Introductions: Ambiguous genitalia is a congenital disorder defined by atypical development at the chromosomal, gonadal, or anatomical levels of the sex organ. The incidence of ambiguous genitalia is estimated to be 1 in 4500-5500 births. The management of ambiguous genitalia takes an extended time. This can lead to psychiatric manifestations such as depression, anxiety, suicidal ideation, and substances. Objectives: The study aimed to describe the management of ambiguous genitalia in the scope of psychiatry to optimize the comprehensive treatment of the disorder and achieve a good quality of life for a person with ambiguous genitalia in Indonesia. Methods: This study is a literature review that collects from various sources of scientific journals related to the psychiatric management of the disorder. Results: Ambiguous genitalia should be treated by a multidisciplinary approach, with a mental health professional and other essential expertise of the team. Improper application of parenting in childhood can create a problem in adolescence and adulthood. Certain aspects of the management need a psychiatrist’s assistance. Psychological management should focus on giving reliable information that is not confusing and preparing children and adolescents to encounter general and sexual life problems. The family and the child should always be involved during the process. Conclusions: The purpose of the entire ambiguous genitalia treatment is to strengthen the patient and family’s adaptive coping to the stressors correlated with ambiguous genitalia and the management to promote good quality of life for children and adolescents.

Introduction. Phantom limb pain is a pain sensation experienced in the area of the missing body part. The pain generally appears in the first few days after surgery. PLP could occur in teeth, tongue, breast, eyes, rectum, bladder, testicles, and penis. Phantom pain in the penis is not only felt as pain but sometimes as an erection or urination, even after the removal of the penis. Clinical Case. A 35-year-old man was referred to the psychiatrist due to phantom erection after undergoing reimplantation of the penis by the urologist. A few days before the referral, he was admitted to the emergency department after a penile amputation that his wife performed. During the recovery phase after the penile reimplantation procedure, the patient worried about his penis’ outcome and became depressed. The patient was in severe anxiety and moderate-to-severe depression status. Treatment. The patient was given nonpsychopharmacology such as supportive psychotherapy, family psychoeducation, relaxation and marital therapy, and psychopharmacology, such as amitriptyline 12.5 Mg PO two times a day and clobazam 10 Mg PO each day for 3 months. One and a half months later, his anxiety and depression were better. Conclusion. A psychiatric approach was needed in an amputated limb patient with psychopathologic symptoms. Nonpsychopharmacotherapy and psychopharmacotherapy were needed if the patient had symptoms. Further studies with a large number will be necessary to validate the psychiatric approach in amputated limb patients with psychopathologic symptoms cases.

Background: Mental disorders in children need special interventions to ensure better quality of life. The epidemiology of pediatric mental disorders is needed to prepare sufficient facilities for their treatment. Purpose: The aim of this study is to describe the epidemiology of pediatric mental disorders in child psychiatric outpatient clinic at Dr. Soetomo General Hospital, Surabaya in the year 2019 and 2020. Methods: This study is a descriptive observational study that uses the medical records of pediatric patients with mental disorders at the child psychiatric outpatient clinic at Dr. Soetomo General Hospital between January 2019 and December 2020. The data was analyzed using descriptive statistics. Results: There were a total of 2773 patient visits to the child psychiatric outpatient clinic of Dr. Soetomo General Hospital, Surabaya between January 2019 and December 2020. Patient visits were 51.37% lower in 2020 compared to 2019. Autism (atypical and childhood autism) is the most frequent cases diagnosed in child psychiatric outpatient clinic of Dr. Soetomo General Hospital in 2019 and 2020. Conclusions: There is a decrease of patient visits in child psychiatric outpatient clinic at Dr. Soetomo General Hospital starting from the second quarter of 2020. Most cases diagnosed in both 2019 and 2020 were Atypical autism, ADHD with predominant inattentive presentation, and Childhood autism.