• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.256-262
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• 1999

Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.

• Anxiety and mood
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• v.15 no.1
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• pp.13-19
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• 2019

Objective : The purpose of this study was to investigate consensus relative to treatment strategies for psychosocial treatment in panic disorder, that represents one subject addressed by the Korean guidelines for treatment of panic disorder 2018. Methods : The executive committee developed questionnaires relative to treatment strategies for patients with panic disorder based on guidelines, algorithms, and clinical trials previously published in foreign countries and Korea. Seventy-two (61.0%) of 112 experts on a committee reviewing panic disorder responded to the questionnaires. We classified the consensus of expert opinions into three categories (first-line, second-line, and third-line treatment strategies), and identified treatment of choice using the Chi-square test and 95% confidence intervals. Results : For psychosocial treatment of panic disorder, individual and group cognitive behavior therapy (CBT) were recommended treatments of choice, and mindfulness based cognitive therapy (MBCT) was recommended as first line strategy. There was statistically significant consensus among experts regarding usefulness of each component of CBT and MBCT, for treatment of patients with panic disorder. Conclusion : Results, that reflect recent studies and clinical experiences, may provide the guideline for psychosocial treatment strategies for panic disorder.

• Korean Journal of Biological Psychiatry
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• v.27 no.2
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• pp.37-41
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• 2020

Modified electroconvulsive therapy (ECT) which started in 1950s is a safe and efficacious treatment for several mental disorders including mood disorders and psychotic disorders. However, its usage in present days is still limited by misconceptions and stigmata of ECT. This paper overviews the background from which the stigmata of ECT stemmed and the current status of stigmata surrounding ECT among the public and medical professionals. In addition, a few potential strategies for reducing stigmata of ECT are provided in this review.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.4 no.1
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• pp.164-172
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• 1993

By observing the psychotherapy process expressed by an adolescent with obssessive compulsive disorder, the author suggests that the main problem of OCD is not merely a product of an unconscious process as traditionally thought, but a learned problem solving process as a method surviving the more realistic conflicts, and therefore the treatment should be directed to more or less conscious and realistic issues and conflicts, family therapy should be offered too.

• Journal of Sasang Constitutional Medicine
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• v.8 no.1
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• pp.1-15
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• 1996

The Sasang Constitutional Medicine seeks the psychosomatic balance, and the Basic principle of treatment according to the symptom(病證藥理) in Sasang Constitutional Medicine could be summarize as follows. 1. The pursuit of Shape-Image Medicine (形象醫學) and the Symptoms of shape - Symptoms of disease (形置病證). It established emotion, symptoms of constitution, and symptoms of constitutional disease on the base of Shape-Image Medicine (形象醫學) which means qi (氣) is inside and shape is outside (氣裡形表). 2. The inductive medicine and positive medicine. It systematized the Symptoms of shape - Symptoms of disease (形證病證) on the base of the medical practice of the ancients and Lee Jae-Ma (李濟馬)'s own experience inductively, and it present show to control the psychosomatic balance practically. 3. The pathology centering on human. Oriental medicine is based on Yin-Yang (陰陽) and Five elements (五行) and the harmony of nature and human (天人相應) of Taoism, but Sasang Constitutional Medicine is based on emotional and ethical pathology of Confucianism (儒學). 4. The treatment according to the symptom (病證藥理) in Sasang Constitutional Medicine centering on clear qi (正氣). The promotion and demotion (補瀉) which is based on clear qi (正氣) and evil qi (邪氣) is a basic principle in Oriental medicine, but In Sasang Constitutional Medicine it is attached importance to control of clear qi and classify obedience symptom and disobedience symptom (順 逆症) as the type to oppose disease. 5. The treatment according to the psychomatic symptoms. It takes importances to control of one-sided emotion as well as the treatment of psychical symptoms, and also to remedy disease as keeping under control one's mind. 6. The preventive medicine and the medicine to develop one's health. It is in pursuit of social health to develop personality through clear qi (正氣) in real life, to prevent disease, and to spread the sickness control of individual person. Sasang Constitutional Medicine pursuits the psychosomatic balance through 'Balance', 'Control', 'Self regulating Control' of the 'Golden Mean (中庸)' with the treatment according to the symptom (病證藥理) in Sasang Constitutional Medicine.

• Korean Journal of Psychosomatic Medicine
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• v.8 no.2
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• pp.149-164
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• 2000

Somatization is regarded as a process rather than a diagnostic entity. It should be emphasized to identify psychopathology rather than to make a choice regarding diagnosis in assessing somatizing patients. Psychiatrists should be aware of the psychosocial cues underlying the patients' physical symptoms. Special skills and strategies are required by nonpsychiatric physicians to facilitate the patients' acceptance of psychiatric treatment. The goal of treatment for somatization is management but not cure. The approach should be flexible, depending on the patients' responses and need. The difficulty in diagnosing and treating somatization is likely to be related to abnormal illness behavior such as the patients' denial of their psychosocial problems and resistance to psychiatric approach. In conclusion, biopsychosocial approach is needed to treat these patients effectively. Psychiatrists should also teach other physicians the interview skill that they could identify these patients as early as possible and facilitate their acceptance of psychiatric treatment.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.2
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• pp.81-92
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• 2013

Newer antidepressants are commonly used in clinical practice to treat psychiatric disorder and psychosomatic disorder including chronic pain syndrome, fibromyalgia, headache. However there are many unexpected adverse effects of these drugs such as nausea and vomiting, weight gain, sexual dysfunction. These are 3 most well-recognized common adverse effects of newer antidepressant and are most common causes of treatment failure. I reviewed mechanisms, epidemiology, and pharmacological management of these adverse effects of newer antidepressants. In this paper, newer antidepressants include selective serotonin reuptake inhibitor(fluoxetine, fluvoxamine, citalopram, escitalopram, sertraline, paroxetine), serotonin norepinephrine reuptake inhibitor(venlafaxine, duloxetine), norepinephrine and dopamine reuptake inhibitor(bupropion), noradrenergic and specific serotonergic antidepressant(mirtazapine), and reversible inhibitor of MAO-A(moclobemide). I suggest that psychiatrists and clinicians in the psychosomatic field should know mechanisms, epidemiology, and management of these common and well-recognized adverse effects of newer antidepressants. Therefore it will be helpful to recognize easily and treat well for patients with psychiatric disorder and psychosomatic disorder using newer antidepressants.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.24-29
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• 2002

The social attention about disaster psychiatry was increased after 911 terror in New York. The role of child psychiatrist and specific consideration for the treatment of child victim in disaster were reviewed. The following were main points. 1) The most single determining factor of prognosis is supporting system and parental attitude to their child victim. So family therapy and parental eucation are needed. 2) Cognitive Behavior Therapy is known to the most effective treatment in many literature. 3) Brief group therapy with fellow victim is cost effective preventive methods and screening tool for more serious victim, 4) Eye Movement Desensitization and Reprocessing(EMDR) could be a very amazing method in reducing repetative horrible traumatic image. 5) Many kinds of drug using in adult are considered with caution.

• 한국벤처창업학회:학술대회논문집
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• 2016.04a
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• pp.239-241
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• 2016

본 연구는 마음챙김(Mindfulness)의 심리치료적 과정을 기술해 보고 현대인의 정신적 질병인 우울증에 대한 마음챙김의 치료효과를 검증하는데 있다. 마음챙김은 최근 미국을 중심으로 심리학과 정신의학 분야에서 크게 주목을 받고 있는 심리치료 프로그램이다. 마음챙김은 일상생활에서 well-being을 추구하는 정신건강에 효과가 있으며, 정신적 스트레스 감소와 임상치료에서 우울, 불안, 강박, 중독, PTSD, ADHD 등 각종 정신병리의 증상완화에도 치료에 효과가 있다고 밝혀졌다. 본 연구는 신경정신과에서 의뢰받은 3명의 내담자들을 대상으로 마음챙김 심리치료를 실시하고 그 결과를 분석하여 우울증에 대한 치료효과를 알아보았다. 내담자의 특성은 장기간 우울증을 겪고 있으며 약물을 복용하고 있는 50대 여성을 대상으로 하였고, 그 결과 마음챙김은 우울증으로 인한 우울감과 불안감, 반추적 성향, 정서조절 곤란 정도에서 감소되는 효과가 있었으며, 정신건강의 긍정적인 지표인 마음챙김 기술 척도는 증가하는 것으로 나타났다. 이러한 연구 결과는 마음챙김이 인지행동치료 뿐만 아니라 약물치료를 대체하는 정신적 치료법으로도 효과가 있다는 시사점이 있다.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.1
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• pp.32-39
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• 2012

Objective : Psychiatry in North Korea is believed to seem very different from psychiatry in South Korea. However, there is nearly no information regarding psychiatry in North Korea until now. Our study aimed to get information about North Korean psychiatry. Methods : Three North Korean defectors in South Korea, whose clinical experience as medical doctors in North Korea was over 10 years, were recruited. They underwent the semi-structured interview, content of which included the clinical experience with psychiatric patients, the details of psychiatry, the treatment of psychiatric patients, the stigma of mental illness, and the suicide, in North Korea. Results : In North Korea, psychiatric department was called as 49th(pronounced as Sahsip-gu-ho in Korean). Only patients with vivid psychotic symptoms came to psychiatric department. Non-psychotic depression or anxiety disorders usually were not dealt in psychiatry. The etiology of mental illness seemed to be confined to biological factors including genetic predisposition. Psychosocial or psychodynamic factors as etiology of mental illness appeared to be ignored. Psychiatry was apparently separated from political or ideological issues. The mainstay of psychiatric treatment is the inpatient admission and out-of-date therapy such as insulin coma therapy. Stigma over mental illness was common in North Korea. Suicide is considered as a betrayal to his/her nation, and has been reported to be very rare. Conclusion : The situation of psychiatry in North Korea is largely different from that of South Korea. Although some aspects of North Korean psychiatry are similar to psychiatry in former socialist countries, North Korean psychiatry is considered to have also its unique characteristics.