• Title/Summary/Keyword: 정신신체장애

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Drug Treatment in Psychosomatic Disease (정신 신체의학에서 최신 치료 약물)

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.133-142
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    • 2001
  • For treating various conditions of the psychosomatic disease, not only psychotropic drugs but also drugs used in internal medicine or other than psychiatric fields would be applied. So psychiatrists who are interested in psychosomatic medicine should make expanded knowledges of those medicine. And modalities of drug treatment should be modified according to the characteristics of illness behavior and disease concept which the patient have. Some drugs used in complementary medicine could be applied to the psychosomatic illness. For example, herbs and/or aromas which have some effects without serious adverse reactions could be used carefully to the patient. And the mode of action and efficacies of them should be evaluated by doctors.

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Development of the Somatization Rating Scale (신체화 평가 척도의 개발)

  • Koh, Kyung-Bong;Park, Joong-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.78-91
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    • 2002
  • Objective : The purpose of this study was to develop the somatization rating scale (SRS), and then to use the scale in clinical pracitice. Methods: First, a preliminary survey was conducted for 109 healthy adults to obtain 40 response items. Second, a preliminary questionnaire was completed by 215 healthy subjects. Third, a comparison was made regarding somatization responses among 242 patients (71 with anxiety disorder. 73 with depressive disorder, 47 with somatoform disorder, and 51 with psychosomatic disorder) and 215 healthy subjects. Results : Factor analysis yielded 5 subscales : cardiorespiratory and nervous responses, somatic sensitivity, gastrointestinal responses, general somatic responses, genitourinary, eye and muscular responses. Reliability was computed by administering the SRS to 62 healthy subjects during a 2-week interval. Test-retest reliability for 5 subscales and the total score was significantly high, ranging between .86-.94. Internal consistency was computed, and Cronbach's ${\alpha}$ for 5 subscales ranged between .72-.92, and .95 for the total score. Convergent validity was computed by correlating the 5 subscales and the total score with the total score of the global assessment of recent stress (GARS) scale, the perceived stress questionnaire (PSQ), and the symptom checklist-90-revised (SCL-90-R). The correlations were all at significant levels. Discriminant validity was computed by comparing the total score and the 5 subscale scores of the patient and control groups. Significant differences were found for 5 subscales and the total score. Only the depressive disorder group was siginificantly higher than control group in all the subscale scores and total scores of SRS among 4 patient groups. In somatic sensitivity, only depressive disorder patients were significantly higher than the normal controls, whereas in general somatic subscale, depressive disorder and somatoform disorder groups were significantly higher than the normal controls. In total scores of the SRS, female subjects were significantly higher than males. Conclusion : These results indicate that the SRS is highly reliable and valid, and that it can be utilized as an effective measure for research in stress- and somatization-related fields. The depressive disorder and somatoform disorder groups showed more widespread somatization than the anxiety and psychosomatic disorder groups.

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Effects of Discrimination Experience and Social Support on Physical and Mental Health among the Disabled - Mediation Effect of Disability Identity and Multiple Group Comparison by Degree of Disability - (고령장애인의 차별경험과 사회적 지지가 신체적 건강 및 정신적 건강에 미치는 영향 - 장애정체감의 매개효과와 장애정도에 따른 다중집단 분석 -)

  • Roh, Seunghyun;Shin, YuRi;Kim, Cheong-Seok
    • 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.

Psychotherapeutic Experience on a Patient with Somatoform Pain Disorder (신체형 동통장애 환자의 정신치료 경험)

  • Kim, Hyun-Woo;Lee, Hyun-Je
    • Korean Journal of Psychosomatic Medicine
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    • v.2 no.1
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    • pp.107-112
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    • 1994
  • The authors tried to look into the process of the individual psychotherapeutic experience of a 18-year-old male diagnosed as somatoform pain disorder or chronic pain syndrome. The patient had showed strong resistance to acceptance of his psychological problems. Some issues such as indications of psychotherapy for chronic pain, changing the mode of the treatment some problems around changing the therapist secondary gain and parents' attitude were discussed considering their relatedness to the outcome. The psychotherapy had lasted about 2 years and the result was estimated as fair.

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Premenstrual Dysphoric Disorder : A Clinical Review (월경전 불쾌기분 장애에 대한 임상적 고찰)

  • Hwang, Gul
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.1
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    • pp.14-21
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    • 2007
  • Premenstural dysphoric disorder(PMDD) imposing 4-5% of women is possibly caused by an enhanced responsiveness to the changes of sex steroid hormones and the decrease of serotonin, melatonin and GABA. The common clinical features between PMDD and depression, seasonal affective disorder, panic disorder and anorexia nervosa suggest a relatedness between PMDD and each of them. The diagnostic criteria of DSM-IV-Tr for PMDD requires psychological symptoms, that commonly include irritability, anger, depression, mood swing, affect lability, tension, anxiety, fatigue and food craving. As of today, the best pharmacological treatment for PMDD is the selective serotonin reuptake inhibiter, and leuprolide, danazol, estradiol, spironolactone and bromocriptine are possible alternatives. Nonpharmacological treatments for patients with mild to moderate symptom severity are diet, exercise, light therapy, psychotherapy and keeping a diary.

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Dissociative Symptoms in Patients with Somatization Disorder (신체화 장애 환자의 해리 증상)

  • Kim, Seong-Hwan;Choe, Byeong-Moo;Kim, Yoon-Won;Hahn, Hong-Moo
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.116-123
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    • 1999
  • Objectives : The authors attempted to assess how much the mechanism of dissociation affects somatization disorder patients psychopathologically, and explore the relationship between sexual or physical abuse and somatic symptoms in somatization disorder patients. Methods : The authors administered the Dissociative Experiences Scales-Korean version(DESK) and Dissociative Disorders Interview Schedule to 25 patients with somatization disorder and 51 normal subjects. Results : There were no significant demographic differences between patient and control groups. The mean score of DES-K for patient group was 18.2, and 10.0 for the control group. The percentage of the individuals with high scores(20 and over) was 36.0 in the patient group and 7.8 in the control group, respectively. The percentage of the individuals with sexual and/or physical abuse was 16.0 in the patient group and zero in the control group. Our results showed that DES-K scores were not influenced by the factor of age or religion in either group, but the scores of the patients with somatization disorder were significantly higher than those in the normal subjects. Conclusion : There was an implication that the mechanism of dissociation affects issues of psychopathogenesis and psychopathology in Korean patients with somatization disorder, even though they have different sociocultural backgrounds in comparison to Western patients. The authors suggest it is useful to focus attention on childhood abuse and dissociation in the evaluation and dynamic psychotherapy of patients with somatization disorder.

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Response Characteristics of Perceived Stress Response Inventory in Patients with Upper Gastrointestinal Disorder (상부 위장관 장애 환자에서의 스트레스반응 지각척도의 반응특성)

  • Suh, Yong-Woo;Cho, In-Hee;Shin, Kwang-Chel;Chung, Yong-Kyoon
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.2
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    • pp.172-180
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    • 2000
  • Objectives : We investigated the characteristics of perceived stress response and relationship between some variables of gastrointestinal symptoms(esp., dyspepsia) and subscales of perceived stress response inventory(PSRI) in patients with upper gastointestinal disorder when they perceived stress. Methods : 84 patients with upper gastrointestinal disorder(gastritis, gastric ulcer, duodenal ulcer etc.) and 94 normal controls completed the PSRI developed by Korean psychiatrists. The patient group performed the questionnaire including some variables of gastrointestinal symptoms. Results : Internal consistency was statistically significant in all subscales of PSRI. The patient group was significantly higher at total score of PSRI, general somatic symptom subscale score, specific somatic symptom score than control group. As the result of stepwise regression analysis for relationship between some variables of gastrointestinal symptoms ans subscales of PSRI, specific somatic symptom subsclae closely related with illness duration, past illness history and severity of symptom, and the lowered cognitive function & general negative thinking subscale related with the existence of emotional distress. Conclusion : Patients with upper gastrointestinal disorder showed stronger perceived stress response than control group and they experiences somatic symptoms related to autonomic nervous system and/or gastrointestinal symtoms rather than emotional, cognitive, behavioral symtoms when they perceived stress. They also responded to stress as they expeirenced specific somatic symtom when they had long illness duration, past illness history, and high severity of symptom and the existence of emotional distress could develop lowered congnitive function and general negative thinking.

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건강칼럼 - 특이한 현대병 '공황장애'

  • Yu, Byeong-Hui
    • The Science & Technology
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    • v.33 no.3 s.370
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    • pp.84-85
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    • 2000
  • 정신계통의 특이한 현대병 '공황장애'는 갑자기 가슴이 조여들고 숨이 막히면서 손발이 저리고 어지러워져 곧 쓰러질 것 같은 느낌이 20~30분간 계속되며 이 증상이 주기적으로 나타나는 정신계통의 질환이다. 정신과 질환임에도 불구하고 여러 가지 급성 신체증상들을 동반해 심장질환 등 내과 계통의 질환으로 오진하기 쉬운 질병이다. 대개의 경우 약물치료후 2~3개월이면 호전되고 1년반 정도 장기 약물복용이 필요하다.

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The Therapeutic Implications of Alexithymia in Patients with Eating Disorders (식이장애 환자에서 나타나는 감정표현불능증의 치료적 함의)

  • Kim, Seung-Jun
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.54-60
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    • 2016
  • Alexithymia is characterized by difficulties identifying and describing feelings, impoverished fantasy life, and concrete and poorly introspective thinking. Alexithymic patients have been reported to show a stable deficit with regard to processing and regulating emotions. Eating disorders are characterized by a persistent disturbance of eating or eating-related behavior that significantly impairs physical health or psychosocial functioning. Like alexithymic patients, patients with eating disorders show the impaired capacity to process and regulate emotions. There is a robust body of literature showing patients with eating disorders are more alexithymic than healthy controls. Specifically, patients with eating disorders experience difficulties identifying and describing emotions. Childhood maltreatment can increase the risk for depression and alexithymia, which can in turn lead to disordered eating symptoms. Also, higher levels of alexithymia are correlated with a less favorable clinical outcome in patients with eating disorder. Therefore, treatments to help processing and regulating emotions of eating disorder patients with pronounced alexithymic traits may seem to lead to a higher possibility of recovery.