• 재활복지
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• v.21 no.2
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• pp.113-137
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• 2017

In this study, we explore whether and how the experience of discrimination and social support affects physical health and mental health through disability identity among the disabled aged 50 and over. We also examine such relationship differs by the degree of disability. For the empirical test, we utilized the data from the Panel Survey for the Disabled conducted by our research team in 2016. According to structural equation model analysis, social support has a direct effect on disability identity. It also has a direct effect on physical health. As for the mental health, there are found direct effects of discrimination experience, social support, disability identity, and physical health, Furthermore, social support influences the mental health through disability identity. This finding suggests that social support for the disabled in old age increases disability identity and, in turn, it contributes their mental health. In the meanwhile, multiple group comparison analysis reveals the effect of discrimination experience on disability identity is found for those with lower level of disability but not for their counterparts. This seems to result from that the level of common ground which constitutes disability identity is low for the severely disabled. Thus, it requires our efforts to enhance disability identity focusing on common ground for the severe disabled.

• Korean Journal of Psychosomatic Medicine
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• v.10 no.2
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• pp.176-180
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• 2002

Hypnosis as a traditional healing method, in its recent development, has generated a multitude of techniques. These serve as practical tools which can be combined with other therapy techniques for the treatment of a variety of psychiatric and medical conditions. The empirical evidence for the effectiveness of hypnosis is considerable and proves its clinical impact in various areas of application. This case review describes the integration of hypnotherapeutic methods into the continuum of psychiatric encounters in a general practice. Guidelines for the application of hypnosis in approaching and treating each patients with headache, sexual dysfunction and bronchial asthma were illustrated. As hypotheses mechanism of effectiveness in psychosomatic disorders has been formulated. Training in hypnotherapy provides the psychiatrist with skills needed to address psychophysiological disorders. Emphasis is placed on the necessity and opportunity for research on the efficacy and specific technique of hypnosis in the psychosomatic disorders.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.2
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• pp.185-194
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• 1997

A comparison was made regarding illness behavior among patients with somatoform disorders, depressive disorders and psychosomatic disorders. The subjects consisted of out-patients with somatoform disorders(N=52), depressive disorders(N=52) and psychosomatic disorders(N=51). illness behavior was assessed by illness Behavior Assessment Schedule and the questionnaire about help-seeking behavior. The patients with somatoform disorders and psychosomatic disorders more often affirmed the presence of somatic disease, were more likely to have phobia of disease, had more preoccupation with ideas of disease and more frequently shopped around oriental clinics than the patients with depressive disorders. The patients with somatoform disorders more often attributed its cause to physical factors, less often attributed the origin of affective disturbance to psychological causes, showed Less depression and irritability, and were less likely to accept psychiatric treatment recommended by other physicians than depressive patients. The patients with somatoform disorders were more likely to report having been told that they suffered from a mild illness than those with psychosomatic disorders. The patients with somatoform disorders with psychological problems tended to inhibit expression of their emotion. Female patients with somatoform disorders more often affirmed the presence of psychological disorder and attributed its cause to psychological factors than male ones. These results suggest that in illness behavior, patients with somatoform disorders are different from depressive patients, whereas the former patients are similar to psychosomatic patients except the discrepancy between therapists and patients regarding evaluation of their symptoms. Thus, it is emphasized that first, therapists need to approach patients with somatoform disorders somatically with understanding of their underlying need to deny psychological problems, followed by either psychological or biopsychosocial approach.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.102-110
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• 2021

Objectives : The purpose of this study is to investigate the characteristics of the perception of the somatic symptoms and the cognitive emotion regulation strategies in patients with posttraumatic stress disorder (PTSD). Methods : A total of 48 patients meeting DSM-5 criteria for PTSD and 48 normal controls were recruited for participation in this study. We evaluated subjects using Clinician-Administered PTSD Scale (CAPS), Somato-Sensory Amplification Scale (SSAS), Hamilton Anxiety Scale (HAM-A) and Cognitive Emotion Regulation Questionnaire (CERQ). We analyzed data using an independent t-test and Pearson's correlation analysis. Results : In terms of SSAS, PTSD patients presented higher average SSAS scores than normal controls but the result is not statistically significant. In PTSD patients, the severity of PTSD is significantly correlated with CERQ-rumination and CERQ-catastrophizing. The SSAS scores of PTSD patients show the significant positive correlation with PTSD hyperarousal symptoms, CERQ-catastrophizing and CERQ-blaming others. Conclusions : These results reveal that patients with PTSD have maladaptive cognitive emotion regulation strategies such as rumination and catastrophizing. Somato-sensory amplification seems to be related with PTSD hyperarousal, CERQ-catastrophizing and CERQ-blaming others. Therefore, reducing somato-sensory amplification, rumination and catastrophizing can be helpful to reduce PTSD symptoms and somatic symptoms in PTSD patients.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.77-85
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• 2021

Breast cancer is the most prevalent oncological disease among women. Various psychosocial distress is common at the diagnosis, treatment, and posttreatment phase of breast cancer. For the treatment of breast cancer, not only medical treatment but also psychosomatic integrative care will be needed. Patients with breast cancer may lead to increased vulnerability to stress, adjustment disorder, anxiety disorder, and depressive disorder, and these psychiatric diseases and conditions are associated with recurrence or exacerbation of breast cancer. Psychosocial treatment of anxiety and depression could increase the quality of life of patients and decrease the recurrence and progression of breast cancer. In this article, we reviewed 5 clinical breast cancer survivorship guidelines focused on psychosomatic integrative care including psychosocial treatment and alternative treatment for psychosocial distress. Because 5 treatment guidelines were using various definitions of evidence, we confirmed evidence of various psychosocial treatments for patients with breast cancer based on the definition of evidence by the US Preventive Service Task Force (USPSTF) guideline. We also reviewed the effect size of psychosocial treatment for anxiety, depression, mood, and quality of life in patients with breast cancer. This article discusses the barrier to the delivery of psychosomatic integrative care and suggests integrative care planning for breast cancer. Multi-disciplinary teams, patient's needs assessment, information technology support, patient and caregiver engagement, planned periodic monitoring of psychosocial distress by a psychosomatic specialist or consultation-liaison psychiatrist are recommended as key features of a psychosomatic integrated care plan.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.203-212
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• 1999

Objectives : "Alexithymia" mean literally "no word for mood(or emotion)". It is not only a marked constriction in emotional functioning but a deficit in their cognitive processing. We designed this study to investigate the level of alexithymia, psychopathology and personality factors of patients with somatoform disorder and with diabetes mellitus. Methods : The subjects were consisted of patients with somatoform disorder(N=20), patients with diabetes mellitus(N=20), and normal control(N=20). The level of alexithymia, psychopathology and personality factors were assessed by the Toronto Alexithymia Scale(TAS), the Symptom Checklist 90-Revision(SCL 90-R), and the Sixteen Personality Factor Questionnaire(16-PF). And we compared demographic characteristics, psychopathology and personality factors among three groups, and assessed the relationship between alexithymia and psychopathology, and between alexithymia and personality factors. Results : The results were as follows. 1) Patients with somatoform disorder showed significantly higher TAS scores compared to patients with diabetes mellitus and the normal control group. 2) Patients With somatoform disorder showed significantly higher scores of somatization, anxiety scales than patients with diabetes mellitus and the normal control group, and showed significantly higher scores of obsessive-compulsive, depression, phobic anxiety, psychoticism scales than the normal control group by the SCL-90-R. 3) The normal control group showed high intelligence scores only as compared to patients with somatoform disorder by the 16-PF. 4) A significant relationship was found between TAS scores and psychopathology in patients with somatoform disorder. 5) All three groups did not shown any correlation between TAS and 16-PF. Conclusion : Patients with somatoform disorder showed higher TAS scores and more multiple psychopathology than patients with diabetes mellitus and the normal controls. A significant relationship was found between TAS scores and psychopathology in patients with somatoform disorder. We suggest that the therapeutic approach to patients with somatoform disorder to express emotions and manage psychopathology, and that the treatment methods of patients with diabetes mellitus aims to improve firstly physical conditions are more helpful.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.174-183
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• 1999

Objective : This study was designed to evaluate the incidence and characteristics of posttraumatic stress disorder(PTSD) after motor vehicle accidents(MVA) in 44 consecutive MVA victims referred to psychiatry for the diagnosis, treatment and psychiatric assessment. Method : The diagnosis of posttraumatic stress disorder was made on the basis of DSM-IV criteria, and posttraumatic stress symptoms were assessed by the Clinician-Administered PTSD Scale(CAPS). Correlation between the extent of physical injury and the severity of PTSD symptoms using the Abbreviated Injury Scale(AIS) was analyzed and the frequency of psychiatric comorbidity of PTSD was invested. Result : Twenty-two(45.5%) MVA victims met DSM-IV criteria for PTSD, while thirteen(29.5%) showed a subsyndromal form of it. AIS scores significantly related with the development of posttraumatic stress symptoms(r=0.565, p=0.0001). PTSD group showed high percentages of each of the 17 symptoms(criterion B, C, D), while subsyndromal PTSD group showed relatively high percentages of criterion Band D. The most frequent symptom was 'distressing dreams' of criterion B in both group. A high percentages(56%) of the MVA-PTSD group also met the criteria for current major depression. Conclusions : These findings suggest that there is apparently a high likelihood of developing all or part of the PTSD syndrome after motor vehicle accidents. So it does appear that for those MVA victims who seek medical attention and eventually need psychiatric referral, diagnostic possibility of PTSD should be taken into account in treatment planning and early intervention.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.2
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• pp.99-105
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• 2013

The movement disorders in psychiatry have been neglected, though it is an important psychiatric dimension to exert unfavorable influence on patients'quality of life. The etiologies of movement disorders in psychiatry can be classified as primary neurological disorders, psychiatric comorbidities of neurological disorders, manifestations of primary psychiatric disorders, drug-induced movement disorders and psychogenic movement disorders. For the rapid and proper treatment for movement symptoms and signs easily observed from psychiatric patients, psychiatrists' ability toward precise disgnosis and differential diagnosis of movement disorders should be preceded.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.95-101
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• 2021

Patients complaining with somatic symptoms are very common in clinical practice, and are often consulted to medical department. But it is difficult to treat well. The treatment of somatic symptom disorder is multi-modal as none of the methods on their own provide a satisfactory outcome. The treatment of somatic symptoms disorders is complicated by lack of boundary, conceptual clarity, and overemphasis on psychosocial causation and effectiveness of psychological treatments. In clinical practice all classes of psychotropics are used to treat somatic symptoms disorder. Drugs such as tricyclic antidepressants, serotonin reuptake inibitors(SSRI), serotonin and noradrenalin reuptake inhibitors (SNRI), atypical antipsychotics are studied. The evidence indicates that these drugs are effective in somatic symptom disorders. All classes of antidepressants seem to be effective against somatic symptom disorders. SSRIs are more effective against hypochondriasis and body dysmorphic disorder, and SNRIs appear to be more effective than other antidepressants when pain is predominant. The author suggest that psychiatrists should know how to treat patients complaining with somatic symptoms by using not only psychotherapeutic approach but also pharmacological treatment. It will be helpful to reduce suffering and increase quality of life of these patients.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.1
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• pp.79-86
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• 1999

A comprison was made regarding perceived family support among patients with somatoform disorders, psychosomatic disorders and depressive disorders. The subjects included 49 patients with somatoform disorders, 43 patients with psychosomatic disorders, and 50 patients with depressive disorders. Perceived social support-family scale was used to measure the extent of family support. The patients with somatoform disorders were significantly lower in family support than the patients with psychosomatic disorders. However, no significant differences were found between patients with somatoform disorders and those with depressive disorders, as well as between patients with psychosomatic disorders and those with depressive disorders. Patients with older age had significantly higher scores on family support than those with younger age. Married patients were significantly higher in family support than unmarried ones. These results suggest that low family support may be associated with either the etiology or the sequelae of somatization. Thus, it is emphasized that the role of family support is essential in evaluation and treatment of somatization. In addition, longitudinal studies will be required to investigate the causative role of low family support in somatization.