• Title/Summary/Keyword: 불안 신체 증상

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Psychosomatic Symptoms Following COVID-19 Infection (코로나19 감염과 그 이후의 정신신체증상)

  • Sunyoung Park;Shinhye Ryu;Woo Young Im
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.72-78
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    • 2023
  • Objectives : This study aims to identify various psychiatric symptoms and psychosomatic symptoms caused by COVID-19 infection and investigate their long-term impact. Methods : A systematic literature review was conducted, selecting papers from domestic and international databases using keywords such as "COVID-19" and "psychosomatic." A total of 16 papers, including those using structured measurement tools for psychosomatic symptoms, were included in the final analysis. Results : Psychiatric symptoms such as anxiety, depression, and somatic symptoms have been reported in acute COVID-19 infection, while long-term post-COVID symptoms include chest pain and fatigue. The frequency of long-term psychosomatic symptoms has been estimated to be 10%-20%. Factors contributing to these symptoms include psychological and social stress related to infectious diseases, gender, elderly age, a history of psychiatric disorders, and comorbid mental illnesses. It is suggested that systemic inflammation, autoimmune responses, and dysregulation of the autonomic nervous system may be involved. Conclusions : Psychosomatic symptoms arising after COVID-19 infection have a negative impact on quality of life and psychosocial functioning. Understanding and addressing psychiatric aspects are crucial for symptom prevention and treatment.

Psychotherapy for Somatoform Disorder (신체형 장애의 정신치료)

  • Lee, Moo-Suk
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.269-276
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    • 1996
  • A theroretical study was made on the psychodynamism of somatoform disorder. Somatoform disorder is caused by a defense mechanism of somatization. Somatization is the tendency to react to stimuli(drives, defenses, and conflict between them) physically rather than psychically(Moore, 1990). Ford(1983) said it is a way of life, and Dunbar(1954) said it is the shift of psychic energy toward expression in somatic symptoms. As used by Max Shur(1955), somatization links symptom formation to the regression that may occur in response to acute and chronic conflict. In the neurotic individual psychic conflict often provokes regressive phenomena that may include somatic manifestations characteristic of an earlier developmental phase. Schur calls this resomatization. Pain is the most common example of a somatization reaction to conflict. The pain has an unconscious significance derived from childhood experiences. It is used to win love, to punish misdeeds, as well as a means to amend. Among all pains, chest pain has a special meaning. Generally speaking, 'I have pain in my chest' is about the same as 'I have pain in my mind'. The chest represent the mind, and the mind reminds us about the heart. So we have a high tendency to recognize mental pain as cardiac pain. Kellner(1990) said rage and hostility, especially repressed hostility, are important factors in somatization. In 'Psychoanalytic Observation on Cardiac Pain', psychoanalyst Bacon(1953) presented clinical cases of patients who complained of cardiac pain in a psychoanalytic session that spread from the left side of their chests down their left arms. The pain was from rage and fear which came after their desire to be loved was frustrated by the analyet. She said desires related to cardiac pain were dependency needs and aggressions. Empatic relationship and therapeutic alliances are indispensable to psychotherapy in somatoform disorder. The beginning of therapy is to discover a precipitating event from the time their symptoms have started and to help the patient understand a relation between the symptom and precipitating event. Its remedial process is to find and interpret a intrapsychic conflict shown through the symptoms of the patient. Three cases of somatoform disorder patients treated based on this therapeutic method were introduced. The firt patient, Mr. H, had been suffering from hysterical aphasia with repressed rage as ie psychodynamic cause. An interpretation related to the precipitating event was given by written communication, and he recovered from his aphasia after 3 days of the session. The second patient was a dentist in a cardiac neurosis with agitation and hypochondriasis, whose psychodynamism was caused by a fear that he might lose his father's love. His symptom was also interpreted in relation to the precipitating event. It showed the patient a child-within afraid of losing his father's love. His condition improved after getting a didactic interpretation which told him, to be master of himself, The third patient was a lady transferred from the deparment of internal medicine. She had a frequent and violent fit of chest pains, whose psychodynamic cause was separation anxiety and a rage due to the frustration of dependency needs. Her symptom vanished dramatically when she wore a holler EKG monitor and did not occur during monitoring. By this experience she found her symptom was a psychogenic one, and a therapeutic alliance was formed. later in reguar psychotherapy sessions, she was told the relaton between symptoms and precipitating events. Through this she understood that her separation anxiety was connected to the symptom and she became less terrifide when it occurred. Now she can travel abroad and take well part in social activities.

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A SURVEY OF THE PSYCHOSIS AMONG SCHOOL VIOLENCE VICTIMS (학교폭력 피해자의 정신병 실태 조사)

  • Kwon, Seok-Woo;Shin, Min-Sup;Cho, Soo-Churl;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.124-143
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    • 2000
  • Objectives:The primary purpose of this study is to understand the psychopathology of the victims of school violence in terms of early psychosis. By doing this, the early detection of psychosis among the victims is possible, and early detection may lead to early intervention. Methods:Two-thousand and nine-hundred seventy two students from 16 middle schools in Seoul were asked to fill out questionnaire comprised of popularity and intellectual and school status of Piers-Harris Children's Self Concept Inventory, Symptom Check List-90-Revised, and Ostracism Scale. The subjects whose scores upon Ostracism Scale were higher than average by two standard deviation were labeled as ‘Repelled and Isolated group', and subjects whose scores on popularity were significantly lower than average and whose scores on psychoticism of SCL-90-R were higher than average were defined as 'tentative early psychosis group'. Odds ratios were calculated from the numbers of subjects with and without high psychoticism scores and high ostracism scores. On the subjects of 'tentative early psychotic group', we examined every clinical characteristic and conducted correlation analysis and regression analysis in order to find out the risk factors and to construct theoretical model that explains the psychoticism scores. Results:The results were as follows:1) Total 157(5.3%) subjects were rated significantly higher on ostracism scale, and among them, 47 subjects(29.9%) were rated significantly higher than average on psychoticism scale, while only 50 subjects among 2,135 students who were rated within normal range showed significantly higher score on psychoticism scale. Odds ratio for psychotic group of isolated group were 17.82 and it was statistically significant. 2) Forty-seven subjects(31 boys, 16 girls) who were rated as they were unpopular and rejected from peers had significantly higher psychoticism scores. They were not significantly different from simply high psychoticism subjects in anxiety, social anhedonia scale, magical thinking, obsessivecompulsive symptoms, phobic anxiety, psychoticism, somatization, but showed higher ostracism scores and paranoid tendencies. Among school violence victims, who rated themselves unpopular and showed higher psychoticism scores, the psychoticism scores were mainly explained by anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization scales($r^2=0.93$). Conclusion:Thus, it can be concluded that the subjects with higher ostracism score have the substantially high risk for psychosis development. By these results, we propose that school violence victims with anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization should be tested individually considering school adjustment, attentional deficit, concept formation problems.

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Psychological Symptom to Work-Life Balance: An Examination of Negative Belief in Emotional Expression and Emotional Clarity among Working Men and Women (일과 삶의 균형과 정신건강의 관계에서 부정적 정서신념과 정서명료성의 조절효과: 성차를 중심으로)

  • Young Mi Sohn ;Cheong Yeul Park ;Eunjoo Yang
    • Korean Journal of Culture and Social Issue
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    • v.23 no.3
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    • pp.333-359
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    • 2017
  • We examined the moderator roles of negative belief in emotional expression and emotional clarity between work-life balance and psychological symptoms (depression, anxiety and somatization). Also we identified gender differences in their moderating effects. This study was based on a sample of 869 married working employees (man: 424, women: 445). Hierarchical moderated regression analyses showed that work-life balance, negative belief in emotional expression and emotional clarity were strongly associated with depression, anxiety and somatization. While negative belief in emotional expression significantly moderated the relationship between work-life balance and depression and anxiety, emotional clarity showed no significance. We found gender differences in moderating effects of two moderators. In specific, the only women who had more negative belief in emotional expression were more psychological symptoms in a low work-life balance situation. On the other hand, the only men who had higher emotional clarity were less depressive and anxious under the conditions of high work-life balance. We discussed about implications of these results.

Comparison of Clinical Characteristics among Anxiety Disorder, Depressive Disorder, and Co-morbid of Anxiety Disorder and Depressive Disorder with MMPI-2-RF (MMPI-2-RF로 살펴본 불안장애, 우울장애, 불안장애와 우울장애 공병 환자군의 임상적 특성)

  • Lee, JuYeon;Choi, Junho;Kim, Eunkyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.1-7
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    • 2020
  • Objectives : The purpose of this study was to explore comparison of clinical characteristics among Anxiety disorder, Depressive disorder, and Co-morbid of Anxiety disorder and Depressive disorder. Methods : Since January, 2017 to May, 2019, patients were recruited from the department of psychiatry of Hanyang University Guri Hospital. Participants were diagnosed Anxiety disorder, Depressive disorder, and Co-morbid of Anxiety disorder and Depressive disorder using DSM-5 criteria by board certified psychiatrists or clinical psychologists. And each of participants tested with MMPI-2 and clinical psychologists were converted MMPI-2 to MMPI-2-RF. The data were analyzed using SPSS 18.0. Results : The results indicated EID, RC2, HLP, SAV, and INTR-r were the highest in Co-morbid of Anxiety disorder and Depressive disorder group. And BXD, RC4, JCP, and AGGR-r were the highest in Depressive disorder group. Conclusions : The results indicated that Co-morbid of Anxiety disorder and Depressive disorder group were more severe internalizing dysfunction like lower positive emotion, helplessness, social avoidance and discomfort than single-diagnosed group. Single Depressive disorder group were more serious externalizing dysfunction like anger and aggression than single Anxiety disorder and Co-morbid of Anxiety disorder and Depressive disorder. The implications and limitations were discussed.

Psychosomatic Symptoms of Rotating Shift and Daytime Working Nurses in a General Hospital (일 병원의 순환교대근무와 주간고정근무 여성 간호사의 근무형태에 따른 정신신체 증상)

  • Kim, Byoung-Jo;Choi, Mal-Rye;Kim, Tae-Hyung;Kim, Hyeong-Wook;Eun, Hun-Jeong
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.79-86
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    • 2014
  • Objectives : Shift work disorder occurs when you have difficulties adjusting to a work schedule that takes place during a time which most people sleep. Some people may have diverse psychosomatic symptoms, such as sleep problems, depression, anxiety, and headaches even after the shift work schedule ends. The aims of this study are to compare difference of psychosomatic symptoms between rotating shift and daytime working nurse groups. Methods : Volunteer nurses working in a general hospital were recruited in a general hospital. We collected sociodemographic data. We used questionnaires for headache type, headache frequency, and VAS(Visual Analog Scale) for headache intensity, BDI(Beck depression Inventory) and GSAQ(Global Sleep Assessment Questionnaire). We used Mann-Whitney test and Chi-square test for hypothesis testing. Results : Data collected from 84 women nurses. Rotating shift(N=37) working nurses showed younger, more unmarried, and shorter work periods than daytime working nurses (N=47). Also rotating shift group showed more problems of headache, insomnia, excessive daytime sleepiness, depression and anxiety than daytime group. The above results were statistically significant. Conclusions : The rotating shift work women nurses produced more headache, insomnia, excessive daytime sleepiness, depression, and anxiety than daytime working ones.

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Integrative Review of Guidelines Related Symptom Management and Physical Activity for Developing of Self-Care Management Program for Cancer Survivors (암생존자의 자가관리 프로그램 개발을 위한 증상관리 및 신체적 활동 관련 가이드라인의 통합적 고찰)

  • Song, Chi Eun
    • The Journal of the Korea Contents Association
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    • v.18 no.4
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    • pp.586-600
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    • 2018
  • The purpose of this study attempted to collect basic data for development of an integrated self-management program for cancer survivors who completed cancer treatment. Self-management programs are divided into symptom management and physical activity management. Symptom management includes fatigue, sleep disturbance, pain, depression and anxiety. PubMed, CINAHL and EMBASE were used for searching guidelines. Based on the guideline quality evaluation, the final 8 guidelines were analyzed. The structured table was used to extract the screening subjects, timing, contents, subjects for comprehensive assessment and contents, and summarized contents related to the physical activity and exercise in non-pharmacological approach. As a result, after the completion of cancer treatment, all cancer survivors should be screened regularly using reliable and validated tools. In the case of fatigue, physical activity was recommended as the primary intervention, but it was recommended for other symptoms as adjuvant therapy. Therefore, Cancer survivors should be encouraged to be active in their physical activity, and maintain the moderate intensity physical activity as long as they have no complication related to the cancer treatment. Motivation strategies for physical activity need to be developed and applied.

The relationships among smartphone use, mental health and physical health - Focusing on smartphone users' attitudes (스마트폰 사용과 정신건강 및 신체건강 간의 관계 -스마트폰 사용자의 태도를 중심으로)

  • Kang, Hye-Ja
    • Journal of Digital Convergence
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    • v.14 no.3
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    • pp.483-488
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    • 2016
  • This study was conducted to examine the relationships among smartphone use, mental health and physical health by focusing smartphone users' attitudes. For this purpose, 129 college students were asked to complete the questionnaires which contained measures of smartphone use, mental health and physical health. The results of data analysis showed that the positive correlations among smartphone use scores, physical and mental symptoms were significant. The importance of adaptive using smartphone for health was emphasized. Finally, limitations and suggestions of this study were discussed.

Correlation between Behavioral Psychological Symptoms and Caregiver Burden in Alzheimer's Disease (알츠하이머병에서 행동심리증상과 간병인의 부양부담 사이의 상관관계)

  • Kim, Yo Sup;Lee, Kang Joon;Kim, Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.200-207
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    • 2016
  • Objectives : Alzheimer's disease(AD) is characterized by progressive decline of cognitive function and also by various behavioral psychological symptoms of dementia(BPSD) which causes distress to their caregivers. The purpose of this study was to investigate association between each AD patients' behavioral psychological symptoms and their caregivers' burden. Methods : Participants were 80 AD patients and their caregivers. We used Korean neuropsychiatric inventory (K-NPI) to assess the symptoms of patients and Korean version of Zarit Burden Interview(ZBI) to evaluate caregivers' burden. Results : The results showed ZBI score, which is the index for caregivers' burden, had a statistically significant positive correlation with the frequency of delusion, hallucination, agitation/aggression, depression, anxiety, disinhibition and irritability, the severity of hallucination, agitation/aggression, anxiety, disinhibition, aberrant motor, and sleep, and the global score(frequency${\times}$severity) for delusion, hallucination, agitation/aggression, depression, anxiety, disinhibition, aberrant motor, and sleep. There were significant correlations between each scale for cognitive function(i.e. MMSE-KC, CDR, GDS) and ZBI scale. Correlations between each scale for activity of daily living(i.e. Barthel -ADL, K-ADL) and ZBI scale were also significant. Conclusions : There were a significant correlation between BPSD and caregiver burden. Caregiver burden was also correlated with cognitive function and activity of daily living. Early detection and preventive treatment of these symptoms in BPSD might make improvement of caregivers' quality of life as well as AD patients'.

Quality of Life of Patients in Acute Stage of Stroke (급성기 뇌졸중 환자의 삶의 질)

  • Kim, Se-Joo;Kim, Young-Shin;Choi, Nak-Kyung;Lee, Yoon-Young;Lee, Byung-Chul;Lee, Man-Hong
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.1
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    • pp.27-36
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    • 2002
  • Objectives : Stroke is a chronic condition that may carry significant negative impact on the quality of life in patients. Research, treatment and rehabilitation on stoke, however, have focused on physical aspects, neglecting its psychiatric aspects and quality of life. So, aim of this study is to compare quality of life in stroke patients and healthy controls by using WHO Quality of Life(QOL) Scale that evaluates the domains of physical health, psychological health, social relationship and environment. Additionally, relationship between clinical factors in patients with stroke and their quality of life were explored. Methods : 98 patients in acute stage of stroke and 24 healthy controls were recruited in this study and WHO QOL Scales were completed. Total scores and scores of domains of WHO QOL Scale in two groups were compared. Correlation analysis and multiple regression analysis were performed to examine the relationship between quality of life and the clinical characteristics in patients with stroke. Results : Total scores and scores of all domains of WHO QOL scale in patients with stroke were decreased compared to those in healthy controls. Clinical characteristics including the depression, anxiety, social support system showed significant correlation with quality of life in general and most of subscales of QOL. And male patients have higher level of quality of life than female patients. But, physical disabilities rated with Barthel's index did not show significant correlation with quality of life. Multiple regression revealed that the severity of depression, anxiety, gender, and level of social support system were factors directly affecting the quality of life in the patients with stroke. Conclusion : Quality of life in patients with stroke was poorer than that of healthy controls. The severity of depression, anxiety, gender, and the level of social support system were related to the quality of life in the patients with stroke.

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