• Journal of Oriental Neuropsychiatry
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• v.23 no.4
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• pp.183-198
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• 2012

Objectives : This case series aims to report the efficacy of using oriental medical treatment with Melonis Calyx Vomiting Therapy for Hwa-Byung. Methods : Patients were diagnosed with Hwa-Byung through Hwa-Byung Diagnostic interview schedule (HBDIS). They were treated with Oriental medical treatment (Acupncture, Herb-medication) and Melonis Calyx Vomiting Therapy (MCVT). MCVT is a traditional treatment, which induces vomiting by eating Melonis Calyx powder with water. We used VAS score and Scott scale for the symptoms of patients and IOMEHB (instrument of oriental medical evaluation for Hwa-Byung), BDI, STAI for the psychological conditions of the patients. Results : After treatment, the chief complaint and other symptoms of Hwa-Byung have improved. The scores of IOMEHB, BDI, and STAI have decreased. Conclusions : This result suggests that using MCVT with Oriental medical treatment have a positive efficacy for Hwa-Byung.

• Korean Journal of Psychosomatic Medicine
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• v.16 no.2
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• pp.120-124
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• 2008

Objectives : The current study aimed at assessing clinical symptoms and personality characteristics on MMPI of patients in Hwa-Byung clinic. Methods : Thirty-one female patients($45.4{\pm}8.4$ years old) who visited to the Hwa-Byung Clinic in Ewha womans Dongdaemoon hospital were recruited. Semistructured interviews and laboratory tests for symptoms were performed for the patients group. Patients group and control group($42.9{\pm}8.0$ years old) completed MMPI. Results : All patients had symptoms of chest tightness or chest pain. 19(61.3%) out of 31 patients had gastrointestinal complaints. There were respiratory symptoms in 13(41.9%) patients. 12 patients(38.7%) suffered from difficulties in their sleep. 12 patients(38.7%) had psychiatric symptoms including anxiety or depressed mood. 8 patients(27.6%) were diagnosed as gastrointestinal diseases by the laboratory test. After controlling age and education, scores of Hs, D, Hy, Pt on MMPI in patients group were significantly higher than control group (p=0.001, p=0.049, p=0.000, and p=0.029, ANCOVA, respectively). Conclusion : In the current study, patients who have visited Hwa-Byung clinic showed various somatic symptoms including chest tightness, gastrointestinal symptoms, complaints in respiratory system and psychiatric symptoms. Based on laboratory tests, considerable proportion of patients was diagnosed as physical illnesses. Additionally, patients in Hwa-Byung clinic have a tendency to be more hypochondriatic, depressed, hysteric and anxious.

• Journal of Oriental Neuropsychiatry
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• v.23 no.4
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• pp.153-158
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• 2012

Objectives : The objective of the study is to examine what effects the Mindfulness-based stress reduction program can have on Hwa-byung patients. Methods : Ten Hwa-byung patients have participated in this 8-week Mindfulness-based stress reduction program for Hwa-byung. In addition, participants were interviewed regarding the experiences from the changes during meditation or everyday life. Data were collected though a consumer panel and individual interviews. Responses were coded using Consensual Qualitative Research (CQR) methodology. Results : The experiences were categorized into 7 domains and divided to 23 categories. Results showed the psychotherapeutic effects of Mindfulness-based stress reduction program, specifically, positive cognitive changes, emotional stability, and changes in attitude. Also, all participants reported improvement of anger management skill and feeling of tranquility. This means that the Mindfulness-based stress reduction program can relieve the symptoms of Hwa-byung. Conclusions : Mindfulness-based stress reduction program makes changes about emotion, physical symptoms, cognition and personal relationship. This program can be applied to psychotherapy for Hwa-byung.

• Journal of Oriental Neuropsychiatry
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• v.33 no.4
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• pp.463-471
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• 2022

Objectives: The purpose of this study is to introduce the progress of treatment and improve clinical use after the application of Mindfulness & Loving Beingness psychotherapy, for a patient with Hwa-Byung. Methods: The patient was diagnosed with Hwa-Byung which arose as a result of their spouse's affair. The patient mainly reported chest pains, breathing difficulties, fear, and anxiety as symptoms. To address these, we administered a combination of M&L psychotherapy and Korean therapy including Herbal medicine, acupuncture, and moxibustion. Beck's Depression Inventory(BDI), Beck's Anxiety Inventory(BAI), and Hwa-Byung scale were evaluated before and after the treatment, to assess the clinical effect. Results: Following treatment, the patient's overall clinical symptoms of chest pain, breathing discomfort, fear, and anxiety were significantly reduced. Additionally, their scores on the BDI, BAI, and Hwa-Byung scales decreased. Conclusions: M&L psychotherapy and Korean therapy can be effective in treating Hwa-Byung.

• Journal of Oriental Neuropsychiatry
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• v.31 no.3
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• pp.135-147
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• 2020

Objectives: Hwa-byung is a mental illness. It is also known as a Korean culture-related syndrome. In traditional Korean medicine, Sihogayonggolmoryeo-tang is used to treat Hwa-byung related neuropsychiatric symptoms. The purpose of this research was to examine the effect of Sihogayonggolmoryeo-tang on Hwa-byung. Methods: A multicenter, randomized, double-blinded, placebo-controlled study was performed for 160 patients with Hwa-byung. Patients were divided into a Sihogayonggolmoryeo-tang group and a placebo group. Treatment period was 8 weeks. Hamilton Rating Scale for Anxiety (HAM-A), Likert scale for major symptoms of Hwa-byung, Hwa-byung Scale (HBS), Korean Beck Depression Inventory (K-BDI), Korean State-Trait Anxiety Inventory (K-STAI), Korean State-Trait Anger Expression Inventory (K-STAXI), and Korean WHO Quality of Life Scale Abbreviated Version (WHOQOL-BREF) were used to evaluate the effect of Sihogayonggolmoryeo-tang on Hwa-byung. We also used an Instrument of Pattern Identification for Hwa-Byung to evaluate different responses for six patterns of patients. Results: Scores of all the measurements improved significantly for each group, showing no significant differences between the two groups. In the case of deficiency of both Qi and blood pattern, the Sihogayonggolmoryeo-tang group showed a significant decrease in the HAM-A score compared to the placebo group. Conclusions: The effect of Sihogayonggolmoryeo-tang on Hwa-byung did not exceed that of the placebo. Further studies involving more elaborate pattern identification are needed.

• Journal of Oriental Neuropsychiatry
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• v.22 no.1
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• pp.25-35
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• 2011

Objectives : This case series was conducted to report the efficacy of traditional Korean medicine treatments for Hwa-Byung. Methods : Patients were diagnosed with Hwa-byung through Hwa-Byung diagnostic interview schedule(HBDIS). instrument of pattern identification for Hwa-Byung was applied to develop an individualized traditional Korean medicine treatment plan. SCL-90-R, STAI, STAXI, BDI, and instrument of oriental medical evaluation for Hwa-Byung were measured. After 2 weeks of tradiational Korean medicine treatments and K-MBSR practice, STAI, STAXI, BDI, and instrument of oriental medical evaluation for Hwa-Byung were re-assessed to determine the progress of Hwa-Byung. Results : After treatments, chief complaints have improved. STAI, STAXI, BDI and instrument of oriental medical evaluation for Hwa-Byung score have decreased. Conclusions : According to the study, traditional Korean medicine treatments using instrument of pattern identification for Hwa-Byung have shown positive results in managing Hwa-Byung symptoms evaluated by instrument of oriental medical evaluation for Hwa-Byung.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.5
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• pp.1071-1077
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• 2008

Hwa-byung is a form of psychogenic illness among people in Korea and is listed as a culture-bound syndrome of Korea in the DSM-IV. Despite increased clinical researches for Hwa-byung in the oriental medicine of Korea, there has been no agreement of pattern identification for Hwa-byung. The purpose of this study is to develop a standard instrument of pattern identification for Hwa-byung which will be applied to clinical research. The items and structure of the instrument were based on review of published literature. The advisor committee on this study was organized by 15 neuropsychiatry professors of 11 oriental medical colleges nationwide. The experts attended 2 consultation meetings and discussed developing the instrument. and we also took professional advices by e-mail. The results were as follows; First, we divided the symptoms and signs of Hwa-byung into five pattern identification - stagnation of liver Qi, flare-up of the liver fire, disharmony between heart and kidney, deficiency of both Qi and blood, malfunction of gallbladder due to phlegm stagnation. Second, we got the mean weights to each symptom of five pattern identification which had been scored on a 5-point scale - ranging from 0 to 4 by the 15 experts. Third, we made out the Korean instrument of the pattern identification for Hwa-byung. It was composed of 34 questions and decided on question-and-answer form. Though there are some limits in this study, the instrument of pattern identification for Hwa-byung is meaningful and expected to be applied to the subsequent research. And also, we hope to improve the instrument and make up for this study through various research and discussion.

• Journal of Oriental Neuropsychiatry
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• v.21 no.3
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• pp.139-149
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• 2010

Objectives : This study was performed to report the effect of Autogen training and Korean traditional treatment for Hwa-Byung. Methods : In this case, a 41 years old female patient has been suffered by Hwa-Byung symptoms for 20 years. We treated the patient with Korean traditional treatments(acupuncture, herb-medication and aroma theraphy), Autogen training and Korean traditional psychotherapy. The effects of treatment were measured by Beck Depression Inventory(BDI), Zung Depression Rating Scale(SDS), State-Trait Anxiety Inventory(STAI-X-1), SCL-90-R. Results : After treatment, the chief complaints and accompanying symptoms were subsided and improved. And BDI, SDS, STAI-X-1 score were decreased. Conclusions : According to this study, the Korean traditional treatment such as acupuncture, herb-medication and Autogen training are effective for the cure of Hwa-Byung.

• Journal of Oriental Neuropsychiatry
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• v.18 no.3
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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.

• Journal of Korean Academy of Nursing
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• v.29 no.6
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• pp.1221-1232
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• 1999

The purpose of this study was to study how nurses interpreted the meaning of Hwa-Byung. It was carried through a review of literature, and the result is expected to explore ways that nursing intervention can promote the understanding of Hwa-Byung. The literature review focused on cultural psychology and psychiatrists' views toward Hwa-Byung. After that, it was reconfirmed concept of Hwa-Byung in nursing devived from historical analysis of the examples of Hwa-Byung from a true record of the Cho-Sun Dynasty(CD ROM, 1997). Characteristics of patients with Hwa-Byung include 'Hwa', an aspect of somatization, and self-diagnosing. It also could find that Hwa-Byung is characterized as 'Hwa', 'somatization' and 'self-diagnosis(subjectiveness)' according to a true record of the Cho-Sun Dynasty(CD ROM, 1997). The conceptual definition of 'Hwa', 'somatization' and 'self-diagnosing (subjectiveness)' are as follows. The core concept of Hwa-Byung, 'Hwa,' has the property of 'fire', and equals the feeling of injustice. Hwa-Byung means congestion of 'Hwa'. Therefore Hwa-Byung is the accumulation of being mistreated and mortified. The feeling of mistreatment comes from subjective experiences, which cannot be in harmony with the values, beliefs and rights of the patients. The situations that they have to endure again and again, though they are the sufferers, connote suppressed aggression and powerlessness endured over time. Suppressed aggression subordinated hostility, hatred and revengeful thoughts; powerlessness subordinates frustration, resignation, and fatalism. Somatization is another form of expressing 'Hwa' through physical symptoms. The somatization of clients with Hwa-Byung plays a role in expressing non-verbalized and suppressed emotions within themselves. The clients who experiences Hwa-Byung think that they know the cause of their illness and self-diagnose their problem as Hwa-Byung. Therefore, the feeling of unfairness which is the premise of Hwa-Byung infers 'subjectiveness' In conclusion, nursing's concept of Hwa-Byung is the accumulation of feelings of being mistreated and mortified. Hwa-Byung is the internalized 'Hwa' from enduring again and again. The feeling of being mistreated comes from subjective judgements about unfairness that cannot be harmonized with the clients' values, beliefs and rights. Those who can express their 'Hwa' only through their bodies imply suppressed aggression and powerlessness.