• Korean Journal of Psychosomatic Medicine
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• v.12 no.2
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• pp.165-173
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• 2004

Objectives: Diabetes mellitus is a heterogeneous, chronic, progressive disease characterized by hyperglycemia and abnormality in protein, carbohydrate, fat metabolism. Recent studies have reorted two times prevalence of depression in individuals with diabetes compared to individuals without diabetics. This study was designed to investigate glycemic controls, anxiety, alexithymia, stress responses between depressed diabetic patients and non-depressed diabetic patients. Methods The subjects were 60 diabetic patients(mean age : $50.3{\pm}9.7$ years, 31 men and 29 women) who were confirmed to have diabetes depending on the laboratory findings as welt as clinical symptoms at the St. Vincent Hospital Diabetes Clinic, from Mar. 2004 to Sep. 2004. Laboratory test including, blood chemistry. glycated hemoglobin, urinalysis for proteinuria and Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Based on BDI scores, all diabetics were divided into 13 depressed-diabetics group(above 20 point) and 47 non-depressed group(below 20 point). We compared demographic data. glycemic controls, STAI, TAS and SRI scores between two groups by independent t-test. Results : 1) Depressed diabetic groups were 13(mean age : $55.4{\pm}7.2$ years, 7 men and 6 women) and non depressed groups were 47(mean age $48.9{\pm}9.8$ years, 24 men and 23 women). In depressed diabetics, compared with non-depressed group, manifested aged(p=0.031), but other demographic data showed no difference between two groups. 2) No significant differences were noted in FBS, PP2h, Hb A1C, total cholesterol, HDL-cholesterol, SGOT/SGPT, BUN levels between depressed and non-depressed groups. But, blood creatine levels of depressed group were significantly increased than non-depressed group(p=0.026). 3) No significant differences were found in the score of STAI, STAI-S, STAI-T, TAS between depressed and non-depressed groups. 4) The SRI scores of depressed groups were significantly higher than non-depressed groups$(59.7{\pm}24.9\;vs.\;31.5{\pm}22.0)(p=0.000)$. Conclusion : The above results suggest that depressed diabetic patients are have more stress responses and higher blood creatine levels. However, there were no differences in laboratory data related to glycemic controls, and anxiety. alexithymia levels between two groups. We suggest that physicians should consider integrated approaches for psychiatric problems in the management of diabetes.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.103-114
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• 2001

Tourette's disorder is a disease which manifests one or more motor tics and vocal tics for more than a year. Chronic motor tic or vocal tic disorders are characterized by only one kind of tics for more than a year. We intended to investigate the clinical characteristics of the patients with chronic motor tic disorders or Tourette's disorders who had admitted from May 1, 1998 to May 1, 1999 to Seoul National University Hospital Child and Adolescent Psychiatry ward. In addition, we compared the clinical characteristics of the patients in order to elucidate the relationship between the two disorders. The patients with learning disabilities were selected as controls. There was no statistically significant difference between the onsets of the patients with chronic motor tic disorders(n=13, $7.3{\pm}2.5$ years), and Tourette's disorder(n=39, $7.2{\pm}2.2$ years), but with learning disability($4.2{\pm}1.9$ years). Also, the patients with chronic motor tic disorder and Tourette's disorder showed similar age at admission($11.7{\pm}2.7$ versus $11.5{\pm}2.6$ years), duration of admission($5.7{\pm}5.4$ versus $11.0{\pm}8.7$ weeks), mothers' ages at child birth($27.3{\pm}2.9$ versus $28.3{\pm}6.7$ years old),and fathers' age at child birth($32.2{\pm}3.2$ versus $33.3{\pm}5.2$ years old). We observed that those who had learning disabilities were alike in those aspects, except for age at visit to clinic($9.8{\pm}3.2$ years old). Family history of psychiatric illnesses(24.1% versus 46.2%), recognized precipitating factors(11.1% versus 35.7%) and response to pharmacological treatments(77.8% versus 76.9%) of the patients with chronic motor tic disorders and Tourette's disorders were observed and no differences were found. Comorbid patterns of diseases were noted. Intrafamilial conflicts were more common in the patients with learning disabilities than those with chronic tic disorders or Tourette's disorders. Precipitating factors were observed more frequent in chronic tic disorder and Tourette's disorder than learning disability. Neurocognitive profiles were investigated, and verbal IQs of the patients with chronic motor tic disorder, Tourette's disorder and learning disability were $92.3{\pm}10.7$, $94.7{\pm}14.9$, $94.3{\pm}13.8$, performance IQs $93.0{\pm}20.5$, $97.5{\pm}13.0$, $95.0{\pm}16.9$ and full-scale IQs $91.9{\pm}20.1$, $95.8{\pm}14.5$, $93.9{\pm}15.1$, respectively, which were found to be not significantly different. No difference was found in structural neurological abnormalities and EEG profiles. The patients with learning disabilities showed more common Bender-Gestalt test abnormalities. In conclusion, we have not found any affirmative clues for the division of chronic motor tic disorder and Tourette's disorder in clinical perspective.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.2
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• pp.137-148
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• 2003

Introduction: This research was performed to contract the attitude of dietary restriction and the psychological problems such as depressive mood and perceived stress and to investigate the relationship of these and obesity in women who visited the obesity clinic. Methods: During May 2001, sociodemographic variables, physical characteristics, Three Factor Eating Questionnaire(TFEQ), Symptom Check List-90-R(SCL-90-R) and Perceived Stress Scale were assessed from 150 female who visited the obesity clinics which were located at downtown, Seoul and the Hospital of Ajou University, Medical College. Hamilton depression rating scale(HDRS) was estimated by author. And then 116 female cases who filled up the questionnaire faithfully were included. Results: Obese group more than Body Mass Index(BMI) $25.0kg/m^2$ was 50% of the total subjects. BMI was increased as the age goes up(p<0.001). The frequency of unmarried cases in the under normal weight group was high rate of 48.8% while it in the obese group was 13.8%(p<0.001). There was no significant difference in the rate of smoking and alcohol drinking among subjects by BMI. There was no significant difference of TFEQ among subjects by BMI and the percent of body fat. Factor 2(r=0.27, p<0.01) and Factor 3(r=0.24, p<0.01) were significantly correlated with Global Severity Index(GSI). Only the paranoia scale among each estimated mean value of T scores of SCL-90-R by BMI was the significant difference between the overweight group and the obese group(p<0.05). T scores of scales of SCL-90-R were less than 50, but T scores of the under normal weight group and the obese group were higher than overweight group. GSI was significantly correlated with HDRS(r=0.75, p<0.01) and Perceived Stress Scale(r=0.32, p<0.01). Depressive mood in the obese group was significantly higher than non-obese group that HDRS was compared to two groups by the percent of body fat(p<0.05). Perceived Stress Scale was no significant correlation with BMI and the percent of body fat. All of the subject were in trouble of high stress. Stress affected dietary restriction owing that perceived stress had a relation with Factor 2(r=0.29, p<0.01) and Factor 3(r=0.37, p<0.01). Also, it affected psychological characteristics owing that perceived stress had a relation with the depression scale, GSI and HDRS(r=0.33, r=0.32, r=0.34, p<0.01). Conclusion: Obese women have more psychological difficulties including depression and high perceived stress, which closely related with the attitude of dietary restriction. Psychiatric intervention and aggressive assessment of psychological problems will be needed to the people who visit the obesity clinic in the future.

• Sim-seong Yeon-gu
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• v.37 no.2
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• pp.184-254
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• 2022

Through this thesis, the psychological meaning of the Korean folktale 'the servant who ruined the master's house' was examined. The opposition between the master and the servant is a universal matter of the human psychology. It can be seen as a conflict between the hardened existing collective consciousness and the new consciousness to compensate for and renew it. From different angles, it has become the opposition between man's spiritual and instinctive aspects, between the conscious and the unconscious, or between the ego and the shadow. In the folktale, the master tries several times to get rid of the youngest servant, but the servant uses tricks and wits to steal food, a horse, the youngest sister, and all money from the master, and finally, take his life. It ends with the marriage of the youngest sister and the servant. Enantiodromia, in which the master dies, and the servant becomes the new master, can be seen that the old collective consciousness is destroyed, and the new consciousness that has risen from the collective unconscious takes the dominant position. In an individual's psychological situation, it can be seen that the existing attitude of the ego is dissolved and transformed into a new attitude. In the middle of the story, the servant marries the youngest sister by exploiting naive people to rewrite the back letter written by the master to kill him. This aspect can be understood negatively in the moral concept of collective consciousness, but it can also be seen as a process of integrating mental elements that have been ignored in the collective consciousness of the Joseon Dynasty, symbolized by a woman, a honey seller, and a hungry Buddhist monk. The new consciousness, represented by the servant, has the characteristics of a trickster that is not bound by the existing frame, so it can encompass the psychological elements that have been ignored in the collective consciousness. Such element may represent compensation or an alternative to the collective consciousness in the late Joseon Dynasty. The master puts the servant in a leather bag and hangs it on a tree to kill the servant. However, the servant deceives a blind man; he opened his eyes while hanged. Instead of the servant, the blind man dies, and the servant is freed. As the problem of the conflict between master and servant is finally entrusted to the whole spirit (Self) symbolized by a tree, the blind man gets removed. It can be understood as an intention of the Self to distinguish and purify the elements of recklessness, stupidity, and greed included in the trickster. Through these processes, the servant, which symbolizes a new change in collective consciousness or a new attitude of ego, solves the existing problems and takes the place of the master. While listening to the cunning servant's performance, the audience feels a sense of joy and liberation. At the same time, in the part where the blind man and the master's family die instead and the servant becomes the master, they experience feelings of fear and concern about the danger and uncontrollability of the servant. The tricksters appearing in foreign analogies are also thoroughly selfish and make innocent beings deceive or die in order to satisfy their desires and escape from danger. Efforts to punish or reform these tricksters are futile and they run away. Therefore, this folktale can also be seen as having a purpose and meaning to let us know that this archetypal shadow is very dangerous and that consciousness cannot control or assimilate it, but only awe and contemplate it. Trickster is an irrational manifestation of revivifying natural energy that rises from the unconscious as a compensation for hardened existing structure and order. The phenomenon may be destructive and immoral from the standpoint of the existing collective mind, but it should be seen as a function of the collective unconscious, a more fundamental psychic function that cannot be morally defined. The servant, a figure of the trickster archetype, is a being that brings transformation and has the duality and contradiction of destructiveness and creativity. The endings of this folktale's analogies are diverse, reflecting the diversified response of the audience's mind due to the ambivalence of the trickster, and also suggesting various responses toward the problem of the trickster from the unconscious. It also shows that the trickster is a problem of inconclusive and controversial contradictions that cannot be controlled with a conscious rational attitude, and that we can only seriously contemplate the trickster archetype within us.