• 정신신체의학
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• 제28권1호
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• pp.89-97
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• 2020

Objectives : We investigated heart rate variability (HRV) patterns in patients with somatic symptom disorder (SSD) and the relationships of these patterns with alexithymia. Methods : In total, 42 patients with SSD and 33 healthy controls were enrolled in this study. Demographic, psychological, and HRV data were assessed at baseline, and 24 patients with SSD were reassessed after 6 months of treatment. The psychological data included somatic symptoms and levels of depression, anxiety, and alexithymia as indicated by the somatic symptom subscale of the Symptom Checklist 90-Revision (SCL-12), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and the Toronto Alexithymia Scale 20 (TAS-20), respectively. Results : Patients with SSD had a lower standard deviation of normal-to-normal R-R intervals (SDNN) and lower proportions of adjacent R-R intervals greater than 50 milliseconds (pNN50) compared with controls. These HRV parameters were negatively correlated with alexithymia severity. After treatment, patients exhibited significantly decreased levels of somatic symptoms and reduced anxiety and depression, but there were no significant differences in the HRV parameters. In patients with alexithymia, a high baseline SDNN and pNN50 were associated with a decrease in somatic symptoms. Conclusions : Patients with SSD have different HRV patterns, and several HRV parameters are associated with alexithymia severity. These findings suggest that ANS regulation is involved in the pathophysiology of SSD, mediated by alexithymia. Furthermore, these results suggest that certain HRV parameters may be associated with clinical outcomes of SSD.

• 대한불안의학회지
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• 제8권2호
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• pp.133-140
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• 2012

Objective : The aim of this study was to investigate how trauma and personality system was related by comparing TCI profiles of the trauma versus non-trauma groups and PTSD symptom positive (PTSD symptom [+] group) and PTSD symptom negative groups (PTSD symptom [-] group). Methods : We compared the difference of Temperament and Character Inventory (TCI) profiles between the trauma (n=61) and the non-trauma (n=61) groups, and between the PTSD symptom [+] group (n=40) and PTSD symptom [-] group (n=21). Results : Comparison of the TCI's seven higher dimensions between the PTSD symptom [+] and [-] groups showed significant differences only in C (Cooperativeness). And in the analysis of TCI's lower dimensions the significant differences were observed in the HA1 (Worry and pessimism), HA2 (Tension regarding uncertainty), and C4 (Compassion) subscales. However, significant differences in the higher dimensions appeared more clearly between the non-traumatized group and the traumatized group. Compared to the non-traumatized group, the traumatized group scored significantly higher in HA (Harm avoidance) and RD (Reward dependence), while lower in SD (Self-directedness). Conclusion : Overall, present results suggest that traumatic experiences may affect personality systems regardless of the development and of PTSD symptoms.

• 대한불안의학회지
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• 제2권1호
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• pp.22-27
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• 2006

Objectives : There is a paucity of data on the long-term course of obsessive-compulsive disorder (OCD) and chronological relationship between OC symptoms and their related symptoms such as anxiety and depression. The purpose of this study was to investigate the longitudinal course of OC symptoms as well as anxiety and depression which are believed to be associated with OC symptoms. Methods : Data for 155 patients with OCD who completed general evaluation for OCD were used. Forty four were excluded to minimize the effect of the different age of onset on the clinical course. One hundred eleven patients finally participated in the analysis. Cross-sectional correlations between each symptom as well as between such symptoms and the duration of illness were analyzed. Further correlation analysis was done within two groups that were divided by 7 years of the duration of illness. Results : There were significant correlations not only between the severity of OC symptoms and anxiety but also between anxiety and depressive symptom, regardless of the duration of illness. These correlations between such symptoms were also found within patients with the duration of illness below 7 years, whereas these were not within the group with the duration of illness above 8 years. Conclusion : Patients with OCD in this study shows the moderate to severe level of OC symptoms irrespective of the duration of illness. Our finding also suggests that the OC symptoms, especially obsessions are closely related to anxiety and depressive symptoms and these relationships might be pronounced in relatively early phase of the OCD after onset.

• 대한불안의학회지
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• 제3권1호
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• pp.8-14
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• 2007

Although treatments of anxiety symptom have been available for decades, the biological basis for anxiety disorders in humans is just beginning to emerge. Recently, there is a growing body of literature suggesting that group II metabotrpic glutamate (mGlu) receptors and group I mGlu receptors are important in the physiological and behavioral sequelae associated with stressful stimuli. Moreover, compounds selective for mGlu receptors, particularly mGlu2/3 and/or mGlu5, have proven as effective as classical anxiolytics in various animal models of anxiety without producing many of the unwanted side effects that are typical of current therapies. This article will focus on the emerging preclinical and clinical data that implicate modulation of the mGlu receptors as a potential anxiolytic strategy.

• 정신신체의학
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• 제31권2호
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• pp.118-124
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• 2023

연구목적 우울장애와 불안장애는 흔히 공존하며 임상전단계에서도 흔히 공존한다. 본 연구는 일반인구 집단에서 우울장애와 불안장애가 공존시의 복합 네트워크를 구성하여 중심 증상과 중개 증상을 밝히고자 했다. 방 법 2022년 아산시 청년 정신건강실태조사 데이터를 활용하여 진행하였다. 일반 인구집단 810명의 성인을 대상으로 PHQ-9과 GAD-7을 이용하여 각각 우울과 불안증상의 정도를 측정하였고, 각 증상에 대해 Isingfit model을 기반으로 네트워크 구조를 도출하였다. 주요 증상 및 중개 증상을 찾기 위해 네트워크 지표 중 강도 중심성과 bridge expected influence를 활용하였다. 결 과 우울한 기분, 안절부절 못함과 초조함이 네트워크에서 가장 높은 강도중심성을 보였으며, 불안증상과 우울증상 간의 높은 중개 역할을 하는 증상은 안절부절 못함과 과민성이었다. 결 론 일반 인구집단에서 우울증상과 불안증상이 공존할 때의 중심증 상과 중개증상을 규명하였고 치료적 중재의 목표가 되면 두 질환의 동반이환율을 감소시키는데 기여할 수 있을 것으로 기대된다.

• 대한불안의학회지
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• 제1권1호
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• pp.14-17
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• 2005

By the influence of the descriptive approach of DSM-III, the anxiety became the same thing as the anxiety disorder to the clinicians. This unfortunate result sacrificed psychodynamic model of symptom formations and simplified the anxiety as one of the disease entity not as the overdetermined symptoms. These phenomenon awakened the psychoanalytic interest which was in sleep. Freud was the first major articulator of the basic significance of anxiety in human behavior. He attributed the particular quality of the anxiety experience to the trauma of birth, and subsequently to the fear of castration. Such classification of the anxiety according to the psychosexual development is helpful for the clinicians in understanding the origin of anxiety which the patient shows during the psychotherapy. The other analytical view of interpersonal psychoanalysis came from Sullivan. A large part of his therapy is taken up with recognizing and correcting parataxic distortions that interfere with realistic self-appraisal of events and of oneself in relation to others. Perhaps no explanation is the 'most basic' explanation for human anxiety. Anxiety is a multifaceted entity consisting of aspects of realm of discourse. Existential anxiety is inescapable in Western culture but it can be transcended by the cultivation of mind in Eastern culture. The analysts need to stay attuned to their own propensities for anxiety and must permit their own experiences with anxiety to be the grist for the psychotherapeutic mill.

• 대한불안의학회지
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• 제6권2호
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• pp.93-101
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• 2010

Research on obsessive-compulsive disorder (OCD) has advanced substantially since the DSM-IV was published in 1994. It is time to reexamine the nosology of this disorder, reviewing conflicting views regarding the classification as well as subtypes and specifiers of OCD. Although there is ongoing debate, OCD experts have suggested that OCD be retained in the section related to anxiety disorders and also that along with OCD, this section include obsessive-compulsive spectrum disorders (OCSD), a group of disorders closely related to OCD. A combined 'anxiety and obsessive-compulsive spectrum chapter' has also been proposed to include OCSDs. A growing body of scientific data has provided empirical support for the inclusion of a 'tic-related' subtype of OCD in the DSM-V. However, it remains controversial as to whether to introduce OCD symptom dimensions as specifiers as well as items in the diagnostic criteria. With regard to compulsive hoarding, there has been sufficient evidence to recommend that it be classified in the DSM-V as a separate disorder. Much work remains in order to ensure that the DSM-V is as evidence based as possible. It is necessary to strive toward integrating the biological and psychological data related to OCD and OCSD based on their endophenotypic features.

• 대한간호학회지
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• 제42권2호
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• pp.269-279
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• 2012

Purpose: To develop a expressive writing program for women with breast cancer and to identify its effects on stress physical symptom, cancer symptom, anxiety, depression, and QOL. Methods: A non-equivalent control pre-post design was used. Participants were recruited from self-help groups in six hospitals and were assigned to the experimental group (29) or control group (29). Data were collected before, after, and at four weeks after the intervention program. Changes in the variables were evaluated to test effects of the developed program, using $X^2$-test, Fisher's exact test, repeated measures ANOVA, and paired t-test. Results: The expressive writing program was developed for women with breast cancer based on Pennebaker's expressive writing. Significant differences were found between the two groups for stress related to physical symptoms ($p$<.00) and quality of life ($p$=.024). No significant differences were found in cancer symptoms, anxiety, or depression between the two groups. Conclusion: The results indicate that the expressive writing program designed to express cancer-related deep thoughts and emotions helps in decreasing physical symptoms and improving QOL. Further studies are needed to identify the effect on emotions such as anxiety and depression for women with breast cancer with above average levels of anxiety and depression.

• 한방재활의학과학회지
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• 제31권3호
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• pp.149-157
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• 2021

This study aims to report the effectiveness of complex Korean medicine (KM) therapy on a somatic symptom disorder (SSD) patient. A 58-year-old woman had severe somatic pain for more than six months and showed accompanying anxiety and depression. KM doctors administered complex KM therapy to control her pain and psychological conditions. Her pain was rated using the numerical rating scale and her anxiety and depression symptoms with beck anxiety inventory and beck depression inventory. The somatic symptoms as well as the anxiety and depression significantly improved after KM treatment. This study suggests that complex KM therapy for SSD may be effective to manage both somatic and psychological symptoms.

• 보건교육건강증진학회지
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• 제5권2호
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• pp.110-141
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• 1988

This study was conducted to find out the mental health state of high school students. First-year students and third-year students af liberal high schools is Seoul were subject to this study. Questionnaire of Symptom Checklist-90 and various factors was adopted for the survey. A total of 916 questionnaires was sellected for the analysis, and the results are obtained as follows; 1) The characteristics in responses to mental health scale showed that obsessive-compulsive scale score was the highest, followed by interpersonal-sensitivity, depression, hostility, and anxiety. The subject group of the students showed higher scores in nine symptom dimensions except somatization than other normal group. 2) Girl-students showed higher scores than boy-students in somatization, depression, and anxiety, whereas the opposite was true in hostility. 3) Third-year students got high scores, in somatization, anxiety and Depression. 4) Parental marriage state of the repondents showed significant differences in nine symptom dimensions of mental health. Scores of the students with parents was the lowest, followed by those of students with only mother, only father and the rest(no parents, divorced, sepaerated, step-parent) in increasing order. 5) Smoking students showed high score in obsessive-compulsive, depression, hostility, paranoid ideation, and psychoticism. Especially in hostility, they got much higher score. 6) Students with poor record at school got higher scores in every symptom dimension than those with good record at school, especially in obsessive-compulsive and depression scale. 7) Parents' attitude toward student showed significant effect on every scale. Students under over-expectation or indifference from parents were in bad mental health state. 8) Students who have advisor proved to be in better mental health state than those who never consult their personal problems with others. 9) He who has family history got higher scores in some scales. 10) Respondents who looked upon what they have learned in high school as being rather an obstacle to sound social life got high scores in all the symptom dimensions and next came those of the students who answered that there were a lot of unnecessary things in their learning. 11) Those for whom it would not quite necessary to enter college if there were little formal schooling discrimination in society got high scores in obsessive-compulsive, interpersonal sensitivity, depression, hostility, and in psychoticism, especially higher in obsessive-compulsive scale. 12) Mental health state of the students who are influenced by the social surroundings, mass media, and the home environments showed high score in 8 symptom dimensions. 13) Abnormal response frequency of this sample is as follows; 24.0％ of boys, 23.8％ of girls, 22.5％ of the first-year students, and 26.9％ of the third-year students. There were significant difference among the grades. 14) The factors of distinctive correlation between the dimensions of SCL-90 and 16 factors were the father's negative attitude and depression, negative responses on teaching contents and anxiety, and smoking and hostility. In conclusion, mental health state of liberal highschool students on the whole showed worse than other normal groups. It had close terms with relation with their parents, schoolwork, smoking, teaching contents, the social surrounding, mass media, and the home environments. Thus I believe there need not only mental health education of students, training of teachers, counceling of parents, but also changes in teaching contents, and the improvement of educational system and the social surroundings under the national support.