DR. Dr.

Nurmiati Amir, SpKJ(K)

Department of Psychiatry University of
Indonesia
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PSYCHO
LOGY

BIOLOGY

SOCIAL

Biopsychosocial model: George Engel (1997)

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Factors influencing the degree or severity of

illness / mental disorder of a person
Severe

Severity of
stressor

Mild

Unhealthy / sick

Healthy

Resilience / perception
Personality
strong

weak
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Environ
mental
risk

A: sick
B: spectrum condition
C: normal

Genetic predisposition
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PSYCHOSOCIAL STRESSOR
PSYCHOENDOCRINE SYSTEM

CHPA-AXIS

C-SMA AXIS

FEAR / ANXIETY
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Disturbance in
temporal lobe is
related to:
1.Halusination
2.Delution
3.Not recognize
an object or
face

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Frontal lobe
hypoactivity:
1.decreased
cognitive function
2.Disturbance in
behavioral planning
3.Blunted affect
4.Social isolation
5.Apathy
6.ect

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ACETYLCHOLIN

AG

IS
N
O

AN
TA
GO
NIS

DEPRESSI
ON
1. Psychmotor
retardation
2. Lethargy
3. Sleep
disturbance
4. Learned
helplessness

MANIA
1.
2.
3.
4.

Motor hyperactivity
Energetic
No need to sleep
Self esteem

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DOPAMINE
SYSTEM

TUBERO
INFUNDIBU
LAR

CONTROLLE
D
PROLACTIN
E
PROLACTIN
E

SUBSTANSI
A NIGRA

MOTOR
ACTIVITY

SUBSTANSI
A NIGRA

MESOLIMBI
C
EMOTION
EXPR
LEARNING
REINFORCEME
NT
HEDONIA
MESOLIMBI
C

MANIA/DEPRESS

MESOCORTE
X
MOTIVATIO
N
CONCENTRA
TION

EXCECUTIVE
FC
MESOCORTE
X

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The same symptom

might be shown in
schizophrenia and
bipolar, because the
limbic system involves
in both disorder
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CONCLUSIONS

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