogol
• Banjir DKI Jakarta Posko Bidara Cina Sudin
Jaktim
• Bencana Social Eksodus Ex-GAFATAR posko
Jakarta 2015
• Likuifaksi Palu 2018
• Gempa Lombok 2019
• DKJPS Covid-19
 Seminar Nasional Keperawatan
Program Studi Profesi Ners Fakultas Ilmu Kesehatan
Universitas Respati Indonesia
Jakarta, 20 November 2021

Diabetes Mellitus
and
Mental Health Aspects
Ns. Thika Marliana,M.Kep.,Sp.Kep.J
 01 Current Situation

The Link Between Diabetes

02 and Mental Health Problems

OUTLINE 03
Psychological Effect of
Diabetes

Screening and Assessment

04 of Mental Health Symptoms

05 Psychosocial Treatments
 PART ONE

01 Current
Situation
01 Current Situation

10 Countries With
The Highest
Number Of Prevalence of DM
Diabetes in Indonesia by
Province

Prevalence of Prevalence of
Diabetes Mellitus (Source: Riskesdas, 2018)
Diabetes Mellitus
in Indonesia in Indonesia By
2013-2018 Age
(Source: International DiabeteFederations, 2019)

(Source: Riskesdas, 2018)

 PART TWO

02 The Link Between

Diabetes and Mental
Health Problem
02 The Link Between Diabetes and Mental Illness

Why Are Diabetes and Mental

Health Problem Linked?
➢ Unfortunately, some treatments for
mental illness, especially second- The Incidence of
generation antipsychotics are linked to
diabetes. Diabetes First
➢ Biochemical changes in mental disorder
OR
may also play a role in the appearance Mental Health Problem First
of diabetes.

➢ It is also know that those with chronic

illnesses, like diabetes, have a higher
chance of mental illnesses like
depression.

➢ Prevalence of depression in the diabetic

population is approximately 10%, which
is double what is seen in the average
population.
02 The Link Between Diabetes and Mental Illness
Depressive symptoms
NO Mental Health Prevalence among people with
Problems diabetes is approximately
Riskesdas Riskesdas Riskesdas 30%
2007 2013 2018
Diabetes and
Mental Disorder schizophrenia
1 (ODGJ) 0.46% 0.17% 0,67% 14% of individuals with together lead to more
diabetes suffered from CV complications and
2 Mental Emotional 11.6% 6.0% 9,8 % generalized anxiety all-cause mortality
Disorder (ODMK) compared to people
disorder
with diabetes alone

3 Subtitle
Depression - - 6,1%
Night eating
Subtitle
People with bipolar disorder have been found to
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(RAN Kemenkes RI, 2015) noted to occur in that of the general population for metabolic
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individuals with type syndrome and triple for diabetes
5 Pasung 14,3 % 2 diabetes
(Source: Canadian Diabetes Association, 2021)

➢ People with depression have approximately a 60% chance of developing

Subtitletype II diabetes
➢ People with bipolar disorder have a high risk of diabetes also
➢ Eating disorders are more common both in individuals with type I and
type II diabetes than in the general population
➢ People with schizophrenia and other psychotic disorders appear to
have an increased risk of diabetes both before and then
 PART THREE

Psychological
03
Effect of
Diabetes
03 Psychological Effect of Diabetes

The interplay between diabetes, major depressive disorder and other psychiatric conditions.
 PART FOUR

Screening and
04 Assessment of
Mental Health
Symptoms
 Screening and Assessment
04 of Mental Health Symptoms

Patient Health
Questionnaire (PHQ-9)
van Steenbergen-Weijenburg KM, de Vroege L, Ploeger RR, et al. Validation
Hospital Anxiety of the PHQ-9 as a screening instrument for depression in diabetes
patients in specialized outpatient clinics. BMC Health Serv Res 2010;10:235.
and Depression
Scale (HADS)
Collins MM, Corcoran P, Perry IJ. Anxiety and depression
symptoms in patients with diabetes. Diabet Med 2009;26:153–61.

Centre for
Epidemiological
Studies-Depression
Beck Depression Scale (CES-D)
Mantyselka P, Korniloff K, Saaristo T, et al. Association of depressive
Inventory (BDI) symptoms with impaired glucose regulation, screen-detected, and previously
Fisher L, Skaff MM, Mullan JT, et al. A longitudinal study of affective known type 2 diabetes: Findings from the Finnish D2D survey. Diabetes Care
2011;34:71–6.
and anxiety disorders, depressive affect and diabetes distress in
adults with Type 2 diabetes. Diabet Med 2008;25:1096–101.
 Screening and Assessment
04 of Mental Health Symptoms
Comparison of main features and assessment methods:
diabetes distress vs. major depressive disorder

Subtitle
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SRQ-20 used In Primary health care service in

Indonesia for screening mental emotional disorder
 PART FIVE

05
Psychosocial
Treatments
We are not humans with
spiritual experiences.
However, we are spiritual
beings who experience
life as humans.
- P i e r r e T e i l h a r d d e C h a r d i n - .
05 Psychosocial
Treatments
05 Psychosocial Treatments

Five Fingers Focusing Technique

Relaxation
05 Psychosocial Treatments

Progressive
Muscle
Relaxation
(PMR)
05 Psychosocial Treatments

Features of CBT that can be applied to

diabetes treatment
CBT in
Advance
05 Psychosocial Treatments Suggested cognitive behaviour
therapy for fear of hypoglycemia
Features of psychological
insulin resistance
CONCLUSION
Mental health is as
important as
physical health
Psychological conditions,
defined as
syndromes,disorders, and
diabetes-specific
psychological issues affect
a larger proportion of
individual
“Psychological insulin
resistance” is the
reluctance or refusal
to initiate insulin
therapy, which may
delay the start of a
necessary treatment for
a period of time
Efforts to promote well-
being to mitigate distress
should be incorporated
into diabetes management
for all individuals