CASE REPORT: COGNITIVE BEHAVIOR THERAPY PADA PASIEN GAMBLING DISORDER DAN INTERNET GAMING DISORDER BERKOMORBID DENGAN GANGGUAN AFEKTIF BIPOLAR EPISODE KINI DEPRESIF SEDANG TANPA GEJALA SOMATIK

Abstract

ABSTRACT

Gambling Disorder (GD) and Internet Gaming Disorder (IGD) are behavioral addictions that can significantly impair psychosocial functioning and become more complex when comorbid with bipolar affective disorder. This case report aimed to describe the implementation of Cognitive Behavioral Therapy (CBT) combined with pharmacotherapy in a patient with comorbid GD, IGD, and bipolar affective disorder, and to evaluate the clinical outcomes following the intervention. This study employed a case report design involving a single patient. The assessment process included psychiatric interviews, heteroanamnesis, clinical observation, mental status examination, medical record review, and the administration of the South Oaks Gambling Screen (SOGS), Internet Gaming Disorder-20 Test (IGD-20), and University of Rhode Island Change Assessment (URICA) to establish the diagnosis, assess symptom severity, and evaluate the patient's readiness for treatment. Management consisted of pharmacotherapy based on clinical indications combined with structured CBT. Following the intervention, the patient demonstrated reduced craving, decreased frequency of addictive behaviors, improved mood, enhanced impulse control, and better psychosocial functioning. The patient also became able to identify triggers of addictive behaviors and apply more adaptive coping strategies. These findings suggest that integrating pharmacotherapy with CBT may provide an effective approach for managing patients with comorbid GD, IGD, and bipolar affective disorder by addressing biological, psychological, and behavioral aspects in a comprehensive manner.

ABSTRAK

Gambling Disorder (GD) dan Internet Gaming Disorder (IGD) merupakan adiksi perilaku yang dapat mengganggu fungsi psikososial dan semakin kompleks apabila disertai gangguan afektif bipolar. Laporan kasus ini bertujuan menggambarkan penerapan Cognitive Behavior Therapy (CBT) yang dikombinasikan dengan farmakoterapi pada pasien dengan komorbid GD, IGD, dan gangguan afektif bipolar, serta mengevaluasi luaran klinis setelah intervensi. Penelitian ini menggunakan desain laporan kasus (case report) pada satu pasien. Asesmen dilakukan melalui wawancara psikiatri, heteroanamnesis, observasi klinis, pemeriksaan status mental, telaah rekam medis, serta penggunaan South Oaks Gambling Screen (SOGS), Internet Gaming Disorder-20 Test (IGD-20), dan University of Rhode Island Change Assessment (URICA) untuk menegakkan diagnosis, menilai tingkat keparahan, dan kesiapan pasien mengikuti terapi. Penatalaksanaan dilakukan melalui kombinasi farmakoterapi sesuai indikasi klinis dan CBT secara terstruktur. Setelah intervensi, pasien menunjukkan penurunan craving, berkurangnya frekuensi perilaku adiktif, perbaikan suasana perasaan, peningkatan kontrol impuls, serta perbaikan fungsi psikososial. Pasien juga mampu mengenali pemicu perilaku adiktif dan menerapkan strategi koping yang lebih adaptif. Temuan ini menunjukkan bahwa integrasi farmakoterapi dan CBT berpotensi menjadi pendekatan yang efektif dalam penatalaksanaan pasien dengan komorbid GD, IGD, dan gangguan afektif bipolar melalui penanganan aspek biologis, psikologis, dan perilaku secara terpadu.