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Depression is the third most commonmedical condition causing moderate tosevere disability in the world. Major de-pression is a severe, often recurrent, andultimately disabling disorder. The goal oftreatment in Major Depression Disorder(MDD) should be the most rapid andmost complete remission. Acute treatment

phase should be followed by a continua-tion period to eliminate residual symptoms,restore function, and prevent relapse. Pa-tients with high risk of recurrences mayneed long-term, life-long maintenancetreatment. Remission from a depressiveepisode implies the absence or near-ab-sence of depressive symptoms. Howeverin many patients, periods between depres-sive episodes are not symptom-free. Re-sidual symptoms are predictors for relapseor recurrence, and may be associated withresidual psychosocial impairment. To pro-

mote better outcomes in MDD treatment,factors considered important : highly ef-fective in acute phase, achieve remissionand promote patient confidence, adequateand ongoing cognitive behavioral therapyand minimal long-term drug side-effect.Although long-term antidepressant treat-ment in clinical practice can reduce the riskof relapse or recurrence, only minority ofpatients achieve this as treatment is oftenprematurely stopped due to long-termside effects such as sleep disturbances,sexual dysfunction and weight gain.

Keywords: major depressive disorder, re-mission, residual symptom

CDK 2012;39 (2): 92-6

Toward Better Outcomes inMajor Depressive Disorder

(MDD) Treatment

Nurmiati AmirDepartment of Psychiatry, Faculty of Medicine,

University of Indonesia / Dr. Cipto Mangunkusumo

General Hospital, Jakarta, Indonesia

cal and social condition that may interacteach other. Psychopathology in the el-derly are situational, depression, anxiety,intellectual, paranoia, and psychologicalchronic disorders. Psychological problem

arises when they fail to find solution fortheir problems. Management of elderlypatients should be based on knowledgeattention, common sense and affection.Increasing number of old people createsincreasing need of holistic and efficientdental treatment. Elderly people requirespecial handling, that influence the suc-cess of dental treatment.

Keywords: Psychological factor, dentaltreatment in elderly

CDK 2012;39 (2): 106-9

Emotional Factors asDeterminants in Dental

Care among Elderly

Eri H. Jubhari*, Moh. Dharmautama*,Ulfarica DD. Ananda**,

Arwiny W. Hipi**, Herman***Department of Prostodontics, **Student, Faculty of

Dentistry, Hasanuddin University, Makassar, Indonesia

One of the main choice of prosthodontictreatment is overdenture. Overdenture is aremovable partial or complete denture thatcovers and rests on one or more remainingnatural teeth, roots, and/or dental implants.Retained teeth can maximize retention, sta-bilize and prevent trauma to oral mucosa;the presence of roots in the bone can alsodelay resorption of alveolar process while

the role of proprioceptor in periodontalligament abutment teeth remains effective.Overdenture is preventive prosthodon-tic procedure. Retained teeth have to bekept healthy. Restoratives (glass ionomer,composite), fluoride and magnet can beapplied to the surface of retained teeth;this procedure is to increase the retentionalability and stabilization of the overdenture.Patients also have to maintain oral hygieneand visit dentist periodically.

Keywords : overdenture, endodontic, oral

hygiene

CDK 2012;39 (2): 102-5

Overdenture : Preventiveand Conservative

Approaches

FX Ady SoesetijoDepartment of Prosthodontics, Faculty of Dentistry,

Jember University, Jember, East Java, Indonesia

Diagnosis of NeuropathicPain in Daily Practice

Rizaldy PinzonDepartment of Neurology, Bethesda Hospital,

Yogyakarta, Indonesia

Neuropathic pain is a challenge to healthcare professional. This common type of pain

is often under diagnosed and undertreated,and it is associated with suffering, disabil-ity, impaired quality of life, and increasetherapeutical cost. Contrary to nociceptivepain, NSAID and opioid have little benefitin neuropathic pain. Adjuvant analgesics(anticonvulsant and antidepressant) is thecornerstone of neuropathic pain treatment.An adequate management should beginwith good clinical assessment and diagnosis.This review discuss the screening tools anddiagnostic approach to patients suspectedwith neuropathic pain in our daily practice.

Keywords:neuropathy, pain, assessment,screening tools

CDK 2012;39 (2): 142-3Aging is a natural process accompaniedwith degradation of physical, psychologi-

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ENGLISH SUMMARY

CDK-190 OK.indd 86 03/02/2012 13:50:58