• 동의신경정신과학회지
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• 제24권spc1호
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• pp.23-36
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• 2013

Objectives : The purpose of this guideline is to show the evidence-based guidelines of diagnosis and evaluation of Hwabyung by the synthesis and organization of existing research contents. Methods : We investigated the existing research on the concept of Hwabyung. Further, we investigated the diagnostic tools, self-diagnostic method, symptoms assessment tools, oriental medical diagnostic methods, treatment evaluation tools and other testing methods of Hwabyung. Results : There was a Hwabyung diagnostic interview schedule (HIBDS) in the standardized measure for the diagnosis of Hwabyung. In the symptoms assessment tools of Hwabyung, there was a self-report measurement tool of Hwabyung and measurement tool of Hwabyung to be evaluated by the interviewer. In the oriental medical diagnostic method, there was an instrument of pattern identification for Hwabyung. In the treatment assessment tool, there was an instrument of oriental medical evaluation for Hwabyung. In addition, MMPI, SCL-90R, Zung's self-rating anxiety scale (SAS), Zung's self-rating depression scale (SDS), State-Trait Anger Expression Inventory (STAXI) and etc. can be used for the diagnosis and assessment of Hwabyung. Conclusions : We expect 'Clinical Guidelines for the Treatment of Hwabyung' to be useful for the diagnosis and assessment of Hwabyung.

• 대한한방체열의학회지
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• 제1권1호
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• pp.13-19
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• 2002

Objectives : This study was performed to apply thermography as an method in diagnosis of hwabyung patients. We studied 11 Hwabyung patients who visited to chronic diseases center and circulatory oriental internal medicine of Kangnam oriental medicine hospital and 11 patients control group. Methods : Diagnosis of Hwabyung was based on the dignostic criteria of Hwabyung. The temperature was measured on Chonjung(CV17) Shimsu(B15), Kansu(B18), Kyonjong(G21) in each group. The ${\Delta}T$ was measured between Chonjung(CV17) and Chungjong(CV16), left and right Chungjong(CV16), Shimsu(B15), Kansu(B18), Kyonjong(G21) in each group. We compared the ${\Delta}T$ and DITI types between patients and control group. Results : The ${\Delta}T$ between left and right Chungjong(CV16), Shimsu(B15), Kansu(B18), Kyonjong(G21) were not statistically significant. But the ${\Delta}T$ between Chonjung(CV17) and Chungjong(CV16) was statistically significant(P<0.05) in each group. In control group, DITI type was straight 36%, diamond 27%, multiple small spot 18%, others 18%. In Hwabyung patients group, DITI type was inverse triangle 64%, multiple small spot 9.1%, round 9.1%. Conclusions : The ${\Delta}T$ between Chonjung(CV17) and Chungjong(CV16) and DITI type is considered useful diagnostic methods on Hwabyung patients.

• 동의신경정신과학회지
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• 제16권2호
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• pp.149-158
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• 2005

Objective : The aim of this study is to investigate the traits of psychiatric state on Hwabyung patients by using Symptom Check List-90-Rivision(SCL-90-R) Method : We studied 96 patients who visited Daegu Hanny University Oriental Medical Hospital from November 2003 to October 2004. Hwabyung Diagnostic Interview Schedule was conducted for diagnosis. And Symptom Check List-90-Rivision was carried out each group. Results & Conclusions : Hwabyung group was 22 persons among 96 patients 1. Hwabyung group has higher scores in all demensions of SCL-90-R than control group.(p<0.0l) 2. In female, Hwabyung group has higher scores in somatization, obsessive-compulsive, depression, hostility and psychoticism of SCL-90-R than control group. In male, Hwabyung group has higher scores in somatization, obsessive-compulsive, interpersonal-sensitivity, depression, anxiety, hostility and phobic anxiety of SCL-90-R than control group. 3. In 20s&30s, Hwabyung group has higher scores in all demensions of SCL-90-R except psychoticism than control group. In over 40, Hwabyung group has higher scores in somatization, depression, anxiety, hostility and psychoticism of SCL-90-R than control group. 4. In Hwabyung group, male group has higher scores in hostility of SCL-90-R than female, and 20s&30s group has higher scores in interpersonal-sensitivity, anxiety and paranoid ideation of SCL-90-R than over 40 group.

• 여성건강간호학회지
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• 제10권4호
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• pp.283-290
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• 2004

Purpose: This study elicited Korean women's perceptions of the life situations that contribute to Hwabyung, a culture.bound psychiatric illness in Korea, and delineated a typology of the perceived causative factors for this illness. Method: A purposive sample of 21 Korean women was recruited from a church, a senior center in Seoul and a clinic that provides traditional Korean and westernized medical services to patients in the Gyeonggi area. Inclusion criteria were: 1) the diagnosis of Hwabyung by a traditional doctor or "stress reaction and depression" by a westernized doctor; and 2) a score greater than 40 on the Hwabyung Self.Report Instrument. Surveys using the HSRI and individual interviews using Qmethodology were used. Result: The average age of the participants was 53.7 years(range 35-84). The mean score on the HSRI was 46.2(range = 42-52). Data analysis showed that participants perceived three life situations to cause Hwabyung: vulnerable situation, lowered self.esteem, and negative life events. Conclusions: Korean women, suffering from Hwabyung, perceived at least three different causal patterns for this illness. Nursing care plans should be tailored to meet these differences.

• 동의신경정신과학회지
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• 제15권2호
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• pp.45-51
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• 2004

Hwabyung is a Korean culture bound syndrome and translated as anger syndrome at DSM-IV. And it is caused by the suppression of anger and has characteristics of chest discomfort, burning up as physical symptoms, and mortification, chagrin as psychological symptoms. It is very common in the field of psychiatry in Korea with Major Depressive Disorder (MDD). * Objective : 95 patients with MDD or Hwabyung, who visited the department of psychiatry in Korea University Medical Center or oriental medical hospital of Kyunghee Medical Center from May 2003 to August 2003, were selected for the study to compare between Major Depressive Disorder and Hwabyung. * Methods : The Structured Clinical Interview Schedule for DSM-IV (SCID) and Hwa-Byung Diagnostic Interview Schedule (HBDIS) were conducted for diagnosis. And Symptom Check List-90-Revised (SCL-90-R) was carried out for comparison between MDD and Hwabyung. * Result : Among the 95 patients, MDD group was 23 persons, Hwabyung group was 36 persons, and MDD plus Hwabyung group was 36 persons and it occupied 37.9%. MDD plus Hwabyung group had higher scores than any other groups in the whole dimensions of SCL-90-R. Hwabyung group had higher scores than MDD group in somatization, anxiety, hostility, Global Severity Index(GSI) and positive symptom total (p<.05) of SCL-90-R, but two groups had no difference in obsessive-compulsive, interpersonal-sensitivity, depression, phobic anxiety, paranoid ideation, psychoticism, positive symptom distress index of SCL-90-R. * Conclusion : These result showed that Hwabyung is similar to MDD at the point of depression and psychoticism but more severe at somatization, anxiety and anger than MDD.

• 동의신경정신과학회지
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• 제28권4호
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• pp.349-358
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• 2017

Objectives: To analyze whether a concept similar to Korean 'Hwabyung' exists in China. We investigated the status of clinical studies conducted in China for relevant diseases and trends of the traditional Chinese medicinal (TCM) treatment adopted in clinical studies. Methods: To explore the concept of a condition similar to Korean Hwabyung in China, we searched for the existence of concept and pattern that were parallel or similar to those of Hwabyung in TCM text-books and diagnostic guidelines. We searched and analyzed clinical studies of TCM treatment for depression syndrome similar to Hwabyung from CNKI using terms 'depression' and 'qi stagnation transforming into fire'. Using extracted data, characteristics of clinical research, herbal medicine, and acupuncture treatment used in the clinical research and their effects were systematically reviewed. Results: Symptoms of 'qi stagnation transforming into fire' were most similar to those of Hwabyung. Nine articles were selected from a total 258 articles. Most of them used DSM-IV or CCMD-3 for depression diagnosis. They applied 'diagnostic and efficacy guidelines for TCM diseases and syndromes' for pattern diagnosis of 'qi stagnation transforming into fire'. Danzhixiaoyao-san and Jiaweixiaoyao-san were found to be effective when they were used alone or in combination with antidepressants. Acupuncture treatment also showed remarkable effect on LR3, HT7, LI4, PC6, GV20 when it was used alone or in combination with antidepressants. However, careful interpretation is required because a small number of studies are included.Conclusions: 'Qi stagnation transforming into fire' seemed to have symptoms similar to Hwabyung. However, further research is needed to determine its diseases and pattern types compared to Hwabyung. According to included studies of 'depression with Qi stagnation transforming into fire', herbal medicine and acupuncture treatment tended to be effective in relieving depressive symptoms. However, more discussion is required for future application of herbal medicine and acupuncture for treating Hwabyung.

• 동의신경정신과학회지
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• 제18권3호
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• pp.1-14
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• 2007

The objective of tills study is to identify the difference of somatic characteristics between Hwa-Byung and Major Depression by comparing the pattern identification of Hwa-Byung group and Hwa-Byung with Major Depression group(double diagnosis) Method: According to Hwa-Byung Diagnostic Interview Schedule(HBDIS) and SCID, 17 patients as diagnosed Hwa-Byung and 20 patients as diagnosed Hwa-Byung with Major Depression group(double diagnosis) were recruited. and by depression scale like Hamilton Rating Scale for Depression(HRDS) & Montgomery-Asberg Depression Rating Scale(MADRS), we excluded patients complaining moderate & severe depression among Hwa-Byung group and excluded patients showing mild depression among Hwa-Byung with Major Depression group. After this evaluation, we analysed and compared the pattern identification of both groups by OMS-prime. Result: 1. There were no significant differences of demographic data between both groups. 2. In the result of 'analysis on pattern identification' for all participant used by OMS-prime, most frequent pattern was deficiency of Yin and Yang of the heart(49%). 3. In the result of 'analysis on most correlated pattern identification' used by OMS-prime, for Hwa-Byung group was deficiency of Yin and Yang of the heart(45%) and the next were disharmony of the liver and spleen (20%), generation of phlegm due to stagnation of Gallbladder(15%) deficiency of Qi and Yin of the heart(l0%), And for Hwa-Byung with Major Depression group(double diagnosis) was deficiency of Yin and Yang of the heart(53%), the next were generation of phlegm due to stagnation of Gallbladder(18%), and deficiency of Qi and blood of the heart(l2%), 4. In the result of 'analysis on significant pattern identification' used by OMS-prime, for Hwa-Byung group was deficiency of Yin and Yang of the heart(20%) and the next were disharmony of the liver and spleen(15%), generation of phiegm due to stagnation of Gallbladder(15%), deficiency of Qi and Yin of the heart(14%), And for Hwa-Byung plus Major Depression group(double diagnosis) was deficiency of Yin and Yang of the heart(18%), the next were deficiency of Qi and Yin of the heart(18%), deficiency of Qi and blood of the heart(l0%), generation of phiegm due to stagnation of Gallbladder(18%), Conclusion: Hwabyung is syndrome that have many different symptoms, but there is no difference between Hwa-Byung group and Hwa-Byung with Major Depression group(double diagnosis) on the side of symptoms. Therefore, Hwabyung could be a new model for research on depression in Korean.

• 대한한의학회지
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• 제19권2호
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• pp.5-16
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• 1998

Hwabyung is a common emotional disorder which has symptoms expressed like firt's explosion in middle-aged after long period of emotional suppression among Koreans. It is similar in its characteristics such as neurosis, anxiety, panic attacks in Western Medicine, though the treatment method was not effective. So we have done a clinical research on Oriental Medical Method, especially on Acupuncture Therapy, and obtained following results. 1. Patients with Hwabyung complained of pressure pain around the Chunjung(?中, CV-17) point distinctively. About 70% of those were located on the CV-17 point, 25% were 1cm upper than the CV-17 point and 5% of those were 1cm lower point than the CV-17 point. 2. Degrees of pressure pain were divided into 5 grades from ade 1(feeling pain with slight pressure) to grade 5(feeling no pain with severe pressure), respectively. 3. Patients with Hwabyung showed various symptoms compared to fire's explosion such as anger, chest discomfort, difficulty in breathing. tachycardia. and feeling of epigasfric mass etc., and the degrees were divided into 5 grades according to the severities from grade 1(can't keep their usual living) to grade 5(no complaints with heavy stresses), respectively. 4. For the treatment of Hwabyung in this study, we had given Acupuncture therapy on some points such as Chunjung:?中:CV-17, Jungwan:中脘:CV-12) and Chunchu:天樞:S-25, etc. for 15 minutes a time twice a week. And Bunshimkiumgmnihang(分心氣飮加味方) was administered 3 times a day. 5. About 40% of the patients took treatment for more than 2 months, 29% of those took 1 to 2 months and 31% of those took less than 1 month. In this study, we excluded those who stopped treatment within a month without any expected effects. 6. We evaluated the changes of severity of pain according to the following categories such as - for no change, + for 1 grade, ++ for 2 grades, +++ for 3 grades, and ++++ for 4 grades of improvements. Among the patients taken 1 to 2 months of treatment. 48% of the those showed +, 7% of those showed ++, 3% of those showed +++ and 41% of those showed no change. Among the patients taken less than 2 months of treatment, 20%of those showed +, 40% of those showed ++, 28% of those showed +++ and 13% of those showed no change. 7. We evaluate the changes of symptoms according to the following categories such as - for no change, + for 1 grade, ++ for 2 grades, +++ for 3 grades and +++ for 4 grades of improvements. Among the patients taken 1 to 2 months of treatment, 34% of those showed +, 14% of those showed ++ and 52% of those showed no change. Among the patients taken more than 2 months of treatment, 20% of those showed +, 43% of those showed 20% of those showed +++, 3% of those showed +++ and 15% of those showed no change. 8. When we compare the changes of pain and symptoms according to the periods of treatment, the changes in quantity of pain in 1 to 2 months group was $0.72{\pm}0.75$, in more than 2 months group was $1.83{\pm}0.98$, and the changes in quantity of symptoms in 1 to 2 months group was $0.62{\pm}0.73$, in more than 2 months group was $1.75{\pm}1.03$. According to the above results, we have concluded that more than 2 months of treatment is more beneficial than 1 to 2 months of treatment.

• 동의신경정신과학회지
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• 제17권3호
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• pp.87-96
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• 2006

Psychogenic neurological conditions account for 1% to 9% of admissions at neurological unit. They are considered manifestations of underlying psychiatry disorders such as somatoform disorders and factitious disorders or malingering. Diagnosis for psychogenic tremor is difficult because mimic tremor is occurred at the secondary of the organic disorders or coexist in a patient with tremors of organic origin. A patient in this case report was diagnosed as psychogenic tremor, and she also complained the severe anger. A patient did not improved with the chemical medication for a long time. The patient received relaxation training, herbal medication and acupuncture for 20 days and showed short-term alleviation on tremor and decreased anger problem and other somatic problems.

• 동의신경정신과학회지
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• 제15권1호
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• pp.175-185
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• 2004

Objective : For investigating correlation among diagnostic types, MMPI results and Sasang constitutions, in out-patients of Oriental Neuropsychiatry. Method: We got the following result by comparing the out-patients' MMPI and QSCCII from 2000/12/1 to 2001/12/30 at Sanbon Hospital of Oriental Medicine, Wonkwang University. Result and Conclusion: 1. A specific character of population for study's objects was that female (128, 68.4%) was twice bigger that the male(59, 31.6%). And their education levels were 52 of college graduate (27.8%), 40 of high school graduate (21.4%), and 14 of middle school graduate (14 %). A distribution of the occupation, there are 62 of labors (33.2%), 62 of white collars (33.2%), 30 of sales (16%), 16 of students (8.6%). Their marrige statuses were 144 of married (77%), 31 of single (16.6%), 4 of divorced (2.1%), and 1 of bereavement (0.5%). 2. In the physical constitutions there were 70 of Soeumin(37.4%), 56 of Soyangin(29.9%) 55 of Taeumin (29.4%), 6 of others (3.2%). A differentiation with their diagnosis, there were 55 of palpitations (29.4%), 45 of depression (24.1%), 18 of women's diseases (9.6%), 14 of insomnia (7.5%), 13 of headache (7%), 8 of pain (4.3%), 8 of hwabyung (4.3%), 7 of psychosis (3.7%), 4 of dizziness (2.1%), and 15 of others(8%). 3. A result of groupling MMPI, we could classify into 4 different groups. Group 1 is a profile of trasition in a neurosis. Group 2 is a proflie of a mental disease. Group 3 is a proflie of $'{\wedge}'$ type neurosis. And group 4 has normal profile. 4. Regarding each group with physical constitution and a distribution of diagnosis, Group 1 is found out 36.4 % of Soeumin, 34.10 % of palpitations. And group 2 showed 43.6% of Soyangin, 25.6% of depression. Group 3 showed 46.4% of Soyangin, 31.90% of palpitations. Group 4 showed the most in 34.3% of Soyangin, and 31.40% of palpitations 5. A result of the study using Chi-square test is that there is no correlation between the 4 different groups and the Sasang physical constitution.