p-ISSN 2086-6380 Jurnal Ilmu Kesehatan Masyarakat, Maret 2019, 10(1):15-24

e-ISSN 2548-7949 DOI: https://doi.org/10.26553/jikm.2019.10.1.15-24

Available online at http://www.jikm.unsri.ac.id/index.php/jikm

THE PREVALENCE OF SCHIZOPHRENIA

IN SOUTH JAKARTA ADMINISTRATIVE CITY

Atik Ruli Winarti,1 Ratna Djuwita Hatma,²

1
College Student Field Epidemiology Training Program Universitas Indonesia
2
Faculty of Public Health Universitas Indonesia

ABSTRACT

Background: The population of DKI Jakarta is 10,377,186 people, and it is estimated that in DKI Jakarta
there are 11,415 cases of schizophrenia. Newly discovered, recorded and handled during 2017 were 4,690
cases. The prevalence of schizophrenia in DKI Jakarta in 2017 is 1.1 / 1000. This study aims to visualize
descriptively the prevalence of schizophrenia in South Jakarta Administrative city.
Methods: The method of study was cross-sectional. The population of all schizophrenia cases obtained from
the recording of medical records in 10 sub-district health centers during 2017 was 1,641 patients.
Characteristics seen were gender, age, place of residence, patients treated at the health center and those
referred to and regular treatment of schizophrenic patients.
Results: The highest prevalence rate in Kebayoran Baru was 11.4/10,000, the largest proportion of 1,641
schizophrenia cases in South Jakarta Administrative City as much as 14% came from Tebet, the highest
proportion of male sex was 73% in Tebet, the highest female in Mampang Prapatan by 45%, the proportion
of schizophrenia cases was highest in the age 26-45 was 56%, the proportion of schizophrenia in Tebet
treated in Puskesmas was 84%, referred to the Hospital as much as 16%, who were not regularly treated at
the Puskesmas in 2017 was 56 %.
Conclusion: The largest proportion of schizophrenia is at the age 26-45 in Cilandak Subdistrict, Cilandak
Community Health Center handles schizophrenia more because early detection of mental disorders is better
than other regions, Jagakarsa Health Center is further strengthened to handle schizophrenia cases.
Keywords: Urbanization, schizophrenia, prevalence.

PREVALENSI SKIZOFRENIA DI KOTA ADMINISTRASI JAKARTA SELATAN

ABSTRAK

Latar Belakang: Jumlah penduduk DKI Jakarta sebesar 10.377.186 jiwa dan diperkirakan di DKI Jakarta
terdapat 11.415 kasus skizofrenia. Yang baru ditemukan, tercatat dan ditangani selama tahun 2017 sebanyak
4.690 kasus. Angka prevalensi skizofrenia di DKI Jakarta tahun 2017 adalah 1.1/1000. Oleh karena itu
sebagai kota urbanisasi kita perlu melihat gambaran secara deskriptif prevalensi skizofrenia di Kota
Administrasi Jakarta Selatan berdasarkan orang, tempat dan waktu.
Metode: Desain studi yang digunakan dalam penelitian ini adalah cross sectional. Lokasi penelitian Kota
Administrasi Jakarta Selatan. Populasi semua kasus skizofrenia yang didapatkan dari pencatatan rekam medis
di 10 Puskesmas Kecamatan selama tahun 2017 sebanyak 1.641 pasien. Karakteristik yang dilihat adalah
jenis kelamin, umur, tempat tinggal, pasien yang diobati di Puskesmas dan yang dirujuk serta keteraturan
berobat pasien skizofrenia.
Hasil Penelitian: Prevalensi rate tertinggi di Kebayoran Baru yaitu 11.4/10.000, proporsi terbesar dari 1.641
jumlah kasus skizofrenia di Kota Administrasi Jakarta Selatan sebanyak 14% berasal dari Tebet, proporsi
jenis kelamin laki-laki tertinggi yaitu 73% di Tebet, tertinggi perempuan di Mampang Prapatan sebesar 45%,
proporsi kasus skizofrenia tertinggi pada kelompok umur 26-45 tahun yaitu sebanyak 56%, proporsi
skizofrenia di Tebet yang diobati di Puskesmas sebanyak 84%, dirujuk ke RS sebanyak 16%, yang tidak
teratur berobat ke Puskesmas selama tahun 2017 sebanyak 56%.
Kesimpulan: Di Jakarta Selatan proporsi skizofrenia terbesar ada pada kelompok umur 26-45 tahun berada
di Kecamatan Cilandak, Puskemas Cilandak lebih banyak menangani skizofrenia karena program
pendeteksiaan dini gangguan jiwa lebih bagus daripada wilayah lain, Puskesmas Jagakarsa lebih diperkuat
lagi untuk menangani kasus skizofrenia.
Kata Kunci: Urbanisasi, skizofrenia, prevalensi

1
Correspondence Address: Atik Ruli Winarti, College Student Field Epidemiology Training Program Universitas Indonesia
, Jl. Prof. DR. Sujudi, Pondok Cina, Beji, Kota Depok, Jawa Barat 16424 email : [email protected]

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INTRODUCTION according to the 2014 World Federation of

Mental Health, which is 0.7-1% of the total
Mental health is an essential aspect of
world population.5
realizing overall health. Mental health is also
Schizophrenia is a mental disorder that
essential to be considered as physical health.
is quite widespread in Indonesia, which is
Mental health is a fundamental component of
about 99% of patients in a Mental Hospital in
the definition of health. Good mental health
Indonesia are schizophrenic.6 Schizophrenia is
allows people to realize their potential,
the presence of a positive symptom consisting
overcome the stresses of ordinary life, work
of two or more symptoms of delusion,
productively, and contribute to their
hallucinations, speech disorders
community. The health system in the world is
(disorganization speech) such as incoherence,
considered not enough to respond to the
and catatonic behaviour.7 Schizophrenia often
burden of mental disorders.1
occurs in adolescence or early adulthood
In the context of mental health, two
which is mostly experienced by men around
terms are known for individuals who
the age of 15-35 compared to women around
experience mental disorders. First, People
25-35 years.8
with Psychological Problems (ODMK) are
The existence of people with
people who have physical, mental, social
schizophrenia in society is often considered
problems, growth and development, and or
dangerous. Often people with schizophrenia
quality of life, so they are at risk of
are hidden and even ostracized, not taken to
experiencing mental disorders. Second,
see a doctor because of shame. Even in some
People with Mental Disorders (ODGJ) are
areas in Indonesia, there are some who have
people who experience disturbances in
schizophrenia who have been put in stocks.
thoughts, behaviors, and feelings that are
According to the 2013 Basic Health Research,
manifested in the form of a set of symptoms
said that schizophrenia is a public health
and or behavioral changes that are
problem that is a concern because the impact
meaningful, and can cause suffering and
of schizophrenia is not only felt by sufferers
obstacles in carrying out people's functions as
and families but also the community and
humans.2
government.9 Schizophrenia or severe mental
The category of mental disorders
disorders (psychosis) is a severe mental
assessed in 2013 Basic Health Research
disorder. The National Institute of Mental
(Riskedas) data is known to consist of
Health (NIMH) estimates that 40% of people
emotional, mental disorders (depression and
with schizophrenia in the United States do not
anxiety), and severe mental disorders or
undergo special treatment. Schizophrenic
psychosis.3 Other forms of mental disorders
sufferers have differences that vary
are postpartum depression and suicide or
considerably in terms of the number and
suicide. 4
manner of treatment in each country.
The high cases of psychiatric disorders
Countries in Asia constitute the majority of
throughout the world are of particular concern
countries with a high number of
to stakeholders related to mental health
schizophrenia. The Southeast Asian and East
policy. In 2014, WHO established Living with
Asian regions dominate the number of people
Schizophrenia as the theme of world mental
with schizophrenia.10 The recurrence rate is
health day which is commemorated every
very high if no appropriate treatment and
October 12th. This theme was chosen because
treatment is taken.11
Schizophrenia is the most prevalent psychotic
disorder and has a high global prevalence,

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As stated by WHO, mental health is Urban conditions that are increasingly

determined by many factors and social out of control due to excessive urbanization
interactions, psychological and biological have created new problems such as increasing
factors, as well as economic and crime due to poverty, massive unemployment,
environmental, related to WHO behavior.12 increasing slums, and so on. The most
In Indonesia, with a variety of essential stimulation according to Simmel
biological, psychological and social factors includes views, sounds, smells, actions of
with the diversity of the population, the others, so that individuals respond to protect
number of cases of mental disorders continues themselves and adapt to their minds and
to increase which has an impact on increasing hearts. With the stimulation and the way the
the country's burden and decreasing human individual responds, it makes the individual
productivity for the long term.13 more intellectual, rational, and emotionally
According to WHO data in 2016, there distant from others. This is possible for
were around 35 million people affected by individuals to experience personality
depression, 60 million people were bipolar, 21 disorders.17
million were affected by schizophrenia, and Therefore, as an urbanization city, we
47.5 million were affected by dementia.13 need to see a narrative of the prevalence of
China is the 42nd country with the schizophrenia based on people, place and
highest number of schizophrenic sufferers time. This study aims to visualize
from 192 countries that have been studied. descriptively the prevalence of schizophrenia
Statistical prevalence of people with in South Jakarta Administrative city.
schizophrenia worldwide reaches 1.1% or
around 51 million.India is not much different METHOD
from China.14 The population of Indian
schizophrenics' ranks 47th out of 192
The study design used in this study was
countries recorded. Japan is the country with
cross-sectional. The research location is in
the lowest number of people with
South Jakarta Administrative City. The
schizophrenia in Asia.15
population is all cases of schizophrenia found
Based on the 2013 Riskesdas data, the
in health services in 10 District Health
prevalence of severe mental disorders
Centers in 2017.
nationwide was 1.7 ‰ (per mile), or 1,728
The operational definition of
people. This condition declined compared to
schizophrenia is a chronic disease in the form
the data reported in 2007 at 4.6 ‰. The
of a severe mental disorder characterized by a
prevalence of psychosis or schizophrenia is
disruption in the thought process that
highest in Yogyakarta (2.7 ‰), Aceh (2.7 ‰),
influences behaviour.18 Schizophrenic patients
and South Sulawesi (2.6 ‰), while the lowest
experience positive symptoms and negative
is in West Kalimantan (0.7 ‰). 3
symptoms. Positive symptoms include
The population of DKI Jakarta is
hallucinations, delusions, and irregular speech
10,377,186 people, and it is estimated that in
and behavior. They also experience negative
DKI Jakarta there are 11,415 cases of
symptoms, for example, flat affect, apathy,
schizophrenia (Riskesdas in 2013). Moreover,
and social withdrawal. Such conditions cause
the new ones found, recorded and handled
a malfunction in various aspects.19
during 2017 were 4,690 cases and 591,500
This mental health assessment uses the
cases of People with Psychological Problems
same measure and method in Riskesdas 2007
(ODMK). The prevalence of schizophrenia in
and 2013, using the Self Reporting
DKI Jakarta is 1.1 / 1000, and the prevalence
Questionnaire (SRQ) which consists of 29
of ODMK is 5.7 / 1000.16

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questions in real terms in essential health Administrative City in 2017. The total
services carried out by health workers in the population was 1,641 cases.
South Jakarta Administrative City area. The characteristics seen were variables
Data sources were obtained from of gender, age, place of residence, regularity
recording and reporting medical records in 10 of treatment for schizophrenic patients to
District Health Centers in South Jakarta health services.

RESULTS

The distribution of prevalence of Schizophrenia at the Administrative City of South Jakarta

in 2017 could be seen in the following table :
Table 1.
Schizophrenia Prevalence in the Administration City of South Jakarta in 2017

Sub-District Name Amount of Prevalence

case /1000
Populations
Cilandak 203 0.99
Jagakarsa 198 0.50
Kebayoran Lama 132 0.42
Kebayoran Baru 161 1.14
Mampang Prapatan 127 0.88
Pancoran 162 1.06
Pasar Minggu 128 0.41
Pesanggrahan 165 0.73
Setiabudi 135 0.94
Tebet 230 1.12

The highest prevalence rate is found in Kebayoran Baru Subdistrict with a prevalence of 1.14
/ 1000 while the lowest prevalence of schizophrenia is in Pasar Minggu District with a prevalence
of 0.41 / 1000 residents

Table 2.
The Proportion of Schizophrenia in the Administration City of South Jakarta in 2017

Sub-District Name Amount of case Proportion

Skizofrenia (%)

Cilandak 203 12
Jagakarsa 12
198
Kebayoran Lama 8
132
Kebayoran Baru 10
161
Mampang Prapatan 8
127
Pancoran 10
162
Pasar Minggu 8
128
Pesanggrahan 10
165
Setiabudi 8
135
Tebet 14
230

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The largest proportion of 1,641 schizophrenia cases in the South Jakarta Administrative City
of 14% came from Tebet District. The second largest proportion of 12% came from 2 sub-districts,
namely from Cilandak and Jagakarsa Districts.

Table 3.
The proportion of Sex of Schizophrenia in the Administration City of South Jakarta in 2017

Sub-District Name Man Women

(%) (%)
Cilandak 65 35
Jagakarsa 61 39
Kebayoran Lama 57 43
Kebayoran Baru 65 35
Mampang Prapatan 54 45
Pancoran 64 36
Pasar Minggu 62 38
Pesanggrahan 60 40
Setiabudi 58 43
Tebet 73 27

In general, the proportion of sex schizophrenia in men is the most dominant than women.
The highest proportion of male sex is 73% in Tebet, and the highest proportion of women in
Mampang Prapatan Subdistrict is 45%.

Table 4.
The proportion of Schizophrenia Based on Age Group (Year) in the Administration City of
South Jakarta in 2017

Age Group (Year) Amount of Cases Proportion (%)

<15 10 1
15-25 136 10
26-45 764 56
>46 442 33

The proportion of schizophrenia cases was highest in the age group 26-45 years as many as
56% and the lowest in the age group <15 years at 1%. When compared to the overall data per sub-
district, Tebet is the complete area of data quality. Thus we can see the proportion of schizophrenia
in Tebet Subdistrict who seek treatment in health services.

Table 5.
The proportion of Schizophrenia in Tebet Subdistrict who treated to Health Services
in 2017

Criteria Amount of Cases Proportion (%)

Treated at the Puskesmas 194 84
Referred to hospital 36 16
Not regularly seek treatment at the Health Center 128 56
Regularly seek treatment at the Health Center 102 44

Based on the table above of 230 schizophrenia cases in Tebet Subdistrict, the proportion of
schizophrenia in Tebet Subdistrict treated in Puskesmas was 84% and those referred to the Hospital

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were 16% whereas the proportion of irregular medical treatment at the Puskesmas goes to health
care for one year from January d.d. December 2017 is 56%.

Table 6.
The proportion of Schizophrenia by Gender, Age Group and Treatment History Based
on the Regularity of Treatment at the Tebet Community Health Center for One Year
in the Administration City of South Jakarta 2017

Variables Irregularly treated at the Regular treatment at the

Health Centre for a year Health Centre for a year
n % n %
Gender
Man 95 56.89 72 43.11
Women 38 60.32 25 39.68
Age Group
<15 Years old 4 80.00 1 20.00
15-25 Years old 25 89.29 3 10.71
26-45 Years old 37 42.05 51 57.95
>45 Years old 29 50.00 29 50.00
Medical History
Health Centre 103 52.02 95 47.98
Refer to the Hospital (Referral Program to the 30 93.75 2 6.25
Puskesmas)

The proportion of irregular sex treated was 56.89%, the proportion of the irregular age group
treated the majority in the 26-45 year age group was 42.05%, and the proportion of treatment
history from patients referred to irregular hospitals was re-treated to the Puskesmas Tebet is
93.75%.

DISCUSSION The prevalence of schizophrenia in the

DKI Jakarta Province is also still under the
The population in South Jakarta Canadian state. This is evidenced by a
Administrative City in 2017 is 2,232,614 population-based research study conducted
people with schizophrenia as many as 1,641 (the estimated prevalence of one year of
cases. The prevalence of schizophrenia rate in schizophrenia) in Canada is 7.5 to 17 per
DKI Jakarta Province in 2017 is 1.1 / 1000. 10,000.20
The number is not much different compared In proportion, the most significant
to the prevalence of schizophrenia rates in number of schizophrenia cases in the South
South Jakarta Administrative City in 2017 Jakarta Administration City came from Tebet
which is 0.7 / 1000 or 7 / 10,000. Subdistrict, which amounted to 14%, followed
When compared overall, the highest by the second largest 12% from 2 Districts,
prevalence rate in the area Subdistrict is in namely from Cilandak and Jagakarsa
Kebayoran Baru Subdistrict with a prevalence Districts.
of 11.4 / 10,000, meaning that for 10,000 In 10 sub-districts in the Administrative
residents in Kebayoran Baru Subdistrict there City of South Jakarta, the proportion of men
are 11 people with schizophrenia. While the was more significant than that of women with
lowest prevalence of schizophrenia is in Pasar a ratio of 1 (female): 2 (male). Overall, the
Minggu Subdistrict with a prevalence of 4.1 / area of South Jakarta Administrative City in
10,000 population, meaning that for 10,000 2017 is the most dominant proportion of sex
residents in Pasar Minggu Subdistrict there schizophrenia in men, which is 60%
are four people with schizophrenia. compared to 40% of women. If we see table
1.1. The highest proportion of male sex is

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73%, and the lowest male is 27% in Tebet There are cases of schizophrenia that
District. For the highest proportion of women can be controlled or treated at the Puskesmas,
in Mampang Prapatan Subdistrict at 45% and but some are referred to hospitals to get
the lowest women in Cilandak and Kebayoran further treatment. The proportion of
Baru Subdistricts at 35%. schizophrenia in Tebet Subdistrict treated in
Differences in proportions were also the Puskesmas was 84%, and those referred to
found in the research conducted by Wijayanti the Hospital were 16%.
(2014), which was a cross-sectional study, 25 Treatment continuity in the
respondents were schizophrenic in the work management of schizophrenia is one factor in
area of Kasihan II Bantul Yogyakarta Public the success of therapy. Patients who do not
Health Center, in the Ngestiharjo Village adhere to treatment will have a higher risk of
using consecutive sampling techniques, It is recurrence compared to patients who adhere
seen that people with schizophrenia with male to treatment. This disobedience to treatment is
sex are more than female sex, male sufferers the reason for returning to the hospital. 24 One
are 72%, while female sufferers are 28%. 21 of the causes of relapsing schizophrenia is an
This is following the theory which irregularity in treatment, to see the regularity
states that the prognosis and the course of the of data on treatment taken data at the Tebet
disease in men are worse than in women Sub-District Health Center because the Tebet
sufferers so that it is more quickly seen, the Sub-District Health Center is of full quality
cause can be due to genetic, environmental or compared to other regions. As many as 230
internal influences. Likewise, with the theory cases in Tebet Subdistrict, 84% were handled
that schizophrenia was diagnosed in 12 men in Puskesmas, and 16% were referred to
and ten women, it was due to a decline in hospitals, there were two criteria for patients
onset in women. The reason was given for referred to, namely schizophrenic patients
explaining why there is a decline in onset in with nervous and violent behavior. The
women, namely the presence of a protective proportion of irregular sex treated is male as
or neuroprotective effect of female hormones much as 56.89%, and in the age group 26-45
and a high potential for experiencing head years as much as 42.05%, this is due to.
injury in men compared to women. 22 The Administrative City area of South
Forage characteristics, the highest Jakarta, male schizophrenics is higher than
proportion of schizophrenia in the women. This is following the research
Administrative City of South Jakarta in 2017 conducted by Yuliastuti which is a descriptive
in the age group 26-45 years is as much as analysis survey research that is directed at
42.05% and the lowest in the age group <15 explaining a situation or situation by
years is 1% if we look more dominant at a recording data on 42 patient medical records
young age because schizophrenia cases in the and schizophrenic prescription sheets.
South Jakarta Administrative City area are Referral Program at Mungkid Health Center
more prevalent in the younger age group. January-June Period 2014, showed that the
The majority of the productive age proportion of male patients was 54.76%,
groups who suffer from schizophrenia were while the proportion of female patients was
also found in a study conducted by Novitayani 45.24%. The influence of culture can also
(2016) which was a descriptive type of study affect the height of male patients because men
with the population being all outpatients in the are the family pole so that if symptoms cannot
RSJA BLUD polyclinic which showed that be overcome, the family will bring them to the
the age of the respondents was in the range of hospital faster.25
25-44 years at 55.7%.23 For the proportion of irregular age
groups seeking treatment at the Tebet Sub-

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District Health Center, the majority in the 26- schizophrenic patients. Compliance with
45 year age group was 42.05%. In contrast to taking medication for schizophrenic patients
the irregular age group treated in a study outpatients in the mental polyclinic have a
conducted by Rawa with a cross-sectional excellent impact on patients with
study design on the object of the family schizophrenia so that the prevalence of
research of schizophrenic patients as many as recurrence of schizophrenic patients for one
88 respondents in the Polyclinic of the Mental year has never been. This is because of the
Hospital Prof. Dr. V. L. Ratumbuysang patient's routine treatment.
Manado in 2014 was in the age group > 41 The bias that might occur in this study
years with a proportion of 49%. is information bias because there are still
Service Referral Program is a Health missing data and measurement errors when
Service that is given to patients with chronic schizophrenia is misclassified.
diseases with stable conditions and still need
treatment, or long-term nursing care carried CONCLUSION
out in the First Level Health Facilities on
recommendations/referrals from specialist The proportion of schizophrenia in men
doctors / sub-specialists who care. One of the in South Jakarta Administrative City is higher
diseases that include the service of the than women, with a ratio of 2: 1. The highest
Referral Program is schizophrenia. 25 proportion of male schizophrenia is in Tebet
Schizophrenic patients who were Subdistrict and women in Mampang Prapatan
referred to the hospital if they were under Subdistrict. In South Jakarta the largest
control would then be referred to the proportion of schizophrenia is in the 26-45
Puskesmas again (Referral Program) at the year age group in Cilandak Subdistrict,
Puskesmas. It turns out that schizophrenic Cilandak Community Health Center handles
patients who were referred back to the schizophrenia more because early mental
Puskesmas found a proportion of 93.75% illness detection programs are better than
were not regularly treated again at the other regions, Jagakarsa Health Center is
Puskesmas. Even schizophrenic patients who further strengthened for schizophrenia cases,
were treated in the Puskesmas with a given the number most densely populated than
proportion of 52.02% were not regularly other regions. Biologically, schizophrenia is
treated to the Puskesmas, non-compliance more often experienced by men than women,
with treatment would be at risk for recurrence. because the female hormone estrogen is
This is reinforced in the Rawa study somewhat protective, so the tendency to get
which is a quantitative study conducted at the schizophrenia is more prolonged than men.
Prof. RSJ. Dr. V. L. Ratumbuysang, North Also, more men are rampaging, so the
Sulawesi Province in February-April 2017, treatment of male schizophrenic patients is
the population in this study was the nuclear different from those women. Treatment
family of patients with schizophrenia who continuity in the management of
were outpatient and listed in the medical schizophrenia regularly in schizophrenic
record at the Polyclinic of the RSJ Prof. Dr. patients is essential, because the recurrence
V. L. Ratumbuysang, North Sulawesi rate is very high if appropriate treatment and
Province and the sample in this study were 66 treatment is not taken.
respondents who showed that there was a
relationship between medication adherence
and the prevalence of recurrence in

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