Korean Journal of Psychosomatic Medicine (정신신체의학)

Korean Psychosomatic Society (한국정신신체의학회)
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Somatic Symptoms after Psychological Trauma

심리외상 이후의 신체증상

  • 박주언 (계요병원 정신건강의학과) ;
  • 안현의 (이화여자대학교 심리학과) ;
  • 김원형 (인하대병원 정신건강의학과)
  • Received : 2016.03.28
  • Accepted : 2016.06.08
  • Published : 2016.06.30
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Abstract

Objectives : Somatic symptoms after the exposure of psychological trauma frequently developed. However, the somatic symptoms are not covered under the diagnostic criteria of posttraumatic stress disorder(PTSD) in detail, although they are often associated with social and occupational functioning and patient-doctor relationships. The aim of this article is to highlight the potential mechanisms, the common manifestations, and the treatment of the somatic symptoms. Methods : This article studied the somatic symptoms searched using academic search engines like PubMed, Scopus, Google Scholar, KoreaMed and KISS from the earliest available date of indexing to March 31, 2016. Results : The mechanism of somatic symptoms after the exposure was described as psychological and physiological aspects. Psychological mechanism consisted of psychodynamic theory, cognitive behavioral theory, and others. Physiological mechanism involved changes in neuroendocrine and immune system, autonomic nervous system and central nervous system. Somatization associated with psychological trauma manifested various health conditions on head and neck, chest, abdominal, musculoskeletal, and dermatological and immune system. Few studies described the standardization of treatment for the somatic symptoms. Conclusions : Clinicians and disaster behavioral health providers should think of the accompanying somatic symptoms during intervention of psychological trauma and PTSD. Further studies are needed on the somatic symptoms seen in psychological trauma and PTSD.

연구목적 심리외상에 노출된 이후 신체증상이 매우 빈번히 발생하곤 한다. 이러한 신체증상은 사회기능과 직업기능 및 환자-의사 관계와 종종 연관되지만 외상후스트레스장애 진단 범주에 포함되지 않은 상태이다. 본 논문에서는 이러한 신체증상의 기전, 흔한 임상양상, 그리고 치료에 대해 고찰하고자 한다. 방 법 PubMed, Scopus, Google Scholar, KoreaMed, KISS와 같은 학술검색엔진을 사용하여 2016년 3월 31일까지 검색된 심리외상 노출 이후 신체증상에 관한 자료를 바탕으로 연구하였다. 결 과 심리외상 노출 이후의 신체증상의 발생 기전은 심리적인 측면과 생리적인 측면으로 구분될 수 있었다. 심리기전은 정신역동이론, 인지행동이론, 그리고 다른 이론들이 포함되었다. 생리기전은 신경내분비 및 면역계, 자율신경계, 중추 신경계의 변화로 설명되었다. 심리외상과 연관된 신체증상은 두경부, 흉부, 복부, 기타 근골격계, 피부 및 면역계에서 나타나는 다양한 건강문제로 표현되었다. 이러한 신체증상의 표준화된 치료에 대한 연구는 매우 부족하였다. 결 론 임상의와 재난정신건강지원 실무자는 심리외상에 대한 개입이나 PTSD 치료 동안 동반된 신체증상에 대해 항상 염두에 두어야 한다. 심리외상과 PTSD에서 보이는 이러한 신체증상에 대해 더 많은 연구가 진행될 필요가 있다.

Keywords

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